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Alignment between medical device companies, hospitals may lead to success in CJR
When hospitals, other health care providers closely coordinate care, patients experience better outcomes.
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To succeed in the Comprehensive Care for Joint Replacement model, alignment should be established between medical device companies, hospitals and physicians around common practices and devices to lower cost, improve outcome and increase patient satisfaction.
“This is an opportunity for all stakeholders to come together and truly identify best practices that deliver the best outcomes at the lowest cost, but it is easier said than done,” Randy Kilburn, vice president of customer marketing and solutions for Johnson & Johnson Medical Device, told Orthopedics Today. “Where we have seen best in class in the market today and thriving in a bundled payment environment under these episodes of care is where that alignment starts at the top, and is driven through the organization.”
Who CJR benefits
If alignment is achieved, all of those involved in an episode of care have the potential to benefit through the Comprehensive Care for Joint Replacement model (CJR).
“Medicare beneficiaries, taxpayers, hospitals, physicians and post-acute care providers could all gain from the successful implementation of the CJR model,” a CMS spokesperson said. “By improving care coordination throughout the episode, unnecessary care can be reduced and quality outcomes improved.”
According to the CMS, patients may experience better outcomes, improved patient experience and fewer complications, including preventable readmissions, infections or prolonged rehabilitation and recovery, when hospitals and other health care providers work closely to coordinate care.
“From surgery to recovery, patients receive more comprehensive, coordinated care from their providers regarding the most appropriate options for their recovery and rehabilitative care,” a CMS spokesperson said.
A CMS spokesperson noted hospitals that achieve higher quality and greater efficiency through care redesign would receive incentives, and if partnered with physicians and post-acute care providers, hospitals would earn more as care coordination is improved.
“In this model, hospitals are paid for the outcomes that are important to patients,” a CMS spokesperson said. “Hospitals receive tools, such as spending and utilization data and sharing of best practices, to improve the effectiveness of care coordination.”
Similarly, providers are held accountable for the quality and cost of services while being incentivized to help patients get and stay well, according to the CMS. A CMS spokesperson noted a less-costly health care delivery system would benefit taxpayers.
However, Christine Maroulis, lead for health policy and reimbursement for the medical device sector of Johnson & Johnson, noted that the CJR is a different way of thinking for everyone involved which may cause problems for some institutions.
“In the short term, there will be pain, right?” Maroulis said. “But in the long term, providers should do well under this because goals and incentives are finally aligned for the entire episode of care for the patient.”
Individual solutions
Hospitals must focus on care redesign efforts to improve patient care, according to the CMS.
Kilburn noted Johnson & Johnson has created a separate team to focus on providing solutions to help health systems reduce costs and improve patient satisfaction. He stated their approach to providing solutions focuses on each health care system individually, unlike consulting firms that may follow a one-fits-all approach.
“Every health care system is in a different place as it relates to their episode of care management,” Kilburn said. “We believe that it is important that you understand each health care system’s needs and tailor solutions against that account.” – by Casey Tingle
- For more information:
- Randy Kilburn can be reached at DePuy Synthes Companies, 325 Paramount Dr., Raynham, MA 02767; email: jwerthe1@its.jnj.com.
- Christine Maroulis can be reached at DePuy Synthes Companies, 325 Paramount Dr., Raynham, MA 02767; email: jwerthe1@its.jnj.com.
Disclosures: Kilburn and Maroulis report they are employees of Johnson & Johnson.