While hospitals vie for a competitive edge with increasing volumes in knee or other joint replacement surgeries, they are confronting reduced federal reimbursement rates, projected physician shortages in orthopedics, and increased expenses for implants. And the move toward multidisciplinary approaches also will call for more-affordable care and improved patient outcomes, Naas says.
Some hospitals are establishing joint replacement centers and protocols, and building special operating rooms for joint replacements. That has increased efficiency, with physicians performing as many as 8 to 12 surgeries a day, which also improves ROI.
The joint replacement centers are easing transitions for patients from the moment they enter the hospital to rehabilitation and recovery by hiring nurse navigators or joint replacement coordinators.
For a joint replacement team to be successful, it must have executive as well as physician support, says Scott Russinoff, MD, an orthopedic surgeon at Westchester Medical Center and Hudson Valley Hospital in New York and a HealthLeaders panelist on the Webinar. Joint replacement centers, if administered correctly, earn "good money for the hospital," Russinoff says. "Joint replacement centers drive more business and help patients. It's a way of putting all the pieces of the puzzle together."
While the multidisciplinary approach is often discussed, it is not easily accomplished, especially in joint replacement programs, Naas says.
To overcome turf problems, "there should be increased alliances between surgeons and hospitals" in joint replacement programs," Naas adds. "It's very attractive for bundled payments for efficient outcomes. A lot of that fits into healthcare reform." Bundling payments are designed to allow physicians and hospitals to coordinate care and reduce services of little value.