MyOrthoHealth – Hip & Knee Osteoarthritis FAQs

MyOrthoHealth - Hip & Knee Osteoarthritis is an innovative program that coordinates and “bundles” all the services needed to help patients with osteoarthritis.

The osteoarthritis bundles offered are:

• Knee osteoarthritis
• Hip osteoarthritis

This program provides patients with a personalized care experience through an assigned Vanderbilt Health patient navigator, facilitated access to Vanderbilt Health providers, an enhanced focus on convenience and communication, and predictable out-of-pocket costs.

Please visit your employer’s benefits website to confirm, or contact one of our patient navigators through the Chat box below.

Please check with your employer to confirm eligibility for the bundle, or contact one of our patient navigators through the Chat box below.

Eligible employees must enroll with a patient navigator prior to your next clinic visit. Start a conversation with a patient navigator in the Chat box below or schedule an appointment at this link.

You must be enrolled in a bundle-eligible health plan. You can move between bundle-eligible health plans mid-bundle, but you cannot transition to an ineligible health plan and stay in the bundle. If you make any changes to your health plan, please contact your patient navigator. Please visit your employer’s benefits website to confirm which health plans qualify, or contact one of our patient navigators through the Chat box below.

Services include:

• Concierge support from a dedicated patient navigator
• In-person visits and telehealth options for check-ins and follow-ups
• A personalized treatment plan, including therapies to explore whether a non-surgical approach will achieve desired results
• Care received at Vanderbilt University Medical Center related to diagnosing and managing your osteoarthritis, such as office visits, imaging, joint injections, and physical and occupational therapy

If surgery is determined to be the most appropriate course of treatment, the Osteoarthritis Bundle includes all surgery-related services (the same as the services included in our Hip & Knee Surgery Bundle).

• Services outside of the program window
• Non-osteoarthritis related care
• Medical weight loss consults
• Outpatient prescription drugs
• Durable medical equipment (such as braces and canes) for non-surgical management
• Inpatient hospitalizations outside of total joint replacement procedure window

The program is designed to provide coordinated osteoarthritis care starting with the initial orthopaedic/sports medicine office visit. The bundle lasts for 12 months, with an opportunity to re-enroll each year if clinically appropriate.

If a total joint replacement of the affected joint is performed at any time during the bundle, coverage would end 12 weeks after the joint replacement procedure.

Patients who clinically would benefit from ongoing management may have the option to re-enroll in the bundle for an additional 12-month period.

Any hip or knee appointments and/or services that occur after the bundle ends will be billed to your traditional health insurance. If you need to re-enroll in the bundle, it’s important to do so before the end of the 12-month bundle period so there is no lapse in bundle coverage.

For a current list of locations participating in the bundle program, view this link for a searchable map. The map may take a moment to load depending on your internet connection.

If you don’t clinically qualify for the bundle, Vanderbilt Orthopaedics has a wide range of services to address your condition, including physical therapy, medications and injections. 

Your osteoarthritis-related care is covered by the bundle in which you are enrolled. If both of your hip joints are affected, care for both hips will be covered. If both of your knee joints are affected, care for both knees will be covered. However, you cannot be enrolled in a hip bundle and a knee bundle at the same time.

Start a conversation in the Chat box below to check your eligibility. If you are eligible or have additional questions, schedule an appointment at this link.