Roundtable: Eliminating the Middle Man in Orthopedic Product Acquisition

Last month, Implant Partners and TRG Health Care Solutions, a healthcare consulting firm, led a focus group on how to take control of the OR as part of the Becker’s Hospital Review Annual Meeting. The event was a great success, drawing hospital leaders and payers from across the nation who shared their views on the challenges and processes for gaining hospital-physician alignment.

Among the key points shared was the viability of setting up new payment models, such as gainsharing. Properly structured arrangements like gainsharing increase efficiency, reduce waste and improve profitability. And, with the right partner, a gainsharing program can be implemented in as little as 90 days.

Implant Partners and TRG shared several key components of gainsharing, as outlined by the OIG, that would protect hospitals and health systems from sanctions related to civil monetary penalties and the Anti-Kickback Statute. Key facts of this proposed arrangement include:
• Cap on fixed payments for services and related bonus;
• Tiered bonus structure not based on patient volume;
• Inclusion of satisfaction and patient quality measures balanced with payments tied to cost efficiencies;
• Use of outside parties for benchmarking and annual audit;
• Strong governance and reporting provisions within the hospital;
• Patient disclosure of agreement; and
• Compensation based on fair market value.

Shared savings models, such as bundled payments and gainsharing, enable all hospitals, payers and providers to work toward the same quality and cost goals. But in order to implement programs that facilitate change, hospitals also need knowledgeable and trusted advisors with the right tools and experience to help align clinical and business goals.

Want to learn more about the round table? Check out this recap article from Becker’s Hospital Review to learn more.