The University of Pittsburgh Medical Center has announced a new management agreement with south Dublin's 183-bed Beacon Hospital--its fifth such arrangement overseas in the past dozen years. The international strategy results from a tightening of margins in the healthcare industry and UPMC's market saturation in southwestern Pennsylvania. Top UPMC officials are also discussing new management contracts with hospitals in Dubai and Cyprus while preparing to announce a healthcare information partnership with a hospital trust in the United Kingdom.
Microsoft Corp has announced it will test a new way to measure the effectiveness of Internet advertising in a challenge to an industry standard that has helped the likes of Web search leader Google Inc. and Yahoo Inc. Microsoft's "Engagement Mapping" departs from a standard that ties sales, leads and traffic to the last ad that a user clicked on online. Instead, it attempts to take into account all the Internet interactions that lead a consumer to buy a product and give advertisers a more accurate assessment of organize online campaigns.
Under a new partnership that sets aside years of rivalry, a group of five community hospitals in the Merrimack Valley region of Massachusetts is launching a campaign to encourage residents to stay local for their medical care. The effort is called the "I-495 Partnership" after the interstate highway that links hospitals from Lowell to Newburyport. The five hospitals all invested cash in a Web site and marketing campaign.
According to a new study, while 84 percent of marketers believe multicultural marketing is "critical to my business," almost 40 percent said they don't know the financial value of multicultural groups to their companies. They also had a variety of opinions on which agencies to hire to reach Hispanics, African-Americans and Asians, according to the Brandiosity study.
Editor's note: This is the second in a two-part series on the emerging market opportunity in musculoskeletal services. Last week's article focused on the factors driving the developing market. This week's article discusses how to prepare for key trends in the market and develop a program that will contribute to your bottom line.
Today, more than one-third (37 percent) of the U.S. population is 45 years of age or older. In a little more than 10 years that percentage is projected to increase from 37 percent to 42 percent, and account for more than 118 million people. By 2017, the leading edge of the baby boom will be entering their early 70's. This generation will seek healthcare services that promote good health and longevity, as well as support an active lifestyle. Chief among their needs will be musculoskeletal and orthopedic services.
Combine an aging population with technological advances in orthopedic care and devices, and the stage is set for unprecedented demand and increased opportunities for healthcare providers.
Key trends to watch There are five key trends that hospitals and health systems need to aggressively plan for:
Consumerism: Patients are increasingly taking charge of their healthcare. Our musculoskeletal health research shows that, lacking comprehensive information from their primary care physicians, consumers are developing their own continuums of care to maintain health and vitality. Services in their continuums include physical and occupational therapy, exercise and weight reduction, aqua therapy, chiropractic, yoga, integrative medicine and acupuncture. Consumers are willing to invest time and money to educate themselves about treatment options and create a personalized care pathway that will enable them to reduce pain and maintain an active lifestyle.
Physician specialization: The percentage of sub specialty (fellowship) trained orthopedic physicians has increased from 20 percent in 1990 to almost 40 percent in 2005. Increasingly, orthopedic physicians are specializing in sports medicine, hand, spine and joint replacement. Our research confirms that consumers seek fellowship trained, high volume surgeons when considering surgery. To be considered the preferred provider of care musculoskeletal centers will require a cadre of these specialists.
Rapidly changing technology: Two inpatient areas undergoing significant changes are spine and total joint surgery. In spine surgery, interspinous spacers, dynamic stabilization systems, facet arthroplasty and minimally invasive fusion techniques loom on the horizon. Total joint replacement surgery faces competition from new techniques and new modes of delivery including resurfacing arthroplasty, minimally invasive surgery, computer-assisted surgery, increasingly differentiated joint implants and the movement to outpatient surgical centers. In most cases technological improvements come with increased costs placing increased pressure on procedure margins. With direct to consumer advertising by implant and technology vendors, consumers are seeking the latest implants and equipment.
