About Bundled Care
Bundled care is an integrated funding model designed to promote integration in health care delivery, drive high quality, efficient care, and improve patient outcomes and experience.
Patient Eligibility
The following University Health Network – Toronto Western Hospital (UHN-TWH) patients meet the criteria for bundled care:
- The patient had a primary hip or knee replacement surgery after April 1, 2018;
- The patient had a total/hemi shoulder arthroplasty, reverse shoulder arthroplasty or bilateral hip/knee replacement surgery after April 1, 2019;
- The patient meets Quality Based Procedure (QBP) eligibility criteria.
Patients
not included within bundled care
- Unilateral or bilateral hip or knee revision surgeries.
- WSIB claims.
Terms of Referral Acceptance
By accepting a referral for a confirmed UHN-TWH bundled care patient, the service provider is agreeing to provide care according to the
UHN MSK Bundled Care Toolkit , within the outlined fee structure.
NACRS Lite Reporting
NACRS Clinic Lite is used to capture information on post-acute ambulatory rehabilitative service utilization by Bundled Care patients. In accordance with Ministry of Health directive, UHN requires that all post-acute rehabilitative care funded by UHN be reported into NACRS Clinic Lite. Please see
https://www.cihi.ca/en/nacrs-clinic-lite for further information from CIHI.
Fee Structure
University Health Network's (April 1, 2021 – March 31, 2022) per case prices for each type of rehabilitation care provided by bundle providers are as follows
Updated fees effective Spetember 5, 2023
| Bundle | Outpatient Rehab | Inpatient Rehab | Home Care |
|---|
| Hip | $312.00 | $6,539.00 | $683.00 |
| Knee | $312.00 | $6,076.00 | $618.00 |
| Bilateral | $407.00 | $4,499.00 | $534.00 |
| Shoulder – Total/Hemi | $486.00 | $8,301.00 | $864.00 |
| Shoulder – Reverse | $486.00 | $13,621.00 | $906.00
|
These prices:
- Apply to the full scope of services provided for the episode of care (e.g., per patient, not per visit);
- Are non-negotiable and align with sample prices provided by the Ministry of Health;
- Invoices for any other amount will not be processed and will be required to be resubmitted to the prices noted above;
- Are applicable for qualifying surgeries where patients were discharged between April 1, 2021 to March 31, 2022; and,
- Are subject to change, notification will be provided.
Invoicing Instructions
For all invoice processing inquires please email
MSKBundledCare@uhn.ca.
To bill for bundle rehab services provided once the patient has completed all their visits, please scan and email the following documents to
MSKBundledCare@uhn.ca:
- One Invoice per patient
- One Discharge Summary form per patient (in Bundled Care Toolkit)
Your invoice MUST include the following information:
- Vendor Name and Address
- Invoice Number and Date of Invoice
- Tax (HST) Registration Number (if applicable)
- Sub-total amount
- Tax amount (if applicable)
- Total amount to pay
- Facility Number
Electronic Funds Transfer (EFT)
If you would like to use EFT instead of a mailed cheque, your invoice must meet the following criteria:
- invoice is payable in CAD funds
- vendor has CAD bank account
- complete the EFT authorization form
- provide a void cheque or a letter from their bank to confirm valid bank account information (emailed photo of void cheque is sufficient)
Submit invoice and associated forms above to
MSKBundledCare@uhn.ca.
Contact Information
Email: MSKBundledCare@uhn.ca
