In early November, Force Therapeutics once again attended the 2022 American Association of Hip and Knee Surgeons (AAHKS) annual meeting in Dallas, Texas.
In addition to providing us with an opportunity to connect with some of our client partners in person, we also value this event because it provides us with substantial insight into the state of the market and emerging trends in the hip and knee space.
Our team has assembled the following major takeaways from this year’s event:
The Future of Reimbursement
Evolving reimbursement around value and outcomes is pushing surgeons toward managing patients beyond the surgical episode alone, placing increased focus on non-operative/conservative care, remote patient/therapeutic monitoring, and pre-, peri-, and post-op patient management.
However, current procedure-based bundles are penalizing (rather than incentivizing) surgeon participation. While cost of care has dropped and quality has improved, surgeons are not receiving incentives that are proportionate to the savings accrued while participating in the Comprehensive Care for Joint Replacement (CJR) and Bundled Payments for Care Improvement Advanced (BPCI-A) models. One speaker noted:
“If current [declining] reimbursement trends continue, soon [surgeons] will be paid as much to see patients in office as [they] do to perform surgery.”
As a result, more leaders in the space are looking to take on full condition-based bundled payment models, which would allow them to effectively optimize care across all patient touchpoints, taking on increased financial risk but also benefiting from reductions in the cost of care and delivering superior outcomes. This indicates that fee-for-service models will increasingly become unprofitable and subsequently obsolete.
The Role of Technology
The big focus this year was on major surgical technologies such as robotics, AR/VR, and evolving surgical implants. Despite the emphasis on declining reimbursement and given that reimbursement is becoming increasingly dependent on data and outcomes, there was relatively little discussion surrounding the impact of patient-facing technologies.
This signals the budding nature of this space and the significant financial and time pressures surgeons have encountered in recent years. It also demonstrates some continued confusion and lack of clarity surrounding Centers of Medicaid and Medicare (CMS) reimbursement and guidelines on non-surgical and enabling digital technologies such as for non-operative care and remote therapeutic monitoring (RTM).
Meanwhile, the capacity to collect and report patient-reported outcome measures (PROMs) effectively continues to grow in importance in this space. Submissions to the American Joint Replacement Registry (AJRR), for example, have doubled over the last 4 years, and CJR PROM requirement thresholds for 2023 have been further raised—to a level many surgeons appear to believe is not achievable sustainably.
Instead of encouraging and incentivizing providers to double down on improving outcomes and data collection and reporting, the increasingly stringent thresholds set by CMS along with physician reimbursement contraction has left many feeling defeated and searching for alternatives to protect their revenue.
In addition, large retailers such as Amazon, CVS, and Walmart continue to penetrate the market by partnering with insurers and purchasing physician networks. These players are all aggressively data-driven entities, and providers that are not able to collect, report, and showcase their data and outcomes will find it increasingly challenging to engage with or compete against larger players in the space.
Ultimately, beyond surgical enablement, effective technology solutions should help surgeons reduce administrative burden, identify and manage patients at risk of poor outcomes, and enable longitudinal care at scale. Strategically positioned providers should be able to easily, consistently, and with little impact to clinical and administrative workflows, collect and report the necessary data to showcase outcomes, analyze cost, and identify opportunities for improvement.
Optimizing the patient experience is also central to improving outcomes and engagement, both peri-operatively and beyond the surgical episode. Leveraging the home, preventing patient leakage from the continuum of MSK care, and being able to focus care and resources where most needed—with the patient as the primary consumer—will help surgeons win in this environment.
Finding the right digital partner for your organization’s needs can not only increase patient satisfaction and expand your current revenue generation potential but will also ensure you are prepared in the long term as the reimbursement landscape continues to evolve toward data-driven outcomes-based models and as financial success becomes increasingly dependent on showcasing comprehensive high-quality care data.
Force Therapeutics is more than a PRO collection tool: our provider-prescribed platform, driven by our AI-powered Intelligent Care Plan, enables comprehensive data collection through a personalized patient experience, leading to strong and sustainable patient engagement, improved outcomes, optimized clinical workflows, and increased economic efficiency.
To see what Force Therapeutics can do beyond data collection, schedule a demo today.