An exciting new conference is coming to Newport Beach, California in January 2017. Attendees can be part of a groundbreaking “immersion weekend” that brings together hospital executives and clinicians who are involved in the care of the orthopedic patient.
The “Interdisciplinary Conference on Orthopedic Value-Based Care” will focus on orthopedic bundled payments, Perioperative Surgical Home and Enhanced Recovery, and the team approach critical to success. This multidisciplinary conference strives to gather ALL healthcare providers and administrators who are involved in the episode of care of an orthopedic patient.
I interviewed some of the conference speakers to get their perspectives on the event:
Catherine MacLean, MD, PhD is Chief Value Medical Officer at Hospital for Special Surgery (HSS) in New York City. Dr. MacLean leads the Value Management Office, an established group focused on improving the way HSS defines, measures, and achieves value. Dr. MacLean leads the efforts to improve external quality transparency, giving consumers and other key stakeholders the information they need to make informed care decisions.
Dave Janiec is the Director of Contracting at Rothman Institute. He is involved in all facets of payer contracting, but the focus of his work is assisting the 140 doctor practice in its transition from the traditional fee-for-service care model to the value-based care model. He is actively involved with payers–government, insurance and employer–engaging in Alternative Payment Model development and implementation. He is responsible for performance measurement of clinical activity pertaining to all APMs and regularly meets with clinical staff to communicate all current program guidelines and available performance data.
Editor: Why are you excited to be a part of this new and innovative conference?
Dave Janiec: Healthcare has changed and continues to change, particularly as pertains to alignment of interests (payors, providers, patients). Movement from a transactional model to a true patient-level (value) model is a huge undertaking and not one that can be accomplished overnight. A forum, as this one, that encourages discussion and collaboration among formerly independent parties is important.
Dr. MacLean: The creation of value requires a team effort, both in terms of delivering the the highest quality are and in doing that efficiently. The conference is focused on this important team concept, bringing together all the different people that deliver care across the care episode for total joint arthroplasty.
Editor: Give me a sneak peek of your sessions – what can we expect?
Dave Janiec: My sessions are in two coordinated parts and will discuss 1) understanding the CJR model and considerations in adopting it, and 2) how to use data from an entity’s own systems to improve performance once in the model.
Dr. MacLean: I will share my perspective on the evolving value policy landscape as it pertains to musculoskeletal care and how HSS is responding. I will also share insights into the on-the-ground production of high quality, high value care including the importance of personalized health management.
Editor: Why do you feel these topics are important?
Dave Janiec: Rothman Institute is currently participating in BPCI Model 2, has bundled payment and shared savings arrangements with two commercial payers, will be adding a third in the first quarter of 2017, and expects to be onboarding another by second quarter 2017. All bundled payment and shared savings programs incorporate quality benchmarks. Interestingly, by design, episodic care is self-regulating in terms of quality, because the provider is held accountable for the cost of a patient’s care through a 90-day post-acute period; poor quality care or insufficient care is actually far more costly than proper care (as a result of complications, readmissions, emergency room visits, etc.); that said, cost isn’t a transparent indicator. Quality metrics clearly evidence the results of proper care pathways, and as well, evidence realistic limits on cost reduction. Proper bundled payment management cannot occur without ongoing clinical input.
Dr. MacLean: Peri-operative optimization is critically important to optimizing patient outcomes. This includes pre-hospitalization care, pre-operative care in the hospital, post-operative care in the hospital, and post-acute care after discharge. While this is important for all surgical procedures, there is bigger mandate and opportunity to utilize the pre-hospitalization period to drive optimal outcomes for elective procedures such as total joint arthoroplasty.
Editor: What future do you see for your organization in 2017 and beyond?
Dave Janiec: It is clear that bundled care is not going away. It is also clear that there is a finite period of time during the transition from fee-for-service to value that payers and providers will be on a learning curve, after which period the true cost of various services will be known and reimbursement can and will be established; most, if not all, risk for the cost of care will be transferred to the provider. Successful management of episodes of care will become a part of the business model of every practice out of necessity.
Dr. MacLean: We will continue to refine the important care pathways that have been implemented at HSS to optimize care. Additionally, we are incorporating the routine collection of patient reported outcome measures (PROMs) into clinical care. Data on these PROMs will be essential to our ‘learning delivery system’ and help us to better understand how specific elements of the care we deliver impact outcomes that are important to our patients.
Editor: Anything else you think people should know?
Dave Janiec: There is nothing about the current environment in healthcare that has been vetted and cast in stone. Not unlike episodic care, the approach must be collaborative. There is a lot of knowledge around and many resources being allotted to bundled care but no one has all of the answers at this stage.
Dr. MacLean: Along side the important work that care providers are doing to improve value, we need to be mindful of the need to develop meaningful quality measures that accurately represent the quality of the care we provide. Otherwise, value will be defined largely by cost.
These are just two of the 21 nationally-renown multidisciplinary faculty that will be presenting at the conference in January. Early bird pricing (up to $200 off) for tickets ends on December 9th. See the full agenda and register with the discount code “OSL” here.