Here at Fusion5, we know bundled payments and value-based healthcare will revolutionize patient treatment and strengthen the bottom line of providers by up to 300%. Nowhere is the power of bundled payments and value-based care more obvious than the increasing trend toward treating hip-, knee-, and other joint- replacement procedures on an outpatient basis. Improving efficiency, lowering costs, and increasing the quality of care associated with these procedures is occurring at exactly the right moment. Why? Research presented at the American Academy of Orthopaedic Surgeons 2018 Annual Conference showed that the number of yearly hip-replacement procedures will increase 171% by 2030, to more than 600,000 procedures per year. Additionally, the average age of hip- and knee-replacement recipients is steadily decreasing. The cost of joint-replacement surgeries can also vary widely. In Dallas alone, the cost of a hip replacement can vary from less than $21,000 to more than $99,000. In other words, more patients will have hip and knee replacements conducted at a younger age—and if nothing changes, the cost of those procedures will place additional burdens on patients, providers, and taxpayers. However, something is changing. Innovation in healthcare is happening. Providers in New Jersey report that an episode of care program introduced by Horizon Blue Cross resulted in hip-replacement cost decreases of more than 20%. And, as we covered earlier in the Fusion5 blog, CMS has announced that a Total Knee Arthroplasty (TKA) Outpatient Bundle will be included in the BPCI-A program beginning in 2020. “Innovation in payment models continue to drive innovation in clinical care,” said Jim Gera, Fusion5 CEO. “Value-based healthcare rewards and incentivizes providers to deliver cost-effective, exceptional care—which is what every provider and every patient wants.” While patient and provider preferences are important, the sheer volume of joint-replacement procedures is a significant challenge on its own. “The rapid increase in the number of joint-replacement surgeries is inevitable. Longer lifespans and an aging population mean these procedures are going to continue to increase,” Gera added. “However, patients, providers, and taxpayers do not have to accept wild swings in the cost and quality of care. Taking a value-based, episode of care centered approach that incentivizes outpatient treatment means that patients can continue to receive innovative, exceptional care at a reasonable cost.” The immediate and dramatic impact of bundled payments, and value-based, episode of care focused healthcare is one reason why so many providers have embraced BPCI-A. Interested in learning more about the Outpatient TKA Bundle that will be included in BPCI-A beginning in 2020? Read more here! And follow Fusion5 on LinkedIn, Twitter, and Facebook!

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