Jeff Peters CEO Surgical Directions How the business of perioperative services is changing Why bundles are here to stay Will bundles change under the new administration How reimbursement changes under bundles ID: 1044391
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1. How Bundled Payments Change Reimbursement LandscapeJeff PetersCEO, Surgical Directions
2. How the business of perioperative services is changingWhy bundles are here to stayWill bundles change under the new administrationHow reimbursement changes under bundlesHow should perioperative services be organizedHow the role of the OR Business Manager is evolvingCase StudyNew HanoverAgenda
3. Bundled Payment Covers the Entire Episode of Care3
4. Bundled Payments
5. Accountable Care Act VS. Repeal5ACARepeal
6. “We can’t solve the problems of healthcare with incremental add-on solutions, we have to change the very structure of how we deliver and think about healthcare”ASA National Meeting 2016—Michael Porter PhD
7. Adapting Perioperative Services to a Value Based Model7
8. Value Based Payments Now8Healthleaders 5/18/2017
9. Never Has the Role of OR Business Manager Been More Important9
10. Key Pillars for Success Under Bundles10
11. Perioperative Organization Needs to Change11Duties & DetailsHistoricalUnder Value Based PaymentSpan of ControlSchedulingPATORPACUSchedulingPATORPACUSurgical FloorSICUTitleOR DirectorVP of Surgical ServicesOR Director
12. Keys to Success12
13. New Hanover Medical Center Case Study13
14. Surgical Home Steering Committee14Member:SurgeonAnesthesiaNursingResponsibility:ClinicalMetricsDashboardMonitorDrive ChangeAddress IssuesOrganizationalQualitativeRedesignConsensusGoals
15. Case Volumes – Total Joint Program15
16. Patient Satisfaction16
17. First Case On-Time Starts (FCOTS)17
18. Supply Costs18
19. Length of Stay19
20. All Payor Readmission Rate20
21. Discharge Disposition21
22. Transfusions22
23. Bundled Payment Models Demand Standardization to Be Successful23Total Knee ReplacementBenchmark*Provider AProvider BVolume21,966516236Mortality0.10%0.00%0.42%30 Day Readmissions3.65%3.11%9.79%Complications10.69%7.36%15.25%LOS3.242.753.86Direct Cost per Case$12,041$11,899$14,038Patient SatisfactionTop Decile92%86%*Premier Data Set Top DecileWhen there is large variation in cost and outcomes, organizations are not prepared to offer competitive pricing for bundled payment or take on the financial risk of managing the health outcome of a community
24. ResultsTotal Joint ReplacementColorectal (Open & Lap) Baseline – FY ’14Current –Nov ‘15 – Oct ’16Baseline – FY ’15Current –Nov ‘15 – Jan ‘16Volume2,1802,2605010Mortality0.27%0%2.42%0%Complication9.99%6.77%17.11%0%Readmission5.25%2.13%13.56%0%Patient Satisfaction*78% tile89% tile12% tileUnder ReviewLOS3.342.137.512.5Cost per Case$12,163$10,064$10,219Under Review*Communication with DoctorsSource: PremierItems in red are higher than Premier BenchmarkTotal Joints2,735 Additional patient days availableJoint Readmissions now in line with Medicare penalty thresholdCost per case reduction of $2,099 equates to $4,743,740 in savingsColorectalBased on the provider participating, 50 additional patient days available
25. Outcome25
26. Surgical Directions541 N. Fairbanks CourtSuite 2740Chicago, IL 60611T 312.870.5600 F 312.870.5601www.SurgicalDirections.com