Orthopedics is in a prime position to align with strategic healthcare goals — Here's how

Practice Management

"Compared to other specialties, orthopedics is in the best position to succeed because despite pressures, orthopedics has the best opportunities to align with healthcare industry goals," Surgical Directions President Jeff Peters said at Becker's 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in Chicago on June 22.

Factors driving orthopedic group success
Even though reimbursement rates are declining across the board, the demand for orthopedic procedures is growing. By 2025, the number of Americans older than 65 will likely more than double, said Mr. Peters, and so the need for inpatient and outpatient orthopedic procedures will grow.

Another key growth factor is the movement to the ambulatory setting. Clinical advancements and insurers are increasingly allowing for higher acuity procedures to be performed on an outpatient basis.

"Ten years ago who thought they would be doing spine in the outpatient setting?" said Mr. Peter. "This movement gives orthopedic surgeons an advantage as they can drive and control the trend."

Also, hospitals are under pressure. The ACA lowered reimbursement for hospitals and possible replacement legislation may not change that. Hospitals are looking for ways to cut costs and improve outcomes, and orthopedics offers a way to do that through bundled payments and co-management agreements.

"Hospitals are struggling and if orthopedic surgeons can help them bring costs down, they will be the hospital's savior," Mr. Peters said.

Remaining successful in the orthopedics arena
Here are three things orthopedic groups can do to maintain success:

1. Embrace bundled payments programs. The move towards bundled payments is a clear trend that is not likely to change anytime soon.

"Bundled payments are politically agnostic," said Mr. Peters. "They will be encouraged."

Orthopedics groups can manage the bundles and affiliate with a hospital to execute it, or they can consider a bundled payment joint venture with an ASC.

Bundled payment programs involve:

●    Appropriate preoperative assessment
●    Intraoperative process optimization
●    Right level of postoperative care
●    Coordination through long-term recovery

In many states, commercial payers are driving bundled payments adoption. For example in Tennessee, Humana has established several preferred contracts with certain health groups.

2. Explore co-management agreements. These agreements involve orthopedic groups engaging with hospitals to help manage their orthopedic service line, said Mr. Peters.

Via the agreement, orthopedic providers can get paid for helping redesign care at the hospital. The providers can attend management meetings and  gain opportunities to enhance their clinical education.

3. Develop surgeon scorecards. To improve care and reduce costs, surgeons need information. It is important that orthopedic groups benchmark metrics such as length of stay, surgical site infections, operating room time, implant cost and cost per episode, among others.

Mr. Peters suggests each surgeon in an orthopedic group have a scorecard that shows them their benchmarks in comparison to other surgeons in the practice or region.

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