Boeing's deal with top-rated Cleveland Clinic means about 83,000 managers, some retirees and family members can get a big cost advantage on heart procedures, as well as free travel and lodging, while the aerospace giant will get a fixed-price menu for complex, often unpredictably pricey surgeries.

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Managers, some retirees and family members insured by Boeing will be able to get heart surgeries at Cleveland Clinic in the latest deal struck by a corporate giant to move complex care to top-rated centers in exchange for fixed-price bills.

About 83,000 nonunion employees and retirees and dependents not eligible for Medicare will qualify for the program, which will include the cost of the procedure, travel and lodging for a patient and companion.

Many of Boeing’s top managers and retirees work or live near its corporate headquarters in Chicago, about 350 miles from Cleveland, and its center in St. Louis, about 560 miles away. Others are spread throughout the country. Boeing said about a third of those eligible for the new program live in Washington state.

“Boeing is providing this specialty-care benefit to be sure employees and their dependents have access to high-quality cardiac care available from a leading medical facility with a proven track record of specialized cardiac care,” said Boeing spokesman Joe Tedino. “While the program is initially open to nonunion, we would eventually like all employees to have access to this specialized care.”

The voluntary program is open to those enrolled in Boeing medical plans administered by United Healthcare, Aetna, Cigna and Blue Cross and Blue Shield of Illinois.

Tedino said Boeing would regularly evaluate the effectiveness of the program, which began Oct. 1, to determine if it could be expanded to orthopedic procedures.

Cleveland Clinic’s Michael McMillan, executive director of market and network services, said the program sends patients who need “sophisticated care” to a center with “extraordinary outcomes” for heart surgery — and has long published its treatment results (see

In the Boeing program, patients who need certain cardiac procedures, such as valve replacements and bypass surgery, get the care for little or no out-of-pocket expense, McMillan said. The fixed-price, bundled-payment arrangement, he said, gives the self-insured company “additional predictability,” because all expenses for a given procedure are wrapped into one payment.

Patients can choose other medical centers but would likely pay more, in keeping with the provisions of their individual insurance plan.

Cleveland Clinic has been a pioneer in such arrangements with large employers since 2010, when it announced a similar program with Lowe’s, the nation’s second-largest home-improvement retailer, to allow full-time employees and covered dependents to get heart surgery for no out-of-pocket costs.

Since then, the clinic has made similar arrangements with six other large employers, including Boeing.

Last week, Walmart announced Cleveland Clinic was among four centers where the company planned to send insured workers who need heart surgery. The voluntary program also included Seattle’s Virginia Mason Medical Center, Geisinger Medical Center in Pennsylvania and Scott & White Healthcare in Texas.

In the Walmart deal, Cleveland Clinic and Walmart said it had negotiated bundled payments to meet the twin goals of keeping costs under control and moving toward paying for quality care — rather than simply paying by the procedure.

Dr. Gary Kaplan, CEO of Virginia Mason, noted that his medical center has a decades-long relationship with Boeing. The two have worked jointly to find “innovative ways to deliver high-value health care” for Boeing’s employees, retirees and families, including a program to manage health care for workers with chronic conditions.

That program has significantly reduced hospital admissions, days of hospitalization and absenteeism, while also cutting direct costs of care by more than 20 percent, Virginia Mason said.

“We fully expect to be engaging in future conversations with Boeing about partnering with them to provide destination care for specialized services,” Kaplan said.

Also in the Seattle area, Dr. Joe Gifford, chief strategic innovation officer for Providence Health & Services’ Western region, said Providence and Swedish Medical Center also offer comprehensive heart and vascular care, and actively support the needs of employers for high-quality health care at lower costs.

“With our affiliation, Providence and Swedish are developing packages that will improve our delivery system to ensure it continues to meet the needs of employers around the region,” Gifford said.

In a recent New Yorker magazine, Dr. Atul Gawande, surgeon, writer and public-health researcher, mused about Cleveland Clinic’s fixed-price arrangements and standardization in the medical industry. He compared those trends to The Cheesecake Factory’s standardized production methods which result, in his view, in tasty and affordable food.

“Essentially, we’re moving from a Jeffersonian ideal of small guilds and independent craftsmen to a Hamiltonian recognition of the advantages that size and centralized control can bring,” Gawande wrote.

“We’ve let health-care systems provide us with the equivalent of greasy-spoon fare at four-star prices, and the results have been ruinous. The Cheesecake Factory model represents our best prospect for change. Some will see danger in this. Many will see hope. And that’s probably the way it should be.”

Carol M. Ostrom: 206-464-2249 or On Twitter @costrom.