How Genesis Orthopedics' payment model expands care access

Practice Management

Genesis Orthopedics & Sports Medicine in St. Charles, Ill., developed a payment model that serves primarily Medicaid patients to expand value and access, CEO Andrew Shadid told Becker's

About 60 percent to 70 percent of the practice's patient base is on Medicaid, Mr. Shadid said. Although the practice does not label its model as value-based care, it is aimed at providing more relative value units — or services — per dollar.

"That can sometimes be in the form of bundled payment, sometimes in the form of a fee for service," he said. "By measuring RVUs, you are effectively measuring service. We're just saying we can do more services for less rather than we can do less services for the same amount of money, which traditionally is what bundled payments do."

Mr. Shadid estimated the cost of care is 50 percent to 70 percent cheaper for patients.

Genesis started working on this payment model in 2016 and publicized it June 1, Mr. Shadid said. So far, patient outcomes have been strong, and the model has been implemented in the practice's nine offices, he said.

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