Some orthopedic practices have found allies in payers to bolster services and outpatient growth.
At OrthoWest, partnering with Optum was crucial to get outpatient orthopedics off the ground and soaring in recent years, Amar Patel, MD, a board member of the practice, said.
And at Athens (Ga.) Orthopedic Clinic a new partnership presents new opportunities for the practice’s ASC strategy and patient access.
Here’s what Dr. Patel and Mr. Boblitz shared with Becker’s about these relationships.
Dr. Amar Patel: In our area there’s a high population, but there’s a lot of competition between physicians, hospitals and private equity systems. Right around 2021 we made the deal, but before that, we were looking at all options and did not want to be absorbed by another group and then not be able to manage things and lose autonomy. Every few years, we noticed groups were beginning to be absorbed by other healthcare systems, and those patients would come to us complaining how poor the service they got was there. At times those physicians would complain and say they didn’t want to be a part of it.
Since Optum is vertically integrated, they have access to resources for assistance with other parts of our business and vendor consolidation. These economies of scale can help us reduce costs. As we have more physicians with the same goal, they could then help find more communal ways to reduce costs of care for all parties, including patients, while still providing the same excellent care.
A big part of that was identifying which services create the biggest cost, and one was doing outpatient surgeries in the hospital. We noted that if we could do in the outpatient ASC setting, we could tremendously reduce cost of care because we know hospitals have higher charges and higher costs with the same care. Patients still get the same care from the same doctor, and we just had to find an efficient model to do those in an ASC setting.
Michael Boblitz: I’m always a big believer that two heads are better than one, and strategic partnerships I’ve always referred to as like a retirement account,” he said. “You have a diversified retirement account, and in some years certain funds outperform, and then in other years, certain funds underperform. And occasionally there’s a fund that underperforms for many years, and you just have to replace that with a new partnership. Going back to my days at Johns Hopkins in Baltimore, I learned the significance of partnerships and how that can really accelerate your purpose and your vision and your growth agenda.
When I started as CEO about a year ago, I reached out to the president of Anthem Blue Cross and Blue Shield of Georgia and talked about what we were trying to do here and how it’s just getting started. We had dinner around my third week on the job and started to think about how to support one another and both leverage each other’s synergies.
With site of service differentials, the lion’s share of those patients historically have been cared for in hospitals. In fact when I joined AOC, over 70% of those joint replacement patients and some spine surgery patients were in the hospital settings. But many of those patients didn’t have high-risk BMIs, significant heart disease or other comorbidities. So we knew we could do better, but in order to do that we needed to create and make an investment in a multimillion-dollar ASC designed to replicate the traditional hospital facility in a more private and a lower-cost environment. A big part of our partnership with Anthem was to create solutions for the community and to allow patients to get better access in a lower cost environment with great quality. What I love about Anthem is they cover the state of Georgia and beyond. We’re talking about areas where they have access challenges and cost of care challenges where we could, for example, go well beyond our network and partner in very distant communities where there’s needs. Anthem has that data that I don’t have, and there could be a lot of really amazing partnerships about a much broader network in the future.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
