Becker's ASC Review

17 ASC MANAGEMENT North Carolina orthopedic ASC saves $15M in first 1,000 commercial prospective bundles By Laura Dyrda T he Surgical Center of Greensboro, N.C., an affiliate of Surgical Care Affiliates, released the outcomes of its first 1,000 commercial prospective 90-day bundles in early June, showing high quality and significant savings. e outpatient joint program was started in September of 2017 and is run by Delta Joint Management, a collaborative effort of all orthopedic groups in Greensboro, N.C. e collaborative has prospective commercial contracts with Blue Cross Blue Shield of North Carolina, UnitedHealthcare, Aetna, Cigna and Medcost. As part of the collaborative, surgeons have performed 505 total knee replacements, 320 total hip replacements, 161 partial knee replacements and 14 total shoulder replace- ments. e reoperation rate was 1.1 percent; the readmission rate was 1.4 percent; the infection rate was 0.3 percent; the deep vein thrombosis rate was 0.2 percent; the ma- nipulation rate was 4.4 percent. e patient satisfaction score was 99 percent. Financially, the bundled payments created over $15 million in savings for the payers as well as a new revenue stream for the ASC and extra income for the surgeons based on a quality metric system. "ese results show that outpatient joint replacement is safe and effective. In fact, these results are superior to most inpatient results. In addition, since value is defined as outcomes divided by cost, these results verify that commercial prospective bundles can achieve both improved outcomes and decreased costs. So this program is creating tremendous value," said Frank Aluisio, MD, president of Emerge Ortho and founding member of Delta. e founding members and executive board of Delta Joint Management include Matt Olin, MD, of Raleigh, N.C.-based EmergeOrtho, Frank Rowan, MD, of South- eastern Orthopedic Specialists in Greens- boro, and Steve Lucey, MD, of Winston-Salem, N.C.-based Wake Forest Baptist Health, in addition to Dr. Aluisio. "e key to our success was creating stan- dardized protocols and pathways and provid- ing case management within our practices to provide concierge-level care for our patients. is is why our outcomes have been so good and our patient satisfaction so high," said Dr. Lucey, who serves as president of Delta. e Surgery Center of Greensboro and Delta outpatient joint program runs on a soware system called ValereCare which includes a risk assessment tool, a case management platform, an outcomes measurement tool as well as serving as the financial tool to convene the bundle. Delta is now accepting Medicare patients and will do over 500 joint operations at the ASC this year. It hopes to grow the program by adding simple revisions and Medicare total and reverse shoulders next year. n Johns Hopkins planning 3 ASCs By Patsy Newitt B altimore-based Johns Hopkins Health Care & Sur- gery Center is planning three new ASCs, accord- ing to a June 14 email from the health system. With the addition of the planned ASCs, Johns Hopkins will have nine total centers throughout Maryland. Here are the three planned ASCs: 1. The Howard County Surgery Center in Columbia, Md., will offer ophthalmology, orthopedics, general surgery and breast surgery. It will house two operating rooms and two procedure rooms. 2. The Surgery Center at Bellwood Farms in Rockwood, Md., will offer GI, pain management and orthopedics. It will have two operating rooms and two procedure rooms. 3. The REI IVF Surgery Center in Lutherville, Md., will of- fer in vitro fertilization and gynecology procedures and has one operating room and one procedure room. n Caseload decline for 6 ASC specialties By Patsy Newitt D ermatology saw one of the sharpest declines in average number of patients seen by physicians per week from before COVID-19 to May. Here are six specialties and their caseload declines, based on Medscape's 2021 Physician Compensation Report: Dermatology: 15.6 percent decline, from 141 to 119 Orthopedics: 15.1 percent decline, from 93 to 79 Ophthalmology: 11.4 percent decline, from 132 to 117 Gastroenterology: 9.3 percent decline, from 76 to 69 Cardiology: 6.5 percent decline from 77 to 72 Anesthesiology: 4.3 percent decline, from 47 to 45 n

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