Changing Landscape

syncera helps hospitals and surgeons find opportunities and success

Bundled payment models like Comprehensive Care for Joint Replacement (CJR), Bundled Payment for Care Improvement (BPCI), and quality payment programs like the Merit-based Incentive Payment System (MIPS) are forcing hospitals and surgeons to find new ways to reduce total joint replacement costs without sacrificing patient care. While these mandates pressure hospitals towards rapid changes, the hospitals that stay ahead of the curve by identifying effective solutions have an opportunity to transform healthcare while achieving significant gains.

What Hospitals Need to KnowWhat Surgeons Need to Know

CJR AND BUNDLED PAYMENTS ARE CREATING OPPORTUNITIES FOR SURGEONS

CJR AND BUNDLED PAYMENTS ARE CREATING OPPORTUNITIES FOR SURGEONS

Bundled payment models like BPCI and CJR are challenging, but they offer surgeons significant opportunities to align with hospitals and benefit by working together to coordinate care that ensures better outcomes, fewer complications, and avoids detrimental costs. Legal alignment agreements extending 5 years can be created that, based on episode of care savings, may maximize your gain versus the current physician fee.

See experts share ideas on how surgeons can succeed in the new healthcare environment.

Gain Sharing: Considerations for Physicians
Healthcare attorney David Glaser shares key insights around the legal parameters of gain sharing.

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Why I Choose “Stable Implant Technology”
Dr. Jack Bert discusses the value of clinically proven hip and knee implants.

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Top 5 Reasons to Gainshare in CJR
Jim Gera
Signature Partners

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Alternative Payments are Here to Stay

ALTERNATIVE PAYMENTS ARE HERE TO STAY

HHS has set a goal of tying 50% of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models by the end of 2018. (Merit-based Incentive Payment Systems, also known as MIPS, are also included in this initiative).

Healthcare transformation related to the new mandates incentivize hospitals to create alignments with physicians that can be structured for the mutual financial benefit of both surgeons and hospitals. With Syncera, surgeons are equipped with proven implants that have a proven long-term survivorship of 98% at 15 years1,2, interactive surgical staff training and point of care scanning technology designed to improve OR efficiency and implant-related waste reduction, and ongoing training and support for continuous performance management.

Learn More

1. Victor, et al. Internet Ortho. 2014 Feb, 38(2), 235-241.
2. McCalden R. Synergy Primary Stems. A presentation at the Global Insights Meeting; Copenhagen, Denmark. 2013.
3. Vantage CPS Executive Introduction/Smith & Nephew. Avalere Health. February 2016.
4. Millennium Research Group; Published in: Large-Joint Reconstructive Implants, US. 2014. Market Analysis; © 2014 Decision Resources Group.

MANY HOSPITALS NEED TO LOWER COSTS TO AVOID PENALTIES

An estimated 60% of all CJR hospitals may face CMS penalties due to their current cost structure.3


*Based upon average implant prices and waste savings. Results may vary. 

 

BPCI, CJR AND MACRA—WHAT DO THESE MEAN FOR YOUR HOSPITAL?

BPCI, CJR AND MACRA—WHAT DO THESE MEAN FOR YOU?

You have probably heard these terms thrown around frequently—BPCI, CJR and MACRA—but what are they and how are they causing healthcare transformation and sparking clinical integration in the hospital setting?

BPCI

Bundled Payment for Care Improvement

  • BPCI is comprised of four different models of care by CMS to evaluate effects on costs and patient care1
  • Under the initiative, physicians, hospitals and other healthcare organizations enter into payment arrangements that include financial and performance accountability for episodes of care
  • Designed to move the healthcare system from volume-based to value-based patient care

CJR

Comprehensive Care for Joint Replacement

  • CJR is a retrospective bundled payment model for lower extremity joint replacement, and effective April 1, 2016, is mandatory for hospitals in 67 MSAs2
  • The CJR model holds hospitals financially responsible for the entire cost of a 90-day episode of care. CMS establishes an episode of care target price that is an incentive for hospitals to work with physicians, home health agencies, skilled nursing facilities and other healthcare providers to ensure beneficiaries receive optimal coordinated care2

MACRA

Medicare Access & CHIP Reauthorization Act of 2015

  • MACRA changes how Medicare beneficiary caregivers are paid, creating a new focus on rewarding physicians for better care rather than more care. MIPS (Merit-based Incentive System) and APM (Alternate Payment Models) are two paths within MACRA.
  • MIPS combines and streamlines several government value programs, including the Physician Quality Reporting System and Value-based Payment Modifier, into a single incentive program3
  • Measures and rewards physicians on attributes such as Resource Use and Clinical Practice Improvement3
  • Currently a proposed rule with target implementation of January 2017

CLINICALLY PROVEN PRODUCTS AT A SIGNIFICANT VALUE

CLINICALLY PROVEN PRODUCTS AT A SIGNIFICANT VALUE.

Syncera total knee and hip systems are proven with patient outcomes of 98% survivorship over 15 years,1,2 and are manufactured by Smith & Nephew to exceptional standards.

Learn More

1. Victor, et al. Internet Ortho. 2014 Feb, 38(2), 235-241.
2. McCalden R. Synergy Primary Stems. A presentation at the Global Insights Meeting; Copenhagen, Denmark. 2013.

Get Ahead

GET AHEAD

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