Category: No Gap Surgery For Patients Requiring Joint Replacement

Hip and Knee Surgery, Zero Out-of-Pocket Expenses

Posted by - No Gap Surgery For Patients Requiring Joint Replacement

doctor explaining knee surgery to a woman

Joint replacement is among the most effective surgeries for improving quality of life, and more than 30,000 hip replacement and 50,000 knee replacement procedures are performed in Australia each year.

Now, thanks to a new initiative by Vermont Private Hospital in partnership with the Victorian Orthopaedic Group, Nexus and Medibank, together we can offer no out-of-pocket costs (besides hospital excesses if applicable) for some types of hip and knee replacement surgeries for eligible Medibank members.

Lead orthopaedic surgeon and director of Victorian Orthopaedic Group, says the new initiative was about providing a brighter future for patients with better outcomes.

“I’m a big believer in rapid recovery and providing the best environment for patients to heal and get their life back on track as soon as possible,”

“I specialise in a minimally invasive total hip replacement and rapid recovery total knee replacement and perform several hundred procedures each year. Experience and research tells us that with the right support, patients achieve better outcomes and a better healing experience when they recover in the comfort of their own home (1,2).

“It’s exciting to be part of this new initiative which through working together in partnership, we can provide a brighter future for our hip and knee surgery patients.”

Director of Nursing at Vermont Private Hospital, Fiona Langley, said her hospital is committed to working with surgeons to deliver superior patient care and surgical outcomes.

“We believe in creating a sustainable healthcare system, and are proud to be involved in developing a care model that gives patients certainty over both the level of care, and the costs involved in their surgery,” Ms Langley said.

“We want to provide the best value for patients with private health insurance and I’m grateful to Nexus and Medibank for working together with us to ensure this new initiative makes it possible for eligible Medibank patients to have no out of pocket medical costs.”

How does Zero Out Of Pocket (ZOOP) work?

  1. Pay no out of pocket costs– Nexus and Medibank have worked together to eliminate medical out of pocket costs for hip and knee replacement surgeries for eligible Medibank members. The program is available to Medibank members with appropriate cover, in consultation with their treating practitioner.
  2. Spend less time in hospital– Vermont Private Hospital’s innovative model of care means you can avoid a long stay in hospital, and have the option to recover in the comfort of your own home. Studies have shown that with the right support in place, patients have better outcomes and a better experience when they recover in the comfort of their own home.
  3. Get back on your feet faster– Nexus and Medibank are working together to support patients before and after surgery, including prehabilitation services prior to surgery (delivered by Nexus), and if clinically appropriate, offering Medibank at Home rehabilitation after surgery.

(Read the latest research on joint replacement techniques and recovery below.)

medibank logo

Eligible Medibank Members may also have access to additional support before and after their hospital admission, including options for in-home rehabilitation with expert physiotherapy and other allied health support, when clinically appropriate. Nexus is offering eligible Medibank members zero out-of-pocket medical costs; contact Medibank to find out more. Hospital policy excesses still apply.

 

nexus logo

About Vermont Private Hospital

Located 20km east of Melbourne’s CBD in Vermont South Medical Centre, Vermont Private Hospital is part of the Nexus Hospital Group.

It is renowned for its outstanding patient care and specialist orthopaedic focus. The purpose-built facility is equipped with the latest surgical technology, including four fully integrated operating theatres. Dedicated nursing and support staff are trained in orthopaedic care, and will take of your needs from admission to post-operative recovery.

joint replacement surgery brochure

Download the a Zero Out of Pocket Brochure Here

For more information contact us via phone: 03 9853 7099 or email: reception@vicorthogroup.com.au

 

 

 

[1] What‘s new in hip arthroplasty; MH Huo et al; JBJS Am; 2005 Sep, 87(9):2133-46

[2] Single-incision anterior approach for total hip arthroplasty on an orthopaedic table; JM Matta et al; Clin Orthop Relat Res, 2005 Dec, (441): 115-24

[3] Minimally Invasive total hip arthroplasty: anterior approach; F. Rachbauer; Orthopäde, 2006 Jul;35(7):723-4, 726-9

[4] Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip Replacement; T Siguier et al; Clin Orthop Relat Res,2004 Sep, (426): 164-73

New “No Gap” Trial for Private Health Cover Patients

Posted by - No Gap Surgery For Patients Requiring Joint Replacement

New cooperation between private hospital operator, doctors and health insurer guarantees “no gaps” for patients having joint replacement surgery. 

