As we’ve written about before, stakeholders who pay for healthcare in the US (the government, employers and now traditional consumers themselves) are demanding better care for less money.
Orthopaedics has been a focus area given Musculoskeletal diseases’ prevalence and cost burden. New reimbursement models (e.g. outpatient joint replacement, surgical bundled payments, condition-state bundles, etc.) are being rapidly adopted to incentivize behavior change and reduce costs. These reimbursement models give providers opportunities to share in savings and revenue by developing more efficient, evidence-based pathways.
In order to clinically and financially succeed in these opportunities, leaders are fundamentally rethinking care delivery -- working to find ways to wrap their arms around patients when they’re outside the hospital. Providers have traditionally micromanaged what happens inside the hospital, now they need to figure out how to micromanage what happens outside of it.
Managing care beyond the hospital depends on continuous care in the pre- and post-op period. In order to create a care continuum, leaders are aiming to create a connected set of providers centered around the patient who can ensure care transitions are seamless, efficient and evidence-based.
Many organizations have leveraged analog tactics to accomplish this -- i.e. hiring care navigators, acquiring or building traditional post-acute care like SNFs, home care agencies, or PT clinics, or partnering with these post-acute providers in the community through a preferred (or narrow) network.
These methods aren’t achieving the ultimate goal of the value shift. They’re high cost and struggle to reach patients in between traditional encounters, where 99% of recovery takes place.
As other industries are increasingly scaling through digital technology, Healthcare is the only field in the US that has added employee headcount over the last 10 years. It’s one of the only industries who is still building traditional brick & mortar every chance it gets.
It’s now been proven in myriad research studies that providers can successfully use technology to navigate patients, deliver rehab virtually in the home and track progress in real-time. Digital platforms are the most efficient and effective model for creating access and continuity of care required for success in the rapidly changing healthcare landscape.