Becker's Spine Review

Becker's Spine Review Nov/Dec 2016

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35 PRACTICE MANAGEMENT the first orthopedic groups in the nation to offer patients these kinds of bundled pay- ments. e practice offers the program for the following five procedures: • ACL repair: $10,800 • Hip arthroscopy: $13,250 • Knee arthroscopy: $5,000 • Rotator cuff repair: $11,300 • Shoulder arthroscopy: $10,000 15. Charlotte, N.C.-based OrthoCarolina published an article in the New England Jour- nal of Medicine Catalyst detailing its process for creating a physician-owned bundled pay- ment. e group was able to lower costs by 10 percent to 30 percent as well as improve out- comes for hip and knee replacement surgery. 5 16. Two hospital surveys released last month found the majority of hospitals polled are not ready for CMS' Comprehensive Care for Joint Replacement reimbursement model. A FORCE-TJR survey found 56 percent of hospital orthopedics programs report being unprepared for CJR. Avalere Health's survey results indicated 60 percent of the hospitals required to participate in CJR could lose money in the bundled payment model when downside risk begins in January 2017. 17. Half of all physicians, 78 percent of hospitals and 80 percent of payers find bundled payments appealing, according to a booz&co infograph- ic on Stragety+Business. Additionally, more than 80 percent of hospitals with bundle expe- rience have improved patient engagement, in- creased alignment with physicians and further reduced administrative costs. Miscellaneous 18. Zimmer Biomet recently launched a suite of clinical services and technologies that es- pecially targets orthopedic providers who are part of the CJR program. e suite, Sig- nature Solutions, integrates into the estab- lished Zimmer Biomet consulting platform. e core components include interactive pa- tient engagement tools for patient education, communication and adherence to protocols as well as data mining and analysis platform to collect patient-reported outcomes, among other services. 19. Stryker Performance Solutions, the busi- ness unit of Stryker's Reconstructive Division, partners with hospitals and physician practic- es to help improve healthcare quality, patient satisfaction and profitability. It offers a new digital tool called Episode Performance Man- ager, which translates raw claims data from CMS into reports. e reports compare the performance of hospitals participating in CMS' CJR model. n References: 1 AAOS Academy News 2 AAOS letter 3 International Journal of Spine Surgery study 4 Spine study 5 New England Journal of Medicine Cata- lyst article Dr. Gregory Sherr Sues HealthEast, CentraCare & 6 Neurosurgeons for Allegedly Ruining His Reputation & Career By Megan Wood N eurosurgeon Gregory Sherr, MD, is suing Heal- thEast Care System, CentraCare Health and six affiliated physicians for an alleged "pattern of anti-competitive, tortious and otherwise illegal conduct." Both healthcare systems are based in St. Cloud, Minn. Here are six things to know: 1. Dr. Sherr brought suit against the two health systems and six physicians in Federal District Court on Sept. 15. 2. Dr. Sherr served as Saint Cloud Hospital's neurosur- gery department chair until early 2015. CentraCare wholly owns Saint Cloud Hospital. He resigned from Saint Cloud Hospital and joined Midwest Spine and Brain Institute in Stillwater, Minn. 3. Dr. Sherr and Midwest Spine and Brain Institute opened a neurosurgery clinic within blocks of Saint Cloud Hospital. In addition, Dr. Sherr received privileges at a few Health- East hospitals. 4. Following these actions, Dr. Sherr alleges six neurosur- geons affiliated with the two health systems colluded to bring unfounded complaints against him in the HealthEast "Peer Review" process. Dr. Sherr argues this occurred be- cause he was a competitive threat to the hospitals' in-house neurosurgeons. 5. The complaint alleges these "baseless complaints" re- sulted in the HealthEast committee suspending his privi- leges for violating HealthEast Bylaws. As a result of this sus- pension, Dr. Sherr alleges his reputation and career were ruined and he had to resign from Midwest Spine and Brain Institute and relocate to Florida. 6. Schaefer Halleen law firm is representing Dr. Sherr in the suit, and commented the case will be "groundbreaking," as they plan to reveal anti-competitive collusion among the neurosurgeons at two large Minnesota health systems. "My intent was to develop, with MSBI's support, a state- of-the art neurosurgery approach to treating difficult cranial and spine cases. To have this dream destroyed, and to deprive Minnesota citizens of this resource, sim- ply because I was a competitive threat to in-house neu- rosurgeons, is a tragedy for complex medical care in this state," said Dr. Sherr. n

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