November 19, 2019

Preparing for the Age of Outpatient Joints: Top Takeaways from AAHKS 2019

For more AAHKS highlights, check out our 2-minute video, including commentary from Drs. Greg Golladay, Chair of Orthopedics at VCU Health, and Jonathon Danoff, Orthopedic Surgeon at Northwell Health.

The AAHKS Annual Meeting is one of the most important forums for providing orthopedic surgeons and administrators with the latest and greatest research-based, state-of-the-art information on diagnosis, treatment options and overall management of hip and knee conditions. This year’s meeting in Dallas, Texas on November 7-10 was no exception. Force Therapeutics was honored to be a part of the engaging discussion and to have our research accepted for the 4th year in a row.

Among many of the stand-out topics was outpatient joints ‒ specifically, the new January 2020 CMS ruling removing THAs from the inpatient only (IPO) list, making total hip surgeries eligible for Medicare reimbursement in the hospital outpatient setting. Additionally, TKA will be added to the Ambulatory Surgery Centers (ASC) Covered Procedures List (CPL) in January 2020, along with knee mosaicplasty and three coronary intervention procedures.

Dr. James Huddleston of Stanford Health and Dr. Rich Iorio of Brigham and Women’s Hospital led an insightful health policy update session, sharing that Medicare reimbursement rates for inpatient procedures are continuing to decrease, making outpatient more attractive.

With more patient choices and incentives for site neutrality, how can hospitals best prepare themselves for the changes to come in TJA? Here’s what we learned:

Tip #1: Let the data drive decisions for the appropriate site of service

Just as no two patients are alike, not all procedures should be performed in an ASC. The real challenge lies in gaining a deeper understanding of which patient cases are more appropriate for inpatient vs. outpatient and how to manage each. Episode of care digital solutions can quickly and accurately help care teams analyze pre-operative risk level to determine if a patient is ready for SDD or outpatient procedures, streamline documentation, and provide a seamless framework to prepare patients for discharge.

Tip #2: When you engage the patient with a multidisciplinary approach, everybody wins

During Friday morning’s general session, anesthesiologist Dr. Mark Hamilton and orthopedic surgeon Dr. Charles DeCook from Northside Hospital spoke of a multidisciplinary approach to ensure optimal patient engagement across the episode of care so that the right patients can be identified for a shorter LOS. Essentially everyone that touches the patient from the time they are determined surgical, to the 90 days after surgery, should be aligned on the steps necessary to prepare the patient for SDD and outpatient surgery. Comprehensive episode of care technology can help bridge the communication gap between providers while continuously educating the patient on what to expect for SDD.

Tip #3: Don’t resist the shift: Long term gains are in store for hospitals who fully support the changing landscape for TJA

It’s not just physicians, patients and care teams who stand to benefit from this new era for outpatient joints. Our team had a chance to sit down with Dr. Greg Golladay, Chair of Orthopedics at VCU Health regarding how hospitals can optimize on the shift. While administrators will notice a short-term impact to their bottom line, more options for outpatient procedures open up new opportunities for mutually beneficial joint ventures with ASCs and bundled payment models ‒ ultimately empowering their physicians to make the best clinical decisions for patients while allowing their organization to remain competitive in the changing environment.