Becker's ASC Review

20 ORTHOPEDIC SECTION Johnson & Johnson Medical Device Companies Launch Orthopedic Episode of Care Platform: 5 Things to Know By Laura Dyrda J ohnson & Johnson Medical Device Companies launched their Or- thopaedic Episode of Care Approach, an offering to help health systems and surgeons reduce costs and increase quality for value- based alternative care models in orthopedics. Willis-Knighton Health System in Shreveport, La., partnered with John- son & Johnson Medical Device Companies. "As the market adopts more and more alternative payment models like orthopedic bundled payment programs, improving patient outcomes while driving costs down is vital to maintaining Willis-Knighton's sta- tus as one of the country's leading health systems," said Chris Magnin, physical medicine director of Willis-Knighton Health System. Here are five key notes: 1. e company announced CareAdvantage in conjunction with the Orthopaedic Episode of Care Approach. CareAdvantage is designed to provide a "holistic approach" to helping providers deliver better care. 2. Johnson & Johnson will offer the Orthopaedic Episode of Care Ap- proach under their CareAdvantage capabilities. e alternative care models could include CMS' Comprehensive Care for Joint Replacement and the Surgical Hip and Femur Fracture Treatment models, measuring episodes of care. 3. e Orthopaedic Episode of Care option includes a shared perfor- mance agreement option to help reduce average episodic hip and knee implant patient costs. 4. e platform aims to support hospitals and health systems for the 90 day episodes of care for knee, hip and shoulder implants. 5. e Orthopaedic Episode of Care includes these CareAdvantage ca- pabilities: • Episode Performance Improvement supported by Value Stream Partners. • Infection Risk Management that provides evidence-based prac- tices to address blood stream infections and surgical site infection risk factors. • Hip Fracture Care, an evidence-based care improvement program designed to standardize care. • Digital Care Navigation, a cloud-based platform from CareSense, provided by MedTrak. • Patient Athlete, which uses science-based principles from the Johnson & Jonson Human Performance Institute to prepare for and recover from orthopedic surgery. n Medicare Episode Expenditures for Joint Replacement Decline 20.8% Following CJR: 5 Study Insights By Jessica Kim Cohen A study in JAMA Internal Medicine investigated changes in internal hospital, quality and 30-day post-acute care spending following Medicare's mandatory Compre- hensive Care for Joint Replacement bundled payment model, or CJR. The researchers identified 3,942 patients who underwent lower extremity joint replacement at Jacksonsville, Fla.-based Baptist Health System, one of the approximately 800 hospi- tals where Medicare launched this program. Here's what you need to know: 1. During the research period, July 2008 to July 2016, the average Medicare episode expenditures dropped from $26,785 to $21,208 for patients without complications, rep- resenting a 20.8 percent decline. 2. The average Medicare episode expenditures dropped from $38,537 to $33,216 for patients with complications, rep- resenting a 13.8 percent decline. 3. Readmissions decreased by 1.4 percent, emergency de- partment visits decreased by 0.9 percent and episodes with prolonged lengths of stay decreased by 67 percent; howev- er, patient illness severity did not change over time. 4. The greatest proportion of hospital savings came from re- ductions in implant costs, which, by 2015, decreased 29 per- cent per case on average. 5. Overall hospital spending significantly decreased by 2015; 51.2 percent of this saving came from internal cost reduc- tions, while 48.8 percent came from post-acute care spend- ing reductions. The researchers concluded, "During a period in which Medi- care payments for joint replacement episodes increased by 5 percent, bundled payment for procedures at BHS was associ- ated with substantial hospital savings and reduced Medicare payments." n

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