Advertisement

American Association of Hip and Knee Surgeons

Advocacy, Education, Research

Orthopedic Service Line Optimization

by Geoff Walton, MHA and Heidi Graham, BSE, Stryker Performance Solutions

Healthcare reform, increased competition and a dynamic marketplace are driving healthcare organizations not just to change, but to do more, better, cheaper, and faster. While improving hospital operations has always been motivated by reduced internal costs and a better patient experience, incentives have never been broader or as aligned as in the current reform climate.

Orthopedics is a critical foundation for success in most health systems. It is essential strategically and financially, predictable in clinical patterns and outcomes, and measurable. Thus, it represents the ideal starting point to develop the foundational knowledge, experience and tools to optimize care and then leverage that optimized service line to pursue risk-based contracting opportunities. Organizations that proactively work to optimize their orthopedic service lines will be well positioned to maximize profitability in today’s fee-for-service and volume-based world while building the framework for success in tomorrow’s value-based care models.

At Stryker Performance Solutions we define top-performing service lines as having the following six characteristics – here’s why they are important:

Clinical Care Excellence
  • Standardizes care to reduce variation in outcomes and cost
  • Creates scalable processes and capabilities
  • Coordinates care across the continuum to optimize efficiency, quality and patient experience
  • Differentiates brand for payors and patients
Physician Alignment
  • Enhances collaboration to drive service line improvement
  • Drives volume and market share growth
  • Increases brand loyalty and commitment to excellent patient care
  • Establishes framework for value-based care
Service Line Analytics and Outcomes
  • Measures and reports key service line performance data
  • Turns data into actionable information
  • Drives process improvement efforts
  • Provides proof of service line differentiation for payors and patients
Market Positioning
  • Accounts for population trends
  • Identifies utilization rates
  • Maximizes market share
  • Builds and markets strong service line brand
  • Understands and differentiates from the competition
  • Positions organization to provide high value care across the continuum
Financial Performance
  • Measures key drivers of cost and revenue
  • Aligns clinical and financial performance
  • Identifies efficiency opportunities
  • Measures impact of process improvement initiatives
  • Justifies service line investments
  • Creates foundation for pursuit of value-based contracts
Value-Based Care Strategy
  • Provides business strategy for a  transition from FFS to value-based care payment models that is tailored to individual organizations and local market conditions
  • Outlines opportunities to iteratively take on risk
  • Enhances organization’s ability to remain profitable through Transition-to-Risk

About the Authors

Geoff Walton, MHA, Vice President, Alignment, Strategy and Reform, Stryker Performance Solutions

Geoff brings decades of experience in leading operations and strategic business development activities for hospitals and health systems to his role at Stryker Performance Solutions. As co-founder of Comprehensive Care Solutions—acquired by Stryker in 2012—Geoff and his team continue their work with physician organizations and health systems to align and turn reform into opportunity.

By utilizing new payment and delivery structures, including Accountable Care Organizations and bundled payments, he oversees a diverse range of professionals, including clinical, legal, actuarial, group practice and hospital management to serve a wide range of client needs. Geoff is a co-founder of Secured Independence (now Alere), a geriatric population health company. He has a Bachelor of Arts degree in Economics from the State University of New York at Albany and a Master of Health Administration degree from the University of North Carolina at Chapel Hill.

Heidi Graham, BSE, Senior Business Analyst, Alignment, Strategy and Reform, Stryker Performance Solutions

Heidi joined Stryker Performance Solutions from Stryker Instruments where she worked as a Senior Divisional Quality Engineer in post-market performance. In her past role, she regularly led cross functional teams in root cause determinations and technical assessments developing a strong data analysis and problem solving skill set.

In her role as Senior Business Analyst, Heidi works on various payment reform initiatives with clients around the country. Her projects include the Medicare Bundled Payment for Care Initiative, health system transition to risk for population management, as well as other initiatives like bundled payment in the commercial marketplace. Heidi is currently pursuing a Masters in Business Administration at the University of Chicago Booth School of Business.