Is Musculoskeletal Spend Sustainable?

Beckers Hospital Review recently published an article summarizing a webinar back in October with HOPC (Healthcare Outcomes Performance Company), discussing the margin between musculosketeal spend and successful patient outcomes. Here is a brief overview of this hot topic in Orthopaedic care:

The healthcare landscape is witnessing a rapid increase in musculoskeletal healthcare costs, reaching a staggering 20% of the U.S. gross domestic product in 2020. However, merely pouring funds into this space doesn't necessarily translate to improved value.

1. The Escalating Costs: Musculoskeletal healthcare spending is on an unsustainable rise, with an annual inflation rate of 10-20%. In 2020, 54% of the U.S. population reported chronic musculoskeletal conditions. These statistics underscore the urgent need for effective strategies to address this growing concern.

2. Reevaluating Cost-Saving Models: The traditional episode-bundled payment programs, while designed to cut costs, often fall short in incentivizing better value. Trigger events for surgeries are the norm, but the impact is limited, as savings potential post-surgery represents only a small portion (10%) of overall care costs. The article advocates for a paradigm shift towards better alignment strategies for sustainable value-based care.

3. Data Management and Risk Mitigation: A comprehensive platform is essential to manage risk effectively. This involves ingesting data, understanding care delivery, and developing action plans based on best practices. Care management programs that optimize patients before surgery and during recovery play a crucial role in reducing costs. The importance of data analytics in tracking performance and identifying trends cannot be overstated.

4. Real-time Reporting for Alignment: Achieving alignment among all stakeholders is vital. Real-time, anytime reporting ensures that clinicians and hospital systems are on the same page. Standardization of care order sets, policies, procedures, and clinical pathways based on peer-reviewed data is recommended. Automated dashboards on clinicians' devices can significantly contribute to keeping them updated on performance data.

5. Success of Value-Based Programs: A notable success story comes from the collaboration between Healthcare Outcomes Performance Company and a major payer in Phoenix. Together, they launched a clinically integrated network that, within two years, achieved a deflationary musculoskeletal care spend rate. This success serves as a beacon, showcasing the potential of value-based programs in curbing future healthcare spending.

In the face of rising musculoskeletal healthcare costs, healthcare systems must adopt strategic approaches that go beyond traditional cost-cutting measures. Embracing value-based programs, effective data management, and real-time reporting are crucial steps towards not only controlling costs but also improving patient outcomes.

Read more about it from the direct source: here.