Becker's ASC Review

21 Executive Briefing: CJR's Orthopedic Bundled Payments "Moving forward, it will be important to get data from addi- tional sources outside of the practice to fully understand the quality and cost of the care you provide," says Ms. Scheps. Quality measure reporting will continue to be an important, and required, input to pay-for-performance. Winners and losers The shift toward value-based payments is driving two key trends among independent orthopedists: practice consolida- tion and vertical expansion. Larger groups benefit from: • Pooled resources to build a data gathering infrastructure • Benchmarking and data-sharing capabilities • Improved quality • Enhanced ability to manage costs • Attractiveness to ACO partners "It's usually hospitals and medical homes that manage the bulk of expenditures for the care of its patients, but surgeons repre- sent a critical input to the total and want to present themselves in a positive light," says Ms. Scheps. "If they can produce high- quality care by adopting proven protocols, then cost reduction naturally follows." The larger groups are also preparing for bundled payments and want to control as many aspects of that episode as pos- sible. Large orthopedic groups are now expanding vertically to own MRI, physical therapy and ambulatory surgery centers. "If the risk is at the practice level, the surgeons want to control that," says Mr. Parada. "They want to control as much of the continuum as possible and that's where the data becomes fuzzy. There isn't really good data on the average cost for the continuum or how much the outcomes should change." This year CMS reported that under the Value-Based Payment Program, physicians in 128 groups received reimbursement rate increases due to superior performance while physicians in 5,477 groups saw a 2 percent payment cut for poor performance or not reporting. All physicians falling in between saw no change to their payment rate. However, in the future (under MIPS), it will not just be the groups at the extremes (of quality and cost) that will be impacted by payment adjustments — the adjustments will be implemented on a sliding scale, based on distance from the prior year's average performance level. "So, most physicians will see some adjustment, either positive or negative. The fact is, there will be winners and losers," says Ms. Scheps. If the government is successful in lowering costs and increasing quality, insurance companies will likely develop more pay-for- performance programs. Preparation for the future Define your business strategy; is it growing through acquisi- tions or mergers, or service expansion to increase the con- tinuum of care? Additional steps for 2016 include: • Define your regulatory strategy and make sure partners understand MACRA • Evaluate payer mix, paying close attention to Medicare • Define your environment — is an ACO available? • Define your technology needs — can your current tools sup- port your future goals? In 2017 MACRA will begin and could require workflow chang- es. Next year plan to: • Experiment with alternate payment programs such as PBCI and CCJR • Develop clearer outcomes definitions and benchmarks with data analytics • Optimize processes with hard data and implement changes to drive quality and efficiency The guidance above is the result of hundreds of conversations SRS experts have had with many of the company's nearly 4,000 ortho- pedic specialists and their administrators. It guides the company and directs strategic investments over the next two years. The company has several projects in the works that will continue to drive efficiency and productivity while supporting compliance with regulatory requirements. The first is the patent-pending Smart WorkflowsTM, which was recently introduced. It allows for user-specific workflows and protocoling, which streamlines data collection and visit documentation. Later this year, the company will release the first iteration of the Flexible Data Model. This will allow practices to capture as discrete data any piece of informa- tion they deem important and will make that data interoperable. Given the uncertainty about the regulatory programs or ACOs, or your local environment, this feature intentionally provides practices with flexibility and choice. Speaking of choice, SRS be- lieves practices want technologies that fit them, which is why the company is developing APIs that will support any system with which a practice may want to integrate. The company calls this their Best of Breed strategy. They have outstanding partners with whom they already interface, but should customers have a better fit in mind, SRS empowers them to do so. With these investments happening now and SRS's deep knowl- edge of orthopedic needs, they know that they can take your practice into the future without compromising on what matters to your practice, physicians and patients. n Sponsored by: As a leading innovator in Healthcare IT (HCIT) solutions for orthopaedic practices, SRS is advancing healthcare by creating frictionless technologies that enhance the quality of human interaction within practices and protect the doctor-patient relationship. With 20 years of experience, unmatched implementation success, extensive industry and regulatory expertise, and top-rated US-based customer service and support, it is no wonder that SRS has more happy clients than any other EHR. Offered via the Unified Desktop™, the robust SRS EHR, PM, Integrated PACS, Patient Portal, and Transcription increase speed and efficiency, assure seamless data exchange and government program compliance, boost revenue, and enhance patient care and satisfaction. To see why SRS is the trusted partner of so many prominent orthopaedic practices, and how they can prepare you for the future, visit srssoft.com/orthopaedic-ehr, e-mail info@srssoft.com, or call 800.288.8369.

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