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Why orthopedics is the perfect introduction for Advantage Care Solution

By Michael D. Jacobson, D.O., M.P.H, CHM’s Medical Director

At CHM, we have four goals for our members’ healthcare experience:

  • High quality healthcare that produces successful results.
  • A fair price, which requires upfront transparency.
  • The best experience and to be strengthened in body, soul, and spirit.
  • For the providers serving our members to be blessed and grateful for how they were treated.

When these four goals are accomplished simultaneously, we consider this a Grand Slam.

But this can be tough for members to accomplish on their own. And so, CHM created the Advantage Care Solution (ACS), our model for securing all four of these goals.

Why ACS is so important for CHM members

Transparent, all-inclusive pricing is often foreign in the modern healthcare industry. If you need a total hip replacement and asked your local hospital for a total price for all the goods and services that would be involved in your procedure, you’ll most likely get one of two responses: a blank stare or a statement like, “That’s not possible.” If you were to be given a price, there’s often no rhyme or reason to the amount.

Contrast that with my experience when I went into a car body shop to get an estimate of repairs after a major accident. The attendant gave my vehicle a thorough examination, and then, within a matter of minutes, provided me with a total cost to make my car like new again, along with an itemized list of every part and the labor. Body shops have been doing that for years.

Why can’t a healthcare facility do the same?

Why orthopedics?

As we start off with providing ACS for CHM members, we’re starting with orthopedic surgeries because:

  • Orthopedic surgeries are some of the most common needs of our members.
  • Most of these surgeries aren’t immediate emergencies, meaning there’s time to research providers and hospitals.
  • Quality outcome information is readily available.
  • Orthopedic surgeries are ideal procedures for building all-inclusive bundled pricing, which enables price transparency and simplicity. This typically includes reimbursement directly to the surgeon and anesthesiologist, as well as the facility, which may involve operating room time and staff, recovery room, eligible supplies, and medications.

Things are changing. CHM is working with healthcare professionals all over the country who are tired of the way healthcare currently is operating and are making dramatic changes for the better. These professionals agree to pricing that’s transparent, fair, and dramatically simplify how our members get care and the way providers are reimbursed.

This simplicity, transparency, and fairness will help you and your providers benefit from CHM’s Advantage Care Solution.