The move to value-based care is more than 'prevention vs. intervention,' says CEO

With trends in healthcare moving toward value-based models, the structures that support fee-for-service programs may need to be adjusted or replaced entirely. Philadelphia-based Premier Orthopaedics has partnered with HOPCo to do just that.

The relationship will enhance Premier's value-based care at its 28 locations by integrating partnerships with other practices, physicians, health systems and payers in the region, the practice said May 11. Premier is the newest addition to HOPCo's portfolio of orthopedic partnerships.

Matthew O'Malley, CEO of Premier Orthopaedics, spoke with Becker's about what a value-based system means for orthopedics and how the HOPCo partnership could help the practice.

Question: How does orthopedics fit into a value-based care system?

Matthew O'Malley: Orthopedics is one of the fastest growing areas of cost for patients, employers and payers. As patients age but want to continue to stay active, the need for orthopedic care continues to increase. We wanted to lead our market in the shift from volume-based to value-based care, and HOPCo has demonstrated success in doing just that in other large markets across the country.

Q: With more focus being turned toward prevention rather than intervention, how do orthopedic practices like Premier continue to grow and make money? Is there a looming cliff, or does the transition present economic updrafts you aim to ride?

MO: Our physicians have always believed the issue is more nuanced than "prevention versus intervention" and have instead focused on providing appropriate, clinically indicated treatment to our patients at the right time. With HOPCo's value-based care model, we will create clinically integrated networks for physicians to align on best practices and create value by improving patient outcomes and reducing costs for payers.

Q: What are some specific examples of how HOPCo's outcomes and claims analytics infrastructure will help Premier Orthopaedics continue to grow and improve the patient experience?

MO: The breadth of outcomes, operations and claims data HOPCo provides is truly impressive. This is in addition to their experienced subject matter experts, many of whom have led large health system and payer organizations prior to joining HOPCo.

Utilizing our own data, HOPCo helped us create a roadmap for market transformation. Backed by data from similar-sized practices throughout the country that already work with HOPCo, this gave us a clear vision of the future of our practice.

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