Signature Medical Group (SMG) hosted its second annual Bundled Payment for Care Improvement (BPCI) Conference in Dallas, TX at the end of October where we hosted physicians, administrators, and case managers from the nearly 60 orthopedic physician groups we convene in the BPCI initiative. It was an action-packed three days full of bundled payment content. As convener, we shared highlights, insights, and data trends from the program as a whole. In addition, many groups have made substantial progress in implementing the key aspects of a successful bundled payment program for lower joints and had a lot of rich information to share. Below are 5 main highlights from the conference:
- Behavioral Health
- Collaboration and Networking
- Patient Optimization
- Physicians are the leaders in this movement
Telemedicine is a tool many physician groups are utilizing to increase their interactions with patients who have multiple comorbidities, higher risk, or live in rural communities. Depending on the technology used, physicians talk or video conference with their patients in real time in order to assess their concerns, surgical wound, or symptoms. Physicians are also able to assess their patients who are staying in a skilled nursing facility to review patient therapy progress and assist patients move to the next phase of care.
2) Behavioral Health
In the world of value-based care, specialty physicians now have to assess and address all aspects of a patient’s health, including behavioral health, instead of providing care for only one particular health area or issue.
After participating in BPCI for nearly 2 years, many groups have developed the fundamental components of bundled payments, such as a post-acute care provider network, physician leadership and engagement, and standardized care pathways. With this first phase of implementation accomplished, groups are able to start focusing on patient health needs that remain largely unaddressed on the total joint care continuum, such as behavioral health.
Several physician groups are incorporating behavioral health care pathways for their patients. While there was only one presentation on behavioral health, it was one of the most discussed presentations and well-received by the audience. Many physicians struggle with how to adequately address behavioral health and were interested in learning from other physician groups in how they are responding to these patient needs.
3) Collaboration and Networking
One of the most beneficial aspects of the BPCI conference was that it provided a space for all attendees from across the nation to share ideas, network, and collaborate with one another about all things bundled payments. Since bundled payments is a relatively new concept in the realm of total joints and patient health care, the physician groups implementing BPCI are on the forefront of a new health care payment frontier and often operate within a silo in their communities. Their experience is unique and their ability to talk with others who are also engaged in this work is crucial to progress. Case managers, physicians, and administrators gathered to share frustrations and barriers to success, which in turn pivots to discussing solutions and ideas to move beyond common pitfalls.
4) Patient Optimization
Groups on the progressive end of value-based care and bundled payments in total joint surgery have implemented pre-operative processes and protocols to address more components of patient health, such as cardiac, pulmonary, and behavioral health. Many physician groups have established clinical thresholds patients need to make their best effort to achieve in order to proceed or schedule elective surgery. There was interesting discussion by physicians as to what the thresholds should be and options for patients to better manage their risks in the interim. The patient optimization aspect of the care continuum is where many groups are focusing and is arguably one of the most challenging.
5) Physicians are the leaders in the bundled payment movement
Many physicians presented at the conference about various topics, such as hip fracture protocols, patient optimization, and behavioral health. These presentations sparked interesting discussions and ideas about patient care and bundled payment processes. There were many instances throughout the conference where administrators or case managers would state, “I wish my doctors could have heard that last session.” This sentiment echoes an overarching construct in bundled payments, which is that physician engagement and leadership is essential for success. Administrators and case managers can have all of the things in place for a bundled payment program, but without physician buy in and leadership, it will take twice as long to acquire cost savings or the bundle will fail all together.
Success in bundled payments is a result of a proactive, dedicated team implementing small and large changes in phases over time. Each of the groups have opportunities to improve their bundled payment strategy. The opportunity for our bundled payment community to gather and share best practices and overcome common challenges was invaluable.
Contact us at SignatureCareManagement.com for more information or assistance in working with bundled payments.