While hospitals are trying to find a competitive edge with increasing volumes, they are also confronting reduced federal reimbursement rates in joint replacement, as well as projected physician shortages in orthopedics and increased expenses for implants.
To deal with a competitive environment as well as the squeeze of cost factors, a multidisciplinary approach is a key to improving efficiencies in terms of revenue and patient care, says Farinas.
“It certainly is dependent on [volume],” says Farinas says of joint replacement within an orthopedics service line. “The more volume you can get, the lower you will have for the cost of materials and implants. We can get better prices as more patients come through the system by renegotiating contracts,” Farinas says. “That’s really our target: to build our volume and negotiate with our vendors and distributors, and get the pricing so we can survive on Medicare.”
Large and small hospitals are establishing specialized joint-replacement centers after revising their previous approaches, now working toward patient-centered care under a common philosophy to overcome lack of focus and undefined outcomes.
At the 67-staffed-bed Willamette Valley Medical Center in McMinnville, OR, hospital officials believed it was important to initiate a comprehensive program to compete with other hospitals in the area. An important element for the program is having a dedicated unit with a staff who oversees physical and occupational therapy with a joint-replacement coordinator.