Dr. William Hozack on bundled payments at Rothman Orthoapedics and goals at ValueHealth

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William Hozack, MD, of Philadelphia-based Rothman Orthopaedics, was recently appointed medical director of ValueHealth, a privately-held digital healthcare partner.

Dr. Hozack is the Walter Annenberg Professor of Joint Replacement Surgery at Thomas Jefferson University in Philadelphia and has 30 years of clinical experience.

Here, he shares details on his new position at ValueHealth, bundled payment programs at Rothman Orthopaedics and the future of value-based care in the field.

Note: Responses are lightly edited for style and content.

Question: What was it that drew you to the role of medical director at ValueHealth?

Dr. William Hozack: ValueHealth has a vision that I believe in. As a digital health company with a successful history in the ambulatory surgical care space, ValueHealth is leading the transformation of surgical care from fee-for-service to true value-based models for payers, providers and patients.  

The value proposition is centered on improving clinical quality outcomes, patient and provider experience and reducing the total cost of a surgical episode of care. As a surgeon who has been operating for nearly 30 years, I'm excited about helping other surgeons transform into a better model that truly incentivizes quality.  

Q: What are your key objectives in this new position?

WH: A key objective will be to help clinically guide the organization as it expands its Ambulatory Centers of Excellence surgical network. The ACE designation will be given to surgical facilities that meet a rigorous set of clinical and operational standards that will hopefully position facilities to move from fee-for-service to risk-baring value-based care payment models. 

ValueHealth has been able to prove their ability to transform how surgical care is delivered with value-based care models. Currently, the markets have a large appetite for our value proposition and as a clinician I believe more patients and consumers deserve to receive the benefits of this transformation. That said, helping the organization grow is a key objective.

Q: How have bundled payment programs for spine and orthopedics developed at Rothman Orthopaedic Institute?

WH: Rothman Orthopaedic Institute has been actively involved in bundled payments for years and today Rothman Orthopaedics has approximately 50 payment contracts that are some variation of a bundle. In 2020, Rothman Orthopaedics, with ValueHealth and their platform companies, will enter into our first fully prospective bundle payment, with a 90-day avoidable clinical complications warranty for total hips and total knees arthroplasties performed in ASCs. 

Leveraging our collective digital platforms and business models, Rothman Orthopaedics and Valuehealth have entered into a nationwide joint venture designed to help other orthopedic groups and health systems. Our goal is to replicate nationally what we have accomplished regionally in the Philadelphia market, hopefully becoming the largest and most successful value-based surgical network in the U.S., in partnership with payers and employers. 

Q: How do you see value-based care and bundled payments progressing as the industry looks for more cost-effective options for care?

WH: A sincere expression of a commitment to quality and cost savings backing up performance with a warranty. I think the healthcare industry needs to evolve into more advanced concepts of bundled care models that consider an episode of care that is larger than just the surgical episode. Downstream cost and outcomes need to be considered and managed. Currently, ValueHealth has the capability to perform clinically under prospective bundles with warranty. However, the current reality is that payers and employers are concerned that bundle payment models are too complex to manage. 

ValueHealth, through its network of provider and support companies, has the ability to adjudicate bundles, track data and manage risk with a warranty and reinsurance for facilities and providers who take risk. Taking this approach requires sophisticated processes, technology, and a culture dedicated to leading the transformation of healthcare. This progressive approach to healthcare delivery is what drew Rothman Orthopaedics to align closer with ValueHealth and is why I chose to work as their medical director. 

In the case of total joint replacement surgeries, we believe we can deliver at least 20 percent and up to 40 percent cost savings to consumers while improving quality and experience. 

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