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Cost-Effective MSK Care Platform Supports Quality Outcomes

In September 2022, Dr. Ahmed Siddiqi–TJA surgeon at the Orthopaedic Institute Brielle Orthopaedics–adopted the Force Therapeutics patient engagement platform at his New Jersey practice. Aiming to enable high-quality cost-effective remote MSK care throughout the episode of care, Dr. Siddiqi employed features including communication tools, PROs collection, and remote therapeutic monitoring (RTM), resulting in improved patient engagement, function, and satisfaction.

  • Challenge: Dr. Siddiqi evaluated multiple solutions to enable remote MSK care while decreasing overall costs and achieving a positive ROI. He sought a platform with strong communication tools, including direct messaging and telehealth capabilities, PROMs collection with high patient engagement and retroactive onboarding, high-quality patient education materials, an MSK-focused service line, and RTM enablement.
  • Solution: Utilizing a remote care management platform like Force Therapeutics can result in improved care team efficiency, increased profits, and high-quality care. The Force platform is a comprehensive solution with a proven ROI and economic impact. Integrating Force can decrease readmissions and costly events, streamline reimbursements, increase patient volumes, scale workflows through enhanced care team efficiency, and drive significant cost savings while delivering quality care.
  • Use Case: Dr. Siddiqi onboarded his TJA patients retroactively from September 2021 to August 2022, enabling him to collect PROMs and maintain communication beyond the standard episode of care. Pre- and post-operatively, the platform delivered timely virtual education, PT, and care instructions while monitoring patient progress and compliance through population health management tools. The platform also maintained direct communication to avoid costly events and collect PROMs with high engagement, and also identified and enrolled eligible RTM patients and utilized the RTM module to streamline billing and record active monitoring time.

Patient Engagement

With 467 patients in 2022, Dr. Siddiqi achieved strong connectivity and patient engagement outcomes, as shown below:

  • Opt-in rate: 90%
  • Average % exercise videos watched/exposed: 68%
  • Average % care instructions viewed/exposed: 67%
  • % patients with SMS notifications enabled: 79%
  • Messaging: average 15 messages per patient; maximum 153 messages per patient
  • Average video views: 33 preoperatively; 99 postoperatively

Patient Outcomes

Dr. Siddiqi also saw strong patient-reported outcomes (PROs). In particular, average 1-year KOOS JR. and HOOS JR. scores exceeded the substantial clinical benefit (SCB) thresholds used by the Centers for Medicare and Medicaid Services (CMS), compared to preop scores. In both knee and hip populations, PROMIS Global scores demonstrated a clear clinical improvement at 1-year versus preop, and patient-reported pain levels showed a distinct strong and distinct decline at 12 weeks post-operatively. Moreover, knee and hip patients reported 4.4 and 4.6 patient satisfaction levels, respectively, out of a total of 5.

Remote Therapeutic Monitoring (RTM)

In 2022, new CPT codes were introduced to support coverage of provider time actively spent monitoring patient-reported non-physiological data for MSK care. These codes are different from Remote Patient Monitoring codes and can be used by a broader range of providers. They also have specific nuances regarding patient eligibility, frequency, and provider requirements for each code. The ultimate purpose of these codes is to encourage regular monitoring of patient progress to incentivize more individualized care and reduce costs on the health system.

Dr. Siddiqi began implementing RTM at his practice in Q4 2022; having attempted billing for just 158 of his patients, Dr. Siddiqi received reimbursement of nearly $34,000 over 5 months, from both Medicare and commercial insurers in New Jersey. A substantial portion of his RTM claims are pending, meaning actual reimbursement for that same patient population will be much higher once all claims are processed. Dr. Siddiqi estimates that his practice will generate approximately $100,000 by the end of 2023 from RTM alone.

Saving & Scaling

Through the use of the cost-effective remote MSK care platform Force Therapeutics, Dr. Siddiqi has identified $2m-$3m in potential annual savings, split across his own practice and both public and commercial payers; these savings stem from the use of remote capabilities such as form submission, direct messaging, virtual physical therapy, and telehealth check-ins, as well as from the impacts of using high-quality remote care, such as reduced adverse events.

Beyond potential dollar savings to providers, patients, and payers, the implementation of Force at Dr. Siddiqi’s practice has led to substantial efficiencies to workflows, allowing more effective scaling of annual patient volumes. In addition to empowering providers to deliver high-quality care for more patients and bolstering overall annual revenues, digitally supported care scaling also enables more stable operating costs and keeps patients and payers satisfied. Dr. Siddiqi’s practice is projecting nearly 600 patients in 2023, representing year-over-year growth of almost 30%.

Key Considerations

While some health systems may opt for an organization-wide solution, this may not maximize clinical utility or ROI. Likewise, PROMs-only solutions, which only collect patient-reported data, may be less costly but also ultimately offer less clinical value. A full-suite cost-effective remote MSK care solution will typically be less costly than an organization-wide solution, but more costly than a PROMs-only solution. However, due to maximized patient engagement and clinical value through such solutions, higher clinical value and ROI can be achieved when implemented thoughtfully. To choose the right solution, providers should look for a proven track record of exceptional patient engagement and a validated ROI within MSK care. This is because, without highly engaged patients, it is not possible to achieve a strong clinical impact, subsequently degrading your ROI.

Bottom Line

Full buy-in from your care team and patients is crucial for high engagement, and seamless integration into existing EMRs/EHRs is critical. Effective digital communication is essential for reducing call volumes, avoiding ER visits and complications, and improving patients' overall experience. Monitoring patient outcomes is necessary to ensure standardized patient outcomes, and RTM can be a powerful tool for more targeted care and standardized outcomes across patient populations. The impacts of cost-effective remote MSK care can be achieved only through strong patient engagement, and better, smarter, and digitally enabled care can reduce the national cost burden while improving patients' lives.

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