Wal-Mart Announces Coverage of Heart and Spine Surgeries at No Cost to Workers, Will Use Bundled Payments to Centers of Excellence

October 11, 2012

The Chicago Tribune reports this afternoon that Wal-Mart, the nation’s largest retail chain and largest private employer, will begin covering heart and spine surgeries at no cost to workers, beginning in January 2013. Workers will be able to have the procedures done at six health centers that are considered “centers of excellence” for receiving high health care quality scores while achieving lower associated costs. Wal-Mart will cover the cost of consultations, care for the procedures, travel, lodging, and food for the patient and a caregiver.

The six health centers include the Cleveland Clinic in Cleveland, OH; Geisinger Medical Center in Danvile, PA; Mayo Clinic facilities in Minnesota, Arizona, and Florida; Mercy Hospital in Springfield, MO; Scott and White Memorial Hospital in Temple, TX; and Virginia Mason Medical Center in Seattle, WA.

Wal-Mart will pay the health centers a single bundled payment for all of the care associated with a surgical procedure, and the retailer hopes that covering the procedures with this payment arrangement will reduce its health care costs. The company began covering transplants at the Mayo Clinic under a similar arrangement in 1996 and presently maintains that coverage. Since the company is such large employer, with 1.1 million employees and family members signed up for its health care plans, this innovation in coverage may initiate a broader market trend among other employers.

Lowe’s, a home improvement retail chain, offers another precedent for this type of “direct-to-employer” service arrangement. In 2010, Lowe’s began to cover heart surgeries for its employees through an arrangement with the Cleveland Clinic, and the program has grown to include other types of care as well.


For the full article: http://www.chicagotribune.com/business/breaking/chi-walmart-to-cover-us-workers-heart-and-spine-surgeries-20121011,0,7933470.story