Value-Based Care at OrthoCarolina
At OrthoCarolina, innovation drives everything we do, especially when it comes to improving the quality and cost of care for our patients. As a leader in orthopedics, we’re also proud to be a trailblazer in Value-Based Care (VBC)—a modern approach to healthcare that’s focused on better results, smoother experiences, and greater value for patients.
What Is Value-Based Care?
Value-Based Care is a healthcare model that focuses on quality over quantity. Traditionally, healthcare follows a "Fee-for-Service" model, where providers are paid for each individual procedure or visit. In contrast, VBC links payment to the outcomes of your care—how well you recover, how efficiently your care is delivered, and how satisfied you are with the process.
This model encourages better coordination among your care team and often results in fewer bills, better outcomes, and a more seamless experience for you.
What Does It Mean for You?
Being part of a VBC program can mean:
- Better Results – Your treatment is centered on achieving the best possible outcome.
- A Smoother Experience – With fewer disconnected steps and more communication across your care team.
- Potential Cost Savings – VBC can reduce your out-of-pocket costs, and in some cases, offers incentives for participating.
One common VBC approach we use is called a “bundle.” This means that many services related to your care—such as your surgery, facility fees, physical therapy, and follow-up—are grouped together into one package and covered by a single payment.
VBC Programs at OC
We offer several types of Value-Based Care programs depending on your insurance, type of procedure, and location:
Prospective Programs
These programs bundle your care from up to 30 days before surgery to 90 days after. You typically receive one bill from OC, and the cost includes surgery, anesthesia, physical therapy, and more. These are usually voluntary and require consent to participate.
Retrospective Programs
In these programs, coverage is reviewed after your care is complete. These are often determined by your insurance and may not require enrollment on your part.
Day of Service (DOSe) Programs
These are simplified, pre-set care packages for specific procedures or services, such as a single surgery visit or an office visit with follow-up. These are often employer-sponsored and come in two types:
Employer Direct Healthcare (EDHC) – Your employer partners with OC to provide streamlined, high-quality care.
Direct-to-Employer Contracting – Your employer works directly with providers like us to design custom health plans.
Am I Eligible?
Our Value-Based Care programs are currently available to a select group of patients, based on factors like insurance coverage, surgery location, employer partnerships, and provider participation. In many cases, patients are invited into these programs through their care team or referred directly by an employer. While not every patient is currently eligible, we’re actively working to expand our offerings and make these programs more widely available. We’re also building an easy online tool to help you explore potential eligibility. Until then, if you’ve received information about a specific program—or are interested in learning more—you can reach out to our VBC team here.