Already a thought leader in the shift to value-based care, Regent Surgical Health has launched a bundled payment strategy within the ambulatory surgery center (ASC) marketplace. As part of the program, the company plans to begin managing episodes of care with a bundled payment approach in multiple markets.
“When a bundled payment opportunity comes in, surgeons will act as quarterback for the episode of care, making key decisions including where to do the procedure, what implants to use, and how to manage post-acute care,” says Chris Stine, Regent’s Director of Bundled Payments & Corporate Compliance Office. “All of these decisions will be coordinated by the group, essentially creating a narrow network of the very best surgeons in the area, contracting with quality ASCs regardless of ownership, to save money and improve patient care.”
The new program is a natural for Regent, an experienced management partner in the surgery center industry and a long-time champion for bundled payments as a strategy with the potential to help ASCs drive costs down and patient volumes up, while improving operating margins and quality of care.
“ASCs are at an advantage under bundled payment models because they are less expensive clinical settings compared to hospitals,” Regent CEO Chris Bishop told participants at the recent Becker’s Spine, Orthopedic and Pain Management-Driven ASC Conference, “but that doesn’t mean surgery centers shouldn’t pay close attention to where and what is driving spending, especially as organizations begin designing and engaging in bundled episodes. Post-operative care and unnecessary hospital readmissions also are great cost-saving opportunities.”
According to Stine, the program will help Regent hone the strategy and fine-tune procedures to manage risk and make the concept fully operational. “For example, in Reno, NV, we’ve syndicated a group of orthopedic and spine surgeons dedicated to managing episodes of care in this way. This will be among the first of many groups ready to develop protocols for care pathways. Ultimately, these groups will be able to share best practices and learn from each other. As technology and new techniques evolve to improve patient care, no longer will those improvements remain isolated, but will be shared across the Regent network,” he said.
And, as much as it’s a “learning lab” for providers seeking to proactively thrive under value-based care, the Regent program will provide valuable opportunities for payers to develop their strategies around bundled payments as well.
“With value-based care, we’re taking small steps and organizing our own bundled payment agreements,” says Bishop. “But sometimes what we think will work and what payers think are on two separate ends of the spectrum. It requires diligence, and if you have the right team in place, you’ll be able to move quickly, adapt, and thrive.”
The upside of success with bundled payments is significant, according to Stine and Bishop. In addition to cost savings and improved care, for ASCs that effectively manage expenses the concept has the potential to drive patient volume through partnerships with both payers and self-insured businesses.
For example, Stine cites an arrangement between a national home improvement chain and a multispecialty academic hospital whereby employees can choose a lower co-pay if they select the academic hospital for appropriate treatments as opposed to paying regular, fee-for-service rates if they have the procedure in their local community.
“Applying this kind of thinking, we can go to local businesses who self-insure and negotiate a bundled rate at any of the ASCs in the area,” he explained. “For the right patients, ASCs are ideally suited to do certain procedures, such as total joint replacement, less expensive and better. It’s hard to argue with saving money, cutting down on readmission, and improving patient satisfaction.”
With the foundation for success already built, Stine says Regent plans to aggressively expand this model to new markets throughout the U.S. Value based care is only going to expand, and Regent is poised to break new ground in the efficient and effective management of episodes of care.