The Next Generation of Spine Care; Place, Provider, Price · The Next Generation of Spine Care;...
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The Next Generation of Spine Care; Place, Provider, Price © Corazon, Inc. All rights reserved. Nikhil Thakur, MD, Orthopedic Spine Surgeon, Orthopedics Northeast Robin Hynds, MSN, RN, CPHM, Vice President, Care Continuum Dawn Bollhardt, BS, RN, MSN, CNL, Program Manager, Spine and Orthopedics Djamel Bayliche, Vice President, Corazon Patrick Vega, Vice President, Corazon
Transcript of The Next Generation of Spine Care; Place, Provider, Price · The Next Generation of Spine Care;...
The Next Generation of Spine Care;
Place, Provider, Price
© Corazon, Inc. All rights reserved.
Nikhil Thakur, MD, Orthopedic Spine Surgeon, Orthopedics Northeast Robin Hynds, MSN, RN, CPHM, Vice President, Care Continuum Dawn Bollhardt, BS, RN, MSN, CNL, Program Manager, Spine and Orthopedics Djamel Bayliche, Vice President, Corazon Patrick Vega, Vice President, Corazon
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Agenda
Introductions
Situation- Lawrence General Hospital
9 Essentials for Comprehensive Spine
Common Challenges in Spine
Core Elements of Comprehensive Spine
Assessment
Patient Navigation
Report & Recommendations
High Performance Profile
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Corazon – Industry Resource
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Robin Hynes, MSN, RN, CPHM Vice President, Care Continuum
Service line strategy & development in a community hospital
Implementing and leveraging a Co-Management Agreement with Orthopods
Population Health
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Primary Care & Community-
based Services
Psychiatry / Psychology
Worker’s Comp/
Occupational Medicine
Comprehensive
Spine
Intake, Triage, Navigation
Orthopedics Neurosurgery
Physiatry ED
Ancillaries -Rehabilitation; IP, OP
-Imaging
Pain Management -Acute and chronic
Alternative and Complimentary
Providers
Neurology Skilled
Nursing / Long-term Care
Comprehensive Spine
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Visiting Nurses / Home Care
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Dawn Bollhardt, BS, RN, MSN, CNL, Program Manager, Spine and Orthopedics
Creating a collaborative approach with surgeons
Patient education / “Spine Camp” that spans full episode of care; pre-habilitation through post-acute care
Navigation access and guidance to services; surgical and non-surgical
Ancillary services that impact compliance and outcomes; depression, nutrition…
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Build Comprehensive Spine: IP, OP, ASC
Design an integrated system
Navigate patients
Collect/benchmark/report metrics
Collaboration among spine specialists; employed and private
Engage Primary Care
Understand & manage the costs of care
Prepare for value-based care: data & episode cost, design / redesign care, physician engagement, patient engagement
Integrate Pain Management
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9 Essentials for Spine
in a Value-based Environment
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Common Challenges in Spine
-Poor Access
-Outmigration to Competing Hospitals, Physicians
-Exclusive surgical focus
-Lack of Service Line Vision
-History of failed initiatives, skepticism
-Low Surgical Volumes
-Ill-defined Programming
-Predictably Dissatisfying Patient Experience
-Distrust between Physicians & Executive Administration
-Orthopedic-Neurosurgical tension
-Migration of historically IP bound surgical cases to ambulatory
-Loss of Ancillary Revenues
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Poll Question 1
Does your organization have a patient navigation system that ensures access and guides patients through care?
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Core Elements of Spine Care
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Vision,
Strategy, Planning
Hospital-based
Services: -Pre & Perioperative
Services -Acute Care
-Rehabilitation
Primary Care
Relations
Patient Education
Physician Relations
Non-
Operative Spine:
Pain, Rehabilitation,
Imaging
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Elements- continued
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Outcomes Clinical, Functional, Operational, Financial
Collection, Measurement & Application
Financial Performance -including Medicare
analytics
Marketing Access
Intake, Triage & Navigation
Post-Acute Providers aligned across full Continuum -Rehabilitation, Home Health, Skilled Nursing, Long-Term Care
-a prerequisite for at-risk contracting
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Where to Start…?
Gap Assessment
Understanding key stakeholder visions
Market Opportunity
Data & performance metrics; operational, quality, finance
Patient- Self-referred
Navigation
Physician Specialist
PCP
EHR Fax
Phone
Neurosurgery Orthopedics
Neurosurgery Orthopedics
Physiatry-PMR/ Rehabilitation
PCP with support
Pain Management
Referring physician request Acuity Wait times Diagnostics/symptoms/history Geography Insurance
Intake/Triage/Navigation Process Referral Base
Triage disposition criteria
Chiropractic
Chiropractic
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Marketing Focus: Primary Care Education
Spine programs offers a clear brand for medical professionals and consumers, growing word-of-mouth referrals,
Physician-led education to Primary Care,
Primary near-term task is to build a credible comprehensive spine program, ensure access and communicate to key referral sources
Not principally an advertising activity in; rather - establishing / reestablishing trust and credibility with medical professionals and patients
Rapid growth, without structure will not suffice, new volume can compound disorganization and disappoint reinvigorated expectations.
Ensure access, without it- quality doesn't matter
billboards….
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Financial Analysis
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External Market Data (inpatient only) - this data is used to determine: Market share trending and out-migration Population projections Utilization rates Future volume potential
Internal Financial Data (inpatient and outpatient) - this data is used to determine: Volume trending Financial summary that includes:
Cases Average payments per case Average direct cost per case Average contribution margin per case Average contribution margin % per case
Payer mix Average length of stay compared to CMS benchmark
Projections of post-acute utilization and cost by provider and place of service
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Poll question #2
Does your organization have a written Strategic Plan for spine services?
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Report & Recommendations
Strategy, data and a defined leadership model drive all
other activities…
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Assessment Recommendations
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Strategy -Plan for Spine
-Plan for Musculoskeletal -Resource Focus
Shared Governance
-Service Line Leadership
-Medical Leadership -Structure
Marketing -Audience -Messages
-Tactics -Access
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In-migration
Episode costs known
Comprehensive spine
Access, triage, navigation
Clinical outcomes reliable
Post-acute care algorithms
Population health readiness
Direct-to-employer contracting
Place of service options: Inpatient, Outpatient, ASC
Bundled payment readiness; Medicare, Commercial
Standardization & Implementation of Best Practices
DESTINATION SPINE CENTER
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Thank You for attending!
Thank you- Robin Hynes, Dawn Bollhardt, Dr. Nikhil Thakur
and Lawrence General Hospital
Djamel Bayliche 412 364-8200 [email protected]
Patrick Vega 301 730-2595 [email protected]
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Corazon 2017 Fall Conference
Corazon’s World of Innovation: The Future of Healthcare
September 28-29
The Gaylord Palms Resort & Convention Center
Orlando, FL
Register at www.corazoninc.com.
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Wellbe is a Conference Sponsors-
Today’s webinar attendees can receive a special discount when registering.
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Addendum
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Additional resources
“The Five Keys for Orthopedics & Spine”
“Nurse Navigation for Spine”
“Marketing Spine to Primary Care”
“Helping Your Hospital Help Your Practice”
“4 Strategies to Prepare for Changes in Reimbursement”
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