Healthcare has evolved in recent years, becoming more sophisticated and tech-savvy to achieve today’s value-based care goals and deliver on the promise of patient-centricity. Unfortunately, many hospitals still have limited resources to fully meet the demands of value-based care.
according to American Hospital Association, the total cost to our U.S. hospitals exceeds $1.2 trillion, not including ambulatory surgery centers, walk-in clinics, physicians or specialty clinics. The U.S. has the most expensive health care system in the world, but much of it is considered wasteful spending.recent Research Shows that wasteful spending on health care ranges from $600 billion to more than $1.9 trillion per year, or roughly $1,800 to $5,700 per person per year.
As populations age and their respective healthcare needs skyrocket, there is a heightened sense of urgency to address healthcare waste. By 2030, one in six people The world will be 60 or older, and our already overburdened systems will be forced to take on more responsibility. Especially for the Medicare population, orthopedic diagnostics and musculoskeletal (MSK) procedures will be major drivers of healthcare spending. As these trends increase, so does the need to find efficiencies and eliminate wasteful spending across the orthopaedic care continuum.
Cost Drivers of Orthopedic Care
When it comes to cost drivers and where we can find efficiencies, expensive revision surgery and out-of-network care may be seen as obvious culprits. However, as technology, guidelines, and care regimens have advanced, they have been rare exceptions rather than drivers of increased orthopaedic care costs.
Redundant care is often overlooked as the cost culprit.
MSK Sloan care providers face value-based care challenges every day, but eliminating redundant care can immediately reduce costs with zero impact on quality of care, improve patient experience, and even travel with their MSK care continuum: Insurance Offers business and hospital.
The problem of redundant care
Musculoskeletal patients may interact with multiple providers during diagnosis and treatment, from surgeons and physicians to hospitals and rehabilitation centers, each with their own protocols, electronic medical record (EMR) systems, Online portal and method of tracking patient information. When only one is needed, the same patient may be required to obtain multiple sets of X-rays, and may experience redundant care because each provider, EMR, or online portal does not have access to these images. Although redundancy occurs in a number of different ways, this example describes how miscommunication or lack of coordination can easily increase costs.
The exact cost associated with redundant care varies widely as it is divided into various wasted spending categoryeach with its own distinct description, including:
- Care coordination failed
- Service delivery inefficiencies
- Lack of care coordination
Combined with a lack of data interoperability, communication and coordination among care providers, the biggest barrier to reducing or eliminating redundancies is the inherent mistrust between each group – so much so that each of them believes the other doesn’t value them something that has been done or has already been done.
Distrust only increases when you speak or understand language differently – which is often the case with providers, hospital systems and insurance companies. In this case, the language is ICD-10 codes, protocols and guidelines. We can address this distrust barrier and address redundant care in two key ways: comprehensive, interoperable data exchanges, and stakeholder retention around highly reliable data-driven clinical care pathways and consistent incentive models Consistent.
Eliminate wasted low-hanging fruit
No matter where you are on the care continuum, interoperability is known to be critical to improving patient care and making progress in value-based care programs.In fact, the most recent one Report Interoperability research on CHIME and KLAS Research shows that over the next three years, provider organizations expect strong improvements to patient record exchange and population health.
In addition to working with EMR providers, immediate steps orthopaedic care providers and health systems can take to achieve interoperability is through the adoption of Health Information Exchange (HIE). A healthcare network supported by HIE solutions, standardized care pathways, and organized protocols will effectively facilitate rapid information exchange between patient orthopaedic teams from the start of treatment to the end of care, helping to reduce care costs while improving outcomes.
Based on the fundamentals and principles of information exchange, healthcare networks can further reduce redundancy by aligning shared data and stakeholders involved in the orthopaedic care continuum. Information exchange and true stakeholder coordination may seem impossible for individual agencies, providers and health systems, but it is an achievable goal by leveraging strategic partners proficient in both.
A robust platform should align all stakeholders, reduce variability and drive standardization of care. Implemented in their growth and cost savings plans, orthopaedic healthcare providers leveraging this partnership should not only improve their operational efficiency, financial performance and clinical outcomes, but also as patients and MSK experts appreciate these high-efficiency programs favor and increase their market share.
Layoffs happen from time to time, but by leveraging state-of-the-art analytics and EMR-agnostic decision support tools, orthopaedic care providers can positively influence hospital staff decisions, reduce layoffs and make progress in reducing costs, ultimately for our Patients bring victory.
Photo: Motortion, Getty Images
