Final installment on state-of-the-art Oregon Surgical Institute’s first year success

Rapid change in the healthcare industry is creating both challenges and opportunities for ambulatory surgery center (ASC) leaders, and the surgeon-partners at Oregon Surgical Institute (OSI) are no exception. Dr. Jim Ballard and Dr. Chris Nanson were instrumental in conceptualizing and creating OSI, which opened a little over a year ago with a focus on total joint replacement (TJR), spine, orthopedics, and pain management.

The center’s success in its first year was the topic of a recent question-and-answer discussion with the two leaders, prompting this look at the economics driving TJR to the ASC environment.

Question: What changes in healthcare today are creating challenges and/or opportunities for ASCs like OSI? Specifically for TJR?

“The biggest challenge is cost containment and the appropriate utilization of resources,” Dr. Nanson says, “and the biggest opportunity is to provide high quality care at lower cost than at a hospital.”

“But, the flipside is we have to be very diligent about delivering appropriate care at the appropriate time to appropriate patients so that we get good results. We need very high success rates and patient satisfaction rates because we are under a microscope. The opportunities presented by value-based care and bundled payments are huge for ASCs, but sometimes they aren’t readily embrace by hospitals. Hospitals today use orthopedics cases to pay for their nonprofitable service lines, so their response to outpatient often ranges from a cold shoulder to openly hostile. But it’s going to happen. The question is whether physicians will stay in the driver’s seat by proving we can manage this effectively, or whether we drop the ball. If we take the best care of patients and collect the data to prove we’re doing that, it’s a gigantic opportunity.”

Question: Based on your early successes at OSI, what do you predict for the future when it comes to outpatient TJR?

Answer: “The economics of healthcare are going to drive total joints to the outpatient arena,” Dr. Ballard predicts.

“There are three parts to this puzzle – payers, patients and providers – and total joint replacements offer advantage for all three of these groups. When you get synergy that benefits everybody, it becomes a no-brainer. Payers benefit because they get surgery for less money, and in an environment like ours, they get reproducible higher quality. That automatically sells it. Then for patients, it’s a better experience, they’re not in a hospital, the chance of problems is lower, and their aesthetic experience and kick off to recovery is automatically better. And for surgeons, it puts me in control of my environment. I’m an owner in a business enterprise that’s benefiting the other people that are involved as well. And it improves my quality of life. If I could be here every day, I would never go back to the hospital. But I can’t because there are people who need TJR who still have to be in a hospital.”

Question: What else is notable about your experience with TJR at OSI?

Answer: “It has been incredible, I couldn’t be happier,” says Dr. Nanson. “The team we have and the facility we’ve built is great and things are continuing to go well. But you have to be patient, because this does not happen overnight. Even when you think you’re setting a realistic timeline, it will probably take a little longer. The key is to make sure your patients’ interests trump all others and that’s what takes so long. It can be frustrating, but it’s paying off at OSI. The patients are ecstatic, and our effort is absolutely top tier.”

Dr. Ballard says, “For me personally, the benefit really is the unexplainable, deep satisfaction that we built a place that I know offers the best chance for a good outcome from a hip or knee replacement. And it’s satisfying to know that I’m providing that for people in a moment in time when the macroeconomics in healthcare are begging for an answer. Right now, we have too little money, and demand is too high for a super expensive procedure. The world needs a solution that provides better healthcare for less money. It’s deeply satisfying to know that we are meeting that market need. We are doing it right now.”

For more information about Regent’s partnerships in total joint replacement, click here.