Value Based Purchasing Hip and Knee Joint Replacement

Value Based Purchasing Design (VBPD) CalPERS and Anthem Blue Cross (Anthem) are working together Members need to be aware that they will be responsible for to design a hip and knee joint replacement program. Members their deductible and coinsurance, as well as any charges above who will be scheduling a hip or knee joint replacement should be the $30,000 threshold for single hip joint replacement or single aware of this program. It has been designed to keep your overall knee joint replacement surgeries performed at facilities that out-of-pocket costs down, while limiting the overall increase in are not identified below. medical costs. As a Participating Provider Organization plan member, you In order to manage this variance, payment will be limited to a continue to have the option to choose any facility, but if you $30,000 threshold for single hip joint replacement or single knee seek services from one of the identified 53 facilities, you can joint replacement surgeries. CalPERS and Anthem have identified lower your out-of-pocket costs. 53 facilities throughout where these surgeries can be performed and CalPERS members will have little to no out of Please refer to your Evidence of Coverage booklet for pocket costs beyond the plan’s deductible and coinsurance. further details.

Value Based Sites of Care designated ADVENTIST MEDICAL CENTER ORTHOPEDIC INSTITUTE ALVARADO LLC HUNTINGTON MEMORIAL HOSPITAL ARROYO GRANDE COMMUNITY HOSPITAL JOHN F KENNEDY MEMORIAL HOSPITAL BAKERSFIELD MEMORIAL HOSPITAL JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS BARTON MEMORIAL HOSPITAL JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS CEDARS-SINAI MEDICAL CENTER KAWEAH DELTA MEDICAL CENTER COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA LOMA LINDA UNIVERSITY MEDICAL CENTER DAMERON HOSPITAL LONG BEACH MEMORIAL MEDICAL CENTER DESERT REGIONAL MEDICAL CENTER MERCY MEDICAL CENTER – REDDING EISENHOWER MEDICAL CENTER METHODIST HOSPITAL OF SACRAMENTO EL CAMINO HOSPITAL NATIVIDAD MEDICAL CENTER ENLOE MEDICAL CENTER INC O’CONNOR HOSPITAL FRENCH HOSPITAL MEDICAL CENTER PLACENTIA LINDA HOSPITAL FRESNO SURGICAL HOSPITAL QUEEN OF THE VALLEY MEDICAL CENTER GOOD SAMARITAN HOSPITAL – SAN JOSE SAN ANTONIO COMMUNITY HOSPITAL GOOD SAMARITAN HOSPITAL – LOS ANGELES SAN JOAQUIN COMMUNITY HOSPITAL HEALDSBURG DISTRICT HOSPITAL SANTA MONICA UCLA MEDICAL CENTER SANTA ROSA MEMORIAL HOSPITAL Hospitals SIERRA VISTA REGIONAL MEDICAL CENTER highlighted have SONORA REGIONAL MEDICAL CENTER joined the California ST AGNES MEDICAL CENTER ST HELENA HOSPITAL Joint Replacement Registry ST JOHN’S HOSPITAL AND HEALTH CENTER (CJRR) supported by PBGH. ST JOSEPH HOSPITAL – ORANGE The registry is designed to ST JUDE MEDICAL CENTER collect and share data to provide ST MARYS MEDICAL CENTER credible feedback to orthopedic ST VINCENT MEDICAL CENTER STANFORD UNIVERSITY HOSPITAL surgeons, hospitals and patients STANISLAUS SURGICAL HOSPITAL about their treatment decisions, quality THOUSAND OAKS SURGICAL HOSPITAL of care, and patient outcomes. CalPERS TORRANCE MEMORIAL MEDICAL CENTER recognizes these hospitals and surgeons TWIN CITIES COMMUNITY HOSPITAL INC for their commitment to the long term goal of UC DAVIS MEDICAL CENTER UCSD MEDICAL CENTER improving treatment decisions and care delivery VALLEY PRESBYTERIAN HOSPITAL for patients receiving joint replacements. VALLEYCARE MEDICAL CENTER

Hospitals highlighted in green are in the process of joining the CJRR.

For more information about the CJRR, please visit www.caljrr.org. anthem.com/ca

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