5 Advantages of Orthopedic Groups Aligning With Hospitals

Practice Management
Laura Dyrda -

Here are five potential advantages of orthopedic groups aligning with local hospitals. 1. Expanding reach into the community. OrthoIndy has been able to reach a large number of patients at its location in Indianapolis, and the partnership helped practice physicians reach further out into communities that were underserved in orthopedics. As part of the alignment, OrthoIndy physicians see patients at St. Vincent Health-affiliated hospitals, which have locations beyond the practice's normal reach. "We now have a vehicle for treating people who have struggled in the past to find orthopedic treatment," says John Martin, CEO of OrthoIndy. "The real challenge in most markets is that the metropolitan area is saturated with orthopedic surgeons. Our partnership provides the opportunity for us to meet the orthopedic needs of underserved communities, outside of the metropolitan area."

This aspect of the agreement was also attractive to St. Vincent Health because affiliated hospitals in rural areas could now provide patients with orthopedic care. "We try to keep healthcare local and the patient as close as possible," says Kevin Speer, chief strategy officer of St. Vincent Health. "We were very interested in a relationship where we could work very closely together and provide a high level of orthopedic care in rural areas."

2. Influence over operations. Co-management offers orthopedic surgeons influence over the hospital's orthopedic service line. Areas of governance include clinical quality of care, supply chain management, care coordination, operational efficiency and patient satisfaction. Control over the service line offers physicians "the ability to influence their work environment in a more meaningful way," says Dierdre Baggot, vice president of The Camden Group.

3. Efficient coordinated care. Physicians in alignment with a hospital are able to easily communicate with the other members of the patient's care team, including nurses and physical therapists. With everyone on the same page regarding the patient's care plan, the patient will be more satisfied with their experience at the hospital. "The by-product of better coordinated care for patients is they get a truly unique experience," says Dierdre Baggot, vice president of The Camden Group. In some cases, this alignment could offer co-management agreements for the orthopedic or spine service line.

Co-management offers orthopedic surgeons influence over the hospital's orthopedic service line. Areas of governance include clinical quality of care, supply chain management, care coordination, operational efficiency and patient satisfaction. Control over the service line offers physicians "the ability to influence their work environment in a more meaningful way," says Dierdre Baggot, vice president of The Camden Group.

4. Preparing for ACOs.
Orthopedic surgeons and hospitals can work together to form a type of accountable care organization. The national guidelines stipulating what constitutes an ACO have not been released, but many surgeons and hospitals are beginning to create a partnership that could be the basis for an ACO. "As we move into this new era of ACOs, hospital-physician alignment is going to become even more critical than it ever has in the past," says Matt Reigle, of Marshall | Steele, a healthcare firm focused on transforming hospital services into destination centers. "In order to achieve good outcomes, physicians and hospitals must be aligned on compensation, goals and metrics to improve outcomes, patient satisfaction and compensation."

There are several different ways to facilitate an ACO, and hospitals are acquiring physician practices or creating co-management arrangements to begin the partnership. In many cases, the reimbursement for orthopedic care is based on the quality of outcomes instead of on the volume of patients seen, says Brian McCartie, vice president of Culbert Healthcare Solutions, an operations management, revenue cycle, clinical transformation and information technology firm. The compensation associated with an ACO is bundled and each specific agreement details the percent physicians receive.

5. Access to advanced technology. Much of the new technology today is focused on minimally invasive orthopedic and spine surgery, which sometimes require large and expensive devices such as the C-arm and SpineAssist. Orthopedic and spine surgeons working through surgery centers may not have the capital to invest in these types of systems, whereas the hospital could purchase the technology and partner with a physician trained in the surgery to promote a new procedure, says Mr. McCartie. "The question becomes: How does the hospital facilitate the agreement so the technology is available for the surgeons to use?" he says.

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