Healthcare has begun its migration to value-based care, and ASCs seem primed for success in the new model.
Michael Boblitz, CEO of Tallahassee (Fla.) Orthopedic Clinic, recently connected with Becker's to discuss value-based care in the ASC industry.
Editor's note: This response was edited lightly for clarity and brevity.
Question: How do you see the movement toward value-based care changing the landscape for orthopedic ASCs?
Michael Boblitz: If you ask 10 administrators how they define [value-based care], you're probably going to get 10 different answers. Value-based care at a high level just means, "How do you improve quality and reduce costs?" By taking a patient who historically has joint placements at a hospital and moving them into our surgery center, we're reducing cost of care by 30 to 40 percent.
Creating kind of narrow networks are things we're talking about with the insurance companies. We've started to engage in direct-to-employer contracting. There's these new companies that are out there and I don't want to speak about one versus the other, they all have pros and cons. We're starting to get more into direct-to-employer contracting all around narrow networks where you're seeing these narrow networks now that if they don't participate, they're driving patients hours and hours away to a facility that does and their aim isn't surgery centers.
It's kind of a combination of how to have better quality and lower cost. I think for quality, the key is having very good physicians with an outpatient mix of 75 percent in joint replacement and spine surgery as examples. That's kind of toward the top of the range for the industry average. Then that robotic platform allows for minimally invasive techniques that other practices can't offer.
The thing about quality is you got the experience, the procedure itself. But what about what I call longitudinal quality? Yeah, we might get that patient in a couple of hours, but how do we know they're really better three months from now, six months from now or nine months from now? We have what we call patient-reported outcomes, and we're not the only ones to do that. If you choose to get vaccinated, then you get this little text every so often after so many months checking in to see how you feel. It's a very similar technology to patient reported outcomes. So our patient that gets a joint replacement, receives constant communications electronically, and the series of questions allows us to know if their range of motion really is better or if their pain level is really less. We're able to share that with the insurance companies to say, "Hey, not only is the patient getting good care at that one time of the surgery, but our data is showing that we're really improving the quality of life for that patient for the foreseeable future after that procedure." We track the patient for upwards to a year after and the insurance companies are really interested to see that because obviously they don't want to pay for a surgery and then find that patient's surgery is not successful and is back in surgery or back in other healthcare environments six or nine months down the road. So that's why we're really doubling down on patient-reported outcomes to track that really closely and make sure that long term, patients really are better and in our case, that's what we're seeing and the payers really like what the data says.