Healthcare is facing a rising tide of change, presenting stakeholders with an opportunity to collaborate in this new environment.
"If we don't work together and find ways to leverage our partnerships, we are going to be wiped out by the tide," said Janet Stutzman, senior product director at West Chester, Pa.-based DePuy Synthes, a Johnson & Johnson company.
Ms. Stutzman and David J. Uba, MBA, CEO of Excelsior Orthopaedics and Buffalo (N.Y.) Surgery Center, engaged in a discussion with 34 healthcare executives during an executive roundtable, titled "DePuy Synthes: Leveraging your industry partners to build a successful ASC strategy for orthopedics and total joint reconstruction," at Becker's ASC 23rd Annual Meeting: The Business and Operations of ASCs in Chicago on Oct. 28.
"However you have leveraged [Johnson & Johnson] in the past, we want you to think of us as a partner," began Ms. Stutzman. "We are focused, just like you are focused, in engaging patient populations that are educated healthcare consumers."
She spoke of the company's understanding of the shift from hospitals to outpatient centers, and its commitment to assisting ASCs with marketing. "Think of us as a partner, because we know how to market to consumers," Ms. Stutzman added.
DePuy has positioned itself to offer products, services, education and research and development in joints, trauma, spine, sports medicine and neuro, among other specialties.
"Our aim is your triple aim," Ms. Stutzman said. The company offers an outpatient joints educational program, designed by providers for providers, touching on topics such as: product training, data collection, tray optimization, TRUMATCH Personalized Solutions, patient selection, patient engagement and pain management.
Building an outpatient total joints program
Excelsior Orthopaedics consists of 46 providers, 21 surgeons and physicians, 15 physician assistants and 10 physical therapists. The practice offers comprehensive musculoskeletal services and has a 100 percent physician-owned surgery center equipped with eight procedure rooms on the same campus.
"When you can control the means of production for your outpatient joint program, that's really what's going to enable you to be successful," said Mr. Uba. He noted, however, that market dynamics will dictate how a center should set up its total joint program. For example, a hospital partner or third-party management company may prove beneficial in one market, but not so much in another market.
"You sort of have to figure out how to put the pieces together for yourself," Mr. Uba said.
His surgery center, which offers orthopedics, GI, ophthalmology and pain services, performs about 12,000 cases per year and specifically markets itself as providing hospital-free joint replacements.
"[This] came out of massive frustration of dealing with local hospital systems, trying to get them to cooperate on bundled payments," Mr. Uba explained.
The practice was driven to establish an outpatient total joint program due to estimates of a 700 percent increase of outpatient knee replacements and a 200 percent jump in outpatient hip replacements by 2030.
"There's an intersection of the demand, availability of resources, the pressure that's coming from the government [and] the pressure that's coming from the payers at a time when clinically these things are possible," explained Mr. Uba.
Under their program, Mr. Uba said patient satisfaction is 99 percent and payers save 30 percent to 35 percent of every joint procedure performed in their surgery center, achieving the triple aim.
An outpatient total joint program shifts the balance of power back to the physicians, which Mr. Uba believes presents the best dynamic for improving healthcare.
"But, we wouldn't do this if it wasn't a business opportunity...Every single component of our business makes more because of what we did with our outpatient joint program through bundled payments," added Mr. Uba.
They have bundled payments set up with three commercial payers, but Mr. Uba emphasized they had to perform all the heavy lifting to get the payers on-board. Therefore, it's imperative to establish relationships with payers before you need to know them.
"There seems to be a myth around bundled payments, but it's really not that hard," said Mr. Uba. "As long as it's less than [the payers] are paying now, they're going to give you a bundled payment."
The steps to develop an outpatient total joint program include:
- Aligning resources and goals via physician leadership
- Developing a model complementing market dynamics
- Educating payers and regulators of program benefits
- Negotiating bundled payments (develop patient satisfaction metrics; standardize surgeon preferences; create care pathways; develop marketing strategy)
- Establishing credentialing and proficiency standards
- Implementing technology to track patient outcomes
Since launching their total joint program, Mr. Uba's center has performed about 140 TJA cases and has reported zero surgical complications.
"If there's any key message, it's that it's a team sport; you can't do all of these things by yourself," Mr. Uba warned.
The secret is to look for a solid partner to support you through the process. A true partner will assist a center with not just equipment and pricing, but also patient education, patient advocacy, marketing, site visits and outcomes tools.