SAN FRANCISCO — With the implementation of the Patient Protection and Affordable Care Act mired in controversy, two of the nation’s largest retailers are backing an innovative Employers Centers of Excellence Network that will offer no-cost knee and hip-replacement surgeries at four highly regarded hospitals.
Walmart and Lowe’s issued a joint statement that they and other large employers had joined the Pacific Business Group on Health Negotiating Alliance (PBGH-NA) to launch the national Employer’s Centers of Excellence Network.
“These companies are working to help make sure that their employees get higher quality care and incur lower costs,” said David Lansky, president and CEO of PBGH. “The Employers Centers of Excellence Network is designed to serve as a model for delivering high quality health care with transparent and predictable costs.”
PBGH and healthcare management company Health Design Plus will oversee the program, which includes treatment for knee and hip replacement surgeries for the more than 1.5 million employees and their dependents enrolled in the Walmart, Lowe’s and other employers’ medical plans. The only catch for employees is that they required to obtain care at 1-of-4 designated center of excellence healthcare organizations that include Johns Hopkins Bayview Medical Center in Baltimore, Md.; Kaiser Permanente Orange County Irvine Medical Center in Irvine, Calif.; Mercy Hospital in Springfield, Mo.; and Virginia Mason Medical Center in Seattle, Wash.
Employees will receive consultations and care covered at 100% without deductible or coinsurance, plus travel, lodging and living expenses for the patient and a caregiver. Patients must be healthy enough to travel for the surgeries. The program is voluntary and employees or their covered dependents can still choose to receive care from local providers and incur routine costs, according to program rules.
“This national program is about providing our associates with exceptional care and reducing their medical costs so that they pay nothing out of pocket when they use one of the designated facilities,” said Sally Welborn, SVP global benefits at Walmart. ”Each of these providers has a proven record of practicing evidence-based medicine with above average positive patient outcomes in knee and hip replacement procedures.”
According to Lowe’s VP international human resources Randy Moon, “Under this program, employees and their dependents covered under Lowe’s medical plan have access to medical care at renowned medical facilities at no cost. This is especially important for our employees who live in areas underserved by high quality health care providers. The four healthcare centers are located throughout the United States, making it easier for employees who wish to use this benefit to travel.”
The national Employers Centers of Excellence Network complements Centers of Excellence programs that Walmart and Lowe’s have and will continue to offer separately from the alliance with PBGH-NA.
In 2013, Walmart expanded its long-standing program covering transplants at the Mayo Clinic to also include treatment for certain heart and spine surgeries at five leading hospital and health systems in the United States, including ECEN providers Virginia Mason and Mercy Springfield, for associates and their covered dependents enrolled in medical plans.
In 2010, Lowe’s began an alliance with Cleveland Clinic in Cleveland, Ohio, to provide its full-time employees and their covered dependents enrolled in the company’s self-funded medical plans enhanced benefits coverage for qualifying heart surgery procedures.