Market transformation through hospital musculoskeletal service line optimization

Physicians and healthcare systems are looking for ways to improve patient care, while also reducing costs. This is especially important in the musculoskeletal landscape, as procedures are expensive and the stakes for strong patient outcomes are high. It’s possible, though, to grow market share while lowering costs and increasing patient satisfaction. Dr. Wael Barsoum, president and chief transformation officer of the Healthcare Outcomes Performance Company (HOPCo), and DeLyle Manwaring, HOPCo’s executive vice president of market transformation, discuss ways to do this during a webinar on Nov. 16.

1 Patient expectations are changing

With the increase in high deductible health plans and the wealth of information available online, patients have now begun to shop for elective care options in a way that increasingly resembles traditional consumer behavior. Patients often come to doctor’s appointments with detailed, high-level questions about musculoskeletal issues and procedures like knee or hip replacements. They have less blind reverence and trust in doctors. Now seen as a service provider, not just a doctor, physicians must recognize that patients own their healthcare in a more significant way than in the past.

2 It’s the era of patient-centric healthcare

Clinicians and healthcare organizations should recognize that patient-centric healthcare involves improving the patient experience, not just outcomes. Due to changing patient expectations, patients expect a seamless experience. Patientcentric care also entails enhancing the clinician experience, and reducing the per capita cost of care. One way to do this is ensuring that clinicians follow the evidence-based musculoskeletal order sets and clinical pathways, which minimize variation and improve value.

3 A clinically integrated network provides patientcentric healthcare

When a clinically integrated network is structured correctly, administrators, clinicians and healthcare staff can achieve patient-centric healthcare. The network must have these four components to achieve patient-centric care: systems, people, standards and structure. Systems provide the data and information needed to transform practice patterns, using metrics and benchmarking. Staff members at all levels and roles are essential to change the culture and lead the effort. The network uses standards like MSK protocols, pathways and order sets to streamline clinical processes, tracking compliance throughout the care continuum. And finally, the governance structure ensures that stakeholders have skin in the game.

4 Achieve buy-in with physician incentives

Musculoskeletal care can be financially lucrative for hospitals, so getting cooperation of the surgeons is key to a positive impact. Change is difficult, but physician incentives provide reason to align with the network goals. Offering meaningful annual bonuses based on performance and MSK service line quality will promote physician engagement to transform and improve hospital operations and meet patient goals. A clinically integrated network is even possible with multiple, disparate and competitive MSK physician groups, including community doctors, if incentives are aligned appropriately. With a clinically integrated network and the proper alignment, hospitals, ambulatory surgery centers, providers and payers can all share in the savings from moving MSK procedures from the hospitals to centers.

5 Align physicians and hospitals through active communication

It’s a major investment for hospitals to employ a dedicated group of orthopedic nurses and anesthesiologists because they don’t serve other specialties and are well-paid. But providing a differentiated experience for patients and clinicians in a hospital setting has been shown to lead to better outcomes, lower costs, higher satisfaction ratings and fuller operating room capacity. To successfully leverage orthopedic specialists at a hospital, alignment between the specialists and management is key. One tactic to do this is meeting regularly to talk candidly about how to create a successful infrastructure.

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