The Growth Channel

AAOS: Time for orthopedics to jump on the value-based care bandwagon

by Sebastian Beckmann

Navigating the transition to value-based care is now a top priority for orthopedic physicians, vendors, and strategic planners. That’s the message that our team received when we attended the annual meeting of The American Academy of Orthopaedic Surgeons (AAOS) a few weeks ago.

Read on to learn how these three stakeholders are responding to value-based initiatives to drive orthopedic value and growth.

Physicians respond to CJR

This was the first AAOS annual meeting since CMS finalized the Comprehensive Care for Joint Replacement (CJR) model—and physicians were clearly both excited and somewhat apprehensive about the model, which went into effect on Friday.

At one session on emerging payment models, the presenting physicians offered a set of guiding principles to successfully execute on bundled payment:

  • Minimize LOS: Because hospital and post-acute stays put patients at risk for hospital-acquired conditions, physicians must strive to minimize the time their patients spend in institutions to both control cost and boost outcomes.
  • Reduce variation: Efficiency and quality are essential to success under bundled payment. Standardization around clinical best practice and care pathway redesign simplify care and reduce outcome disparities.
  • Keep protocols simple: While it may be tempting to optimize every detail of patient care, overly complex protocols reduce compliance and increase the administrative burden on physicians.

What we’ve heard from current Medicare bundled payment participants validates these principles. To learn more about strategies to guide your transition to bundled payment, read Key Considerations for Success Under Joint Replacement Bundled Payment.

Vendor innovation refocuses on value

With this renewed emphasis on value, vendors increasingly look to support providers through solutions aimed at care pathway optimization and outcomes tracking.

In fact, a number of vendors have prioritized care pathway and patient flow innovations alongside traditional capital and device introductions. For example, DePuy Synthes announced a partnership with Value Stream Partners, an organization with experience helping Medicare bundled payment participants, to offer support targeted to providers with orthopedic bundled payment contracts

Similarly, FORCE-TJR, a joint replacement registry that collects data on patient risk factors and patient-reported outcomes, has begun offering data collection and analysis services for providers. Using these services, providers can estimate patient risk before surgery and track outcomes against registry benchmarks.

As value-based payment continues presenting new challenges to providers and reduces demand for costly capital technologies, we expect vendors to continue innovating around value-focused solutions.

Planners look beyond surgery for orthopedic value

Although orthopedic surgery was the primary focus of the conference, population health and total cost control also emerged as priorities for planners. As uptake of value-based payment continues, planners will need to find new ways to reduce unnecessary spending and keep orthopedic patients healthy.

During a session on geriatric care, presenters from Regions Hospital presented on its mobile outreach program for elder health care. The program approaches fragility-related fractures as a “sentinel event,” which triggers a multidisciplinary healing and prevention program. Through the mobile outreach program, Regions offers orthopedics telehealth consults with an NP and onsite visits for at-risk patients living in nursing facilities.

These services have a dual purpose: help patients recover after they suffer a fracture due to bone fragility, and prevent future fractures. As a result, they keep patients out of the ED and prevent future surgeries, keeping overall costs down.

Get a free excerpt on CJR success

Learn more about these tactics and understand how active bundled payment participants have successfully implemented them.