Becker's Hospital Review

41 Executive Briefing Sponsored by: T o demonstrate value, healthcare providers aim to deliver the best patient outcomes at the lowest possible cost. Payment models — from the Comprehensive Care for Joint Replacement Model, to the Bundled Payments for Care Improvement, to commercial bundles — require providers to see this value promise through. This proves challenging, however, if patients and providers aren't aligned around the same goals. Under alternative payment models, it is more clear than ever that successful orthopedic surgery requires trust and transparency among stakeholders to foster a collaborative operating environment and informed patient population. "Parties seeking to align incentives and design models of collaboration to reduce costs while maintaining clinical quality and outcomes need information transparency to make it work," says Paul Cummings, COO of InVivoLink. Based in Nashville, Tenn., InVivoLink offers a platform to streamline the orthopedic surgery process through patient education, an implant registry and outcomes data and began partnering with HealthTrust in 2014. Lane Conger Maples, assistant vice president of account management at InVivoLink, and Cody King, chief technology and product officer at InVivoLink, joined Mr. Cummings in collaboratively discussing how to align an orthopedic care community through transparency, technology and data. Question: There are many moving parts within an orthopedic episode of care, and all are important in a value-based environment. How can information transparency help align the care community around patients during orthopedic surgery? Paul Cummings: The transformation in healthcare's clinical, financial and regulatory environment is unprecedented. Competing approaches to healthcare value management collide with the protective instincts of hospitals, payers and surgeons in a continuous cycle of negotiation. Parties seeking to align incentives and design models of collaboration to reduce costs while maintaining clinical quality and outcomes need information transparency to make it work. When the right information is presented to the right care community member at the right time, care delivery partnerships are strengthened and value accountability is increased. Q: What would you say is challenging hospitals the most when trying to align orthopedic care? How would you advise hospitals to overcome these obstacles? PC: It may boil down to the word "trust." While every member of an orthopedic patient's care community has patient satisfaction and clinical outcomes as their primary goal, the reality of operating a total joint service line in a financially sustainable way means continuously evaluating ways to reduce costs while keeping partnerships between hospitals and affiliated surgeons strong. InVivoLink surveyed dozens of surgeons who believe that information transparency — both clinical and financial — is the cornerstone of trust in their hospital relationships. When a difficult, but open and inclusive, conversation is founded on transparent information, we have witnessed stronger and more productive partnerships emerge. Patient journeys are becoming more complex and fragmented as care transforms. Clinic, hospital, ambulatory surgery center, post- acute care and home care only provide each operator a fraction of understanding of the whole patient experience. To optimize the entire patient episode, caregivers and operators across the episode need both patient-specific and aggregate data to inform and evolve their care delivery strategies. Q: Why will care community alignment be critical to hospitals moving forward in value-based care? Lane Conger Maples: The payment model landscape is as complex as it is polarizing, with experts lining up on both sides of mandatory bundled payment initiatives arguing the validity of their position. Underlying every payment model, however — from mandatory CJR, to BPCI, to commercial bundles, to homegrown co-management and gainsharing arrangements — is the simple premise of making the most efficient decisions around patient care that create the greatest opportunity for great clinical outcomes at the lowest possible cost. It's a search for waste, inefficiency and eliminating elements of care that do not add health value to the patient during and after his or her episode of care is long over. As payment design beliefs swing back and forth on political pendulums, as healthcare providers transform and disrupt traditional models, as clinical and marketing science are pursued with equal vigor — the one element that empowers care communities to act in the best interest of the patient is clean, insightful and unbiased information. As a strategic raw material — regardless of the vacillating direction of payment design, medical device technology or clinical partnerships — facts are the foundation with which to flexibly adapt to the surrounding environment. The change healthcare organizations will have to tackle next is ceaseless, unending change itself: change in law, change in surgery venue, change in payment burden and share, and it goes on and on. Modest outlays in tools that provide insight and extend value to patients are always great investments in the face of change. Q: Hospitals often struggle with collecting the right data that yields actionable insights. Which data points are critical to achieving care community alignment? PC: Transparency is about substituting facts and data for marketing claims. At their core, every physician is a scientist, trained to evaluate, challenge and leverage quality data. In a market where billions of dollars annually are spent on effusively marketed, relationship-leveraged orthopedic implants, price inflation can run rampant in the absence of quality information. At InVivoLink, we are passionate about collecting and assembling In Data We Trust: How to Align Around Facts and Improve Outcomes in Orthopedic Care

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