In the Business-Minded Surgeon blog, members of OrthoFounders, a national group of orthopedic entrepreneurs, discuss how orthopedic surgeons can lead efforts to fix the problems in health care that are so palpable and apparent to themselves, but opaque and undervalued by others. Topics include how to maximize return based on business strategy and improved clinical performance, how to navigate the entrepreneurial journey, and how to connect with others who have similar interests.

 

 

BLOG: Value-based care requires collaboration

Stephen Ritter

By Stephen Ritter, MD

The U.S. health care system has a problem. Health spending as a percentage of gross domestic product is growing at an unsustainable rate. Health spending in 1962 represented 5.3% of GDP. The National Academy of Science predicts that by 2022, health spending will reach 19.9% of GDP. CMS have allocated $10 billion per year for the next 10 years to stop, or at least slow down, this runaway train with a variety of innovative efforts, all falling under the umbrella of ‘value-based-care’. The shift from traditional fee-for-service or volume-based-care to value-based-care includes a variety of efforts. My physician friends and our administrative colleagues have been familiarizing ourselves with several new models including Accountable Care Organizations (ACOs), Medicare Shared Savings Program (MSSP), Bundled Payments for Care Improvement (BPCI), and one of my fellow ortho colleagues will be quite familiar with Comprehensive Care for Joint Replacement (CJR).

While change is hard, these efforts are showing signs of success. This new paradigm is coupling caregiver financial outcomes to patient outcomes. However, the old models of health care resulted in a siloed system that lacks the infrastructure to truly collaborate with downstream partners. Today, physicians and health systems struggle to maintain visibility and control of care after their patients are discharged from their facility. This is especially challenging in the case of complex patients who receive acute-care in a hospital or surgery center and then transition to post-acute care in a skilled nursing facility or through a home health agency. Losing visibility of a patient, in which you’re responsible for their full episode of care, is bad for the patient and the bottom line.

Value-based health care requires greater collaboration than we’ve seen in the past. The current instruments for the job, fax machines and EMRs designed to replicate paper processes, fall short of creating connections between caregivers necessary to reduce readmissions and improve patient outcomes. My need and frustration drove me to help create a better care collaboration technology. We created Olio to solve the communication gap that exists between acute-care teams and post-acute care teams, so true care collaboration can take place. With Olio, physician and health system teams have real-time visibility into the location and status of their patients receiving post-acute care.

Value-based care deepens and lengthens the patient–clinician relationship. To improve patient outcome and excel in health care models of today and the future, we must maintain visibility of our patients’ location and condition, standardize care across disparate post-acute partners, open lines of real-time communication with post-acute partners to prevent readmissions, and do so in a way that reduces team burden so direct-to-patient care isn’t sacrificed.