How 10 hospitals took their total joint replacement programs to the next level

Written by Laura Dyrda – September 29, 2016

The following 10 hospitals and health systems updated their total joint replacement programs with new initiatives such as data analytics, bundled payments, quality improvement and telehealth.

Here are their stories

Baptist Health System (San Antonio). Global professional services firm Navigant partnered with Baptist Health System in 2012 to develop and implement a program that would fit under the Center for Medicare and Medicaid Innovation’s Bundled Payments for Care Improvement initiative. The updates involved redesigning teams and improving the clinical information sharing strategy for better overall care. The program went live in October 2013 for joint replacements, including new initiatives for physician engagement; post-acute network partnerships; gainsharing and funds flow; and supporting analytics. A 2016 case study showed the hospital saved $2.3 million in the first year after participating in BPCI. The hospital also reported a 10 percent reduction in readmissions, 20 percent reduction in skilled nursing utilization and 22 percent reduction in patient rehab utilization.

Hoag Orthopedic Institute (Irvine, Calif.). Hoag Orthopedic Institute participated in the Cambridge, Mass.-based Institute for Healthcare Improvement’s Joint Replacement Learning Community in 2014 to gather data and identify areas to maximize value. In 2015, the hospital welcomed a chapter of Avant-garde, which provides hospitals with technology and analytics tools to measure clinical and cost data, to improve scalability and to set standards for care. The next step in the hospital’s journey to providing value-based care includes further data analytics for care cycles through the continuum of care. The hospital also was the subject of a Harvard Business School case study examining outcomes, cost reduction and reimbursement. Finally, the hospital has a bundled payment system covering services and participated in the Integrated Healthcare Association’s pilot program in 2010 and the National Orthopedic and Spine Alliance program in 2015.

Hospital for Special Surgery (New York City). The adult reconstruction and joint replacement service at Hospital for Special Surgery provides more than 9,000 hip and knee replacements per year and U.S. News & World Report has ranked the hospital as No. 1 in orthopedics for seven consecutive years. The hospital is using telehealth to engage patients before and after their surgeries to improve outcomes and stay connected to the patients after they return home. HSS and ViiMed developed a standardized framework telehealth program for personalized patient education, information and recorded video activities designed to open lines of communication between patients and providers. Among total knee replacement patients, 97 percent report pain relief and 96.3 percent report return to function two years after surgery.

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