Becker's ASC Review

24 June 2019 Speaker Series 1,100+ ATTENDEES FROM ACROSS THE NATION REGISTER BY MAY 1, 2019 AND SAVE! KEYNOTES BY 17TH ANNUAL FUTURE OF SPINE + THE SPINE, ORTHOPEDIC AND PAIN MANAGEMENT-DRIVEN ASC CONFERENCE JUNE 13-15, 2019 SWISSÔTEL | CHICAGO, ILLINOIS 140 PHYSICIANS SPEAKING, PRIMARILY SPINE & ORTHOPEDIC SURGEONS 230+ SPEAKERS TOTAL REGISTER HERE beckersasc.com/june-conference registration@beckershealthcare.com jcole@beckershealthcare.com sbecker@beckershealthcare.com or 800.417.2035. BECKER'S ASC REVIEW GEORGE FOREMAN World Boxing Champion and Entrepreneur SARAH KLIFF Award-Winning Healthcare Journalist and Senior Policy Correspondent, Vox.com BOB WOODWARD Legendary Pulitzer Prize- winning Journalist and Author; Associate Editor, The Washington Post unnecessary denials and time-consuming preoperative appeals with their medical directors. But even in the cases that get "ap- proved," we oen find out the authoriza- tion numbers were never sent to the payer, and we get denials aer the procedures have been performed. is oen leads to a drawn-out appeals process and delay in payment. Q: Where do you see the biggest opportunity for bundled payments and other risk-based contracts? Have you considered them for your practice? JS: As a group, we have entered both bundled payment arrangements that have no downside risk, as well as those with risk sharing. e biggest opportunities for bundled payments and other risk-based alternative payment programs revolve around patient navigation, moving cases to the appropriate site and level of care including hospital outpatient and ASCs, and partnering with our healthcare systems to streamline our delivery and eliminate unnecessary pre- and postoperative testing and treatments. With patient navigation, we can intervene at the necessary times to help prevent urgent care and ER visits, help drive down readmissions, promote overall compliance following surgery and limit the number of patients needing to go to expensive inpa- tient rehab facilities. By moving patients to the appropriate level of care, as well as eliminating unnecessary testing and treat- ments, we can drive down the cost associ- ated with the procedure. However, my biggest concern is this "race to the bottom" with target pricing being adjusted down with each new contract. Eventually, there will be no more water to squeeze from this stone. Q: What changes have you made or are you considering for your prac- tice as healthcare moves toward value-based reimbursement and care delivery? JS: Our practice has been collecting our postoperative quality metrics for over five years now. Recently, we began to introduce electronic patient navigation for both our pre- and postoperative patients. We have also hired nurse navigators to assist in this process, with their primary role to ensure compliance of our patients in answering our online surveys, ensuring patient education is reviewed and responding to any patient con- cerns or survey answers which may indicate an issue with a patient. We have also begun discussions with our hospital partners around the delivery of health services, both while an inpatient and in the postoperative period. ese include services such as lab testing, imaging, physical therapy, home health, etc. In addition, our new ASC, opening in Feb- ruary of 2019, will include overnight beds, allowing us to offer procedures, which may require an overnight stay for recovery, in the ambulatory setting. n

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