By Michaela Gibson Morris/NEMS Daily Journal
North Mississippi Medical Center has earned an honor that could pay dividends for joint replacement and spine surgery patients with Blue Cross Blue Shield insurance.
NMMC is one of four hospitals to be named Blue Centers of Distinction for joint replacement and spine surgery by Blue Cross and Blue Shield of Mississippi. The other three hospitals receiving the distinction are Mississippi Baptist Medical Center and St. Dominic Hospital, both in Jackson, and one Forrest General Hospital in Hattiesburg..
“These places are demonstrating really high standards in quality and care,” said John Sewell, director of corporate communication for Blue Cross and Blue Shield of Mississippi.
Blue Cross subscribers will see a benefit if they chose these hospitals for joint replacement and spine surgery, Sewell said.
For example, if a patient had a insurance plan that typically paid 80 percent of the cost, the coverage would increase to 90 percent. Surgeons who practice at these hospitals also will see preferential reimbursement rates, too.
“This is really about incentivizing quality of care,” Sewell said.
Being chosen for the program is a significant achievement for NMMC, said Dr. Mark Williams, chief medical officer. “(It) represents an ongoing commitment to serve the needs of an expanding regional population, and to work closely with partners such as Blue Cross and Blue Shield in assuring truly excellent care,” Williams said.
The complex application process gathered not only information on NMMC’s spine and joint replacement programs including patient outcomes, surgeon’s qualifications and costs. The application also included quality measures for the entire hospital like infection rates, patient satisfaction scores, Williams said.
NMMC will have to continue the good work to retain the distinction.
“We’re continuously evaluated,” Williams said.
Williams expect more insurers and large employers will use a centers of excellence model especially for elective procedures like joint replacements, non-emergency heart procedures, transplants and bariatric surgery. Quality care reduces costs because patients have fewer complications, like infections, and they are more likely to achieve the best possible outcomes.
“They’re focusing on high-volume, high-cost elective procedures,” Williams said.