Vermont Private Hospital (part of the Nexus Hospitals Group) in Melbourne’s eastern suburbs is the first to offer a new style of private health insurance arrangement guaranteeing that patients needing joint replacement can have their surgery with no out-of-pocket costs.

The new service is a first-of-its-kind cooperative arrangement between private hospital, doctors and private health insurer which eliminates out of pocket costs for privately insured patients and implements an innovative model of care which reduces the time patients need to stay in hospital.

Nexus Hospitals CEO Andrew Petering says the new ‘Zero Out of Pocket’ or ‘ZOOP’ arrangement is aimed at giving patients certainty that – apart from any applicable excess under their policy – all other costs for their hospital admission will be covered by their private health insurance.

“Patients with private health insurance want their insurance to cover all of their out of pocket costs.  Historically, private health insurance in Australia hasn’t been able to provide that certainty because of the way that the healthcare system is regulated.

“When you take out car insurance, you know that if you need to use it, all of your costs are covered.  All you pay is a pre-agreed excess and everything else is taken care of by your insurance company.  We’ve introduced ZOOP to give patients with health insurance that same peace of mind.”

Under the new arrangement, patients will also receive cover for additional services both before and after their hospital stay, aimed at improving their recovery and helping patients get back on their feet faster.  These include “prehabilitation” assessment and education by a specialist physiotherapist to optimally prepare them for surgery, access to smartphone app technology to customise their recovery, and options to receive nursing and rehabilitation care at home.

Orthopaedic surgeon was the first surgeon to perform joint replacements at Vermont Private Hospital under the ZOOP initiative.  He said he has wanted to be able to offer this kind of service to patients for some time, but the way the healthcare system is regulated couldn’t guarantee patients wouldn’t pay a gap.

“Eliminating out of pocket costs for patients is the holy grail for private hospital care.  The only way we can ensure no gaps for patients is to have doctors, the private hospital and the private health insurer cooperating to ensure everything is covered.”

“One of the first patients to have their knee replacement at Vermont Private also needs to have her other knee as well as a hip replaced.  Without access to this kind of arrangement she would have had significant out of pocket expenses to cover the cost of all three surgeries, which was prohibitive for her.  Now, she can use her health insurance and be fully covered with no gaps.”

Nexus Hospitals Chief Operating Officer, Scott Bell, says that the additional support services provided before and after surgery means that patients are able to have a much shorter hospital stay after surgery.  A recent patient of Dr Rodda’s was able to have a total knee replacement surgery and was discharged home the same day – the first such procedure performed in Australia as day surgery.

“New surgical and anaesthetic techniques for joint replacement mean that patients can be back on their feet and recovering much faster.  With the right support in place at home, research has shown time and again that patients have better outcomes and a better experience when they recover in the comfort of their own home.”

“The average stay in Australian hospitals after hip or knee joint replacement surgery is over four days, plus many patients have an additional stay for rehabilitation which can be a week or more.  In other countries length of stay has been shortened dramatically in recent years as new surgical techniques have been introduced, and in the US and Europe many hip and knee replacements are being performed as day surgery or discharged the next morning.”

Medibank is the first Private Health Insurer to support the Nexus ZOOP arrangement for joint replacement surgery at Vermont Private Hospital.  Nexus and Medibank are proposing to expand the arrangement to cover joint replacement surgery in other locations around Australia, and Nexus is also looking at expanding the arrangement to offer no-gap surgery for other treatments such as hernia repair.

About Vermont Private Hospital:

First opening in 2016, Vermont Private Hospital is a short stay hospital offering surgical care in orthopaedic surgery, ophthalmology, plastic and reconstructive surgery, chronic pain and other specialties.  Vermont Private is part of the Nexus Hospitals Group. Ph: 03 8547 1111.

MEDIA ENQUIRIES:

Scott Bell  0414 686 073  s.bell@nexushospitals.com.au