Younger Nebraskans are now getting knee and hip replacements, but the cost for these procedures remains stable, according to the latest Health of America study from the Blue Cross and Blue Shield Association.
Planned or elective inpatient orthopedic surgeries for Blue Cross and Blue Shield of Nebraska (BCBSNE) members cost $97 million in 2017 and made up 26 percent of the total orthopedic spending. Most of the surgeries were performed on patients over the age of 50.
“The implants are lasting longer,” said Dr. Debra Esser, BCBSNE’s chief medical officer. “So, doctors are saying, let’s improve their quality of life; go ahead and let these younger patients have their replacements now.”
Nationally, the Health of America study found an increase in knee and hip procedures at younger ages, and at higher costs. In contrast, the cost of knee and hip replacements have remained stable in Nebraska, and in fact has been declining since 2014.
“We’ve identified some very high quality, low cost facilities in the state and have designated them as centers of excellence for knee and hip replacements,” Esser said. “If a patient is eligible and has a hip or knee procedure at one of these facilities, we will waive their deductible and coinsurance.”
The BCBSNE Nebraska Centers of Excellence for knee and hip replacements are Kearney Regional Medical Center, Lincoln Surgical Hospital, OrthoNebraska and Midwest Surgical Hospital.
The Health of America study showed that nationally, Blue Cross and Blue Shield members are increasingly having the procedure performed in an outpatient setting. That trend hasn’t come to Nebraska yet but Dr. Esser says it is only a matter of time.
Dr. Esser said that while it’s best to take care of your hips and knees by maintaining a healthy weight and exercising, if you do need surgery to replace them, be informed about your options.
“If your doctor has determined you need a replacement, use cost transparency tools—such as HATCX—to compare facilities and prices and educate yourself,” she said.
Watch the complete interview with Dr. Esser.