Written by: William Vanderveer, CEO of Redefine Management
With value-based care becoming more of a priority in Healthcare throughout the US, it’s time for more physician practices to begin adopting the framework to realize its benefits, especially for those providing musculoskeletal care.
According to the National Center for Health Statistics, 54% of the population reported chronic musculoskeletal conditions in 2020. Affecting the bones, joints, and muscles, musculoskeletal conditions can be painful and debilitating, affecting a patient’s ability to work, activity levels, and quality of life. Due to the cost of medical treatment and lost wages, musculoskeletal spending is rising quickly, totaling $200 billion annually. Spending continues to rise to keep up with increased utilization.
Additionally, unnecessary tests and procedures in all specialties of healthcare significantly increase costs, adding an estimated $765 billion annually, per the National Academy of Medicine. For example, data continued to support the idea that surgery to remove a disc herniation is more effective than non-surgical intervention; however, our data has found that 95% of patients with a herniated disc do not require surgery. Alternatively, sometimes the opposite is true, and non-surgical modalities are not necessary prior to surgery. Physicians can tell with specifics of an injury or condition that they will eventually need a surgical procedure to fix it, and that no amount of non-surgical care, like physical therapy or pain management, will avoid it. The goal of value-based care is to provide the right treatment, to the right patient, at the right time.
As a leader in multidisciplinary musculoskeletal services in New Jersey, Redefine Healthcare is focused on bringing the value-based care model to the state. Our practice offerings include neurosurgery, orthopedics, pain management, physical therapy, occupational therapy, chiropractic, psychiatry, lab services, and ambulatory surgery centers. Our business model is based upon building partnerships with industry-leading physician practices to accelerate the value through organic patient growth. This, combined with operational and clinical efficiencies, result in better quality, lower-cost care.
How do value-based care programs succeed? One of the biggest goals of our program is to eliminate inefficiencies along the pathway of care. By pre-defining care pathways, we eliminate the waste of resources that may come with changing the course of treatment later on in a patient’s journey of care. Similarly, implementing standardized protocols for surgical and non-surgical treatments eliminates unnecessary utilization and variation. We will leverage certain healthcare providers to improve efficiency of clinical interface. For example, a surgeons’ time, expertise, and ability are used most efficiently when only seeing pre-screened surgical candidates. Other providers like a nurse practitioner may be more well-suited to perform the initial consultation of a patient.
Because Redefine Healthcare is a multidisciplinary practice, we have the ability to provide seamless care transitions since we are operating within somewhat of a “controlled” network. We can build custom programs for long-term conditions that may require several types of specialty care and management. The technology we incorporate into our practice operations provides visibility across this whole continuum of care: a centralized data warehouse, 360-degree view of the patient, artificial intelligence for pattern matching, and an efficient process for obtaining the appropriate diagnosis.
Value-based programs are the future of healthcare and have the ability to reduce spending and increase quality of care. By being an early adopter of the value-based framework, Redefine Healthcare hopes to advance musculoskeletal treatment in New Jersey, with other physician practices to follow.