Market structure and competition: In some markets, hospitals are losing volume to specialty hospitals and ambulatory surgical centers. It is estimated that there are approximately 30 hospitals in the U.S. that specialize in orthopedics. Physician offices are also capturing market share through the development of focused ambulatory surgical centers, the acquisition of imaging equipment-CT and MRI's, therapeutic equipment, and the provision of outpatient rehabilitation. A by-product of this increased competition is that as patients are treated in ASCs and physician offices, the acuity of hospital patients increases.
Quality and cost transparency: CMS and The Joint Commission have targeted the next round of quality measurement on orthopedic procedures. Public reporting of basic measures of volume, length of stay, infection rates, return to surgery, pain management, patient satisfaction and DVT/PE events will evolve to range of motion (pre and post), percent discharged to home, time required for return to work or quality of life, unrestricted activity, and years between implant procedures. The focus of costs will be on the total cost of care between pre-surgery and return to work or quality of life.
These five trends demand that musculoskeletal services be designed and implemented to meet the multifaceted needs of an increasingly savvy consumer, but also for physicians and hospitals facing limited increases in procedure payments.
Creating a musculoskeletal medicine program Implementing a Musculoskeletal Medicine Program or Service Line can create significant bottom-line results. It can equip and position your hospital or health system to:
Provide a service that creates a tangible, positive difference in patients' lives
Increase your top line revenue and net operating income
Increase your case mix index
Increase volume and revenue to your onsite and off-site ancillary services (PT, OT, Lab)
Develop alignment opportunities with your medical staff
Develop partnerships with other community agencies (VNA, DME)
Improve the esprit de corps of the service line clinical staff, and help reduce employee turnover
It is important to acknowledge that musculoskeletal medicine is more than orthopedic surgery. Today's older adult and baby boomers are interested in exploring all options prior to pursuing surgery. Customer-centric, comprehensive musculoskeletal centers will need to offer the following spectrum of services including:
Prevention and Health Promotion: Outreach, Educational Program, Online Information, Weight loss and fitness information
Diagnosis: Primary Care, Radiology, Laboratory
Treatment: Rheumatology, Physiatry, Rx Consultation, PT and OT, Pain Management, Weight Loss, Complementary Medicine, Care Management, Surgery
Rehabilitation: Inpatient PT/OT, Home PT, Outpatient PT/OT, Fitness Programs
Habilitation: durable medical equipment
Strategies for success Hospitals and health systems seeking competitive advantage with a musculoskeletal medicine service line must implement an integrated process of care to facilitate patients' diagnosis, intervention, recovery and wellness.
Implementing key strategies can establish a long-term platform for growth and profitability of your Musculoskeletal Medicine program:
Identifying and assigning responsibility to a service line leader and physician champion
Focusing on those areas where the institution and the medical staff are strong
Providing comprehensive and integrated patient-focused care to manage the entire course of care from beginning to end
Proactively managing all costs, especially implant costs, and capital expenditures for new technology
Streamlining all consumer and physician office staff interactions/processes with the hospital
Aggressively marketing the program to both referring physicians and consumers
Publishing clinical results
It is the masterful, thorough execution of the entire process from health promotion through clinical intervention by the hospital, physicians and ancillary clinical staff that will drive volume and market share. In these days of continuous revenue and margin challenges, musculoskeletal medicine can be--for those institutions with the will, fortitude and quality medical staff--the next big growth opportunity.
John Kessler is vice president of The Strategy Group in Norfolk, VA. He is a consultant, speaker and author. He may be reached at kessler@thestrategygroup.com.
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The planned two-hospital management deal between Metrocrest Hospital Authority and Hospital Partners of America has been dissolved. Charlotte, NC-based Hospital Partners had been negotiating to take over management of Trinity Medical Center in Carrollton, TX, and RHD Memorial Medical Center in Farmers Branch, TX, since 2006. The negotiations were halted due to "outstanding financial issues," said Metrocrest representatives.