orm_april-2024 - 24

OR Business
Adding value
Other developments demonstrate how
data can improve not only reimbursement
rates, but also the quality of surgical
care.
An example from the Mayo Clinic
dates back to 2016, when the organization's
Department of Neurologic Surgery
recognized the need to make better use
of clinical registries: database systems
that collect patient
information such
as comorbidities, surgical procedures,
postoperative complications, and patient-reported
outcomes via standardized
surveys. The department developed
a dashboard to transform this complex
data into actionable information for improving
quality, allowing for more favorable
contracts with payers, and aiding
patient-physician communication.
Completed in 2019, the pilot program
proved the database system's capabilities
to successfully track surgical
outcomes in disparate practice settings.
Another example, courtesy of Dr Reinhorn,
is the opioid reduction task force
at the Abdominal Core Health Quality
Collaborative (ACHQC). Along with
Clayton Petro, MD, a surgeon at the
Cleveland Clinic Foundation, Reinhorn
developed a tool to measure patient
risk factors for opioid use after surgery
as well as actual patient use of opioids
after surgery. As a result, the team can
gather opioid prescribing and patients'
opioid use data on thousands of surgical
procedures each year.
" We provide an annual report to each
surgeon about their patients' opioid use
during our quality improvement annual
summits, " Dr Reinhorn says. The team
also obtains surgeon feedback on tools
that can reduce opioid prescriptions.
" As a result of our initial intervention,
we developed three educational tools
that are provided to all surgeons participating
in the ACHQC, " he says.
As a result of their work, Dr Reinhorn
says there has been a reduction
in opioid prescribing for both inguinal
and umbilical hernia immediately after
24
OR Manager | April 2024
the intervention. " We then performed
additional research that demonstrated
surgeon prescription is an independent
factor contributing to opioid use after
surgery, " he adds.
Dr Reinhorn says efforts are ongoing
to educate the broader surgical community.
He hopes that their efforts can
help reduce the number of leftover opioids
that can be misused after surgery.
" As we strive to reduce opioid use, our
primary responsibility to our patients remains
constant: to improve their quality
of life, " he says.
VBC's data-driven future
Data collected in the service of transitioning
to VBC can yield valuable insight.
The effective use of data in reporting
not only shapes better reimbursement
outcomes for healthcare providers but
also influences their reputation and patient
recommendations.
However, achieving the stated goals
of the new model throughout the healthcare
sector will require higher-quality
data as well as broad adoption of better
tools to analyze it. Making VBC the
norm will also require standardization in
data reporting across different healthcare
systems.
Interoperable systems
that can seamlessly share patient data
will be essential to gauge the holistic
care a patient receives, especially when
multiple providers are involved.
Dr Reinhorn says higher adoption
rates of registries among surgeons is
an encouraging sign. This development
portends significant improvements to
quality and VBC that would be enhanced
even further by integration with the electronic
medical record. The federal government's
funding in this area also can
help reduce providers' efforts in getting
relevant data to improve quality. " When
providers have more time to listen to
their patients' needs, we provide better
care, " he says. ORM
-David Cotriss is a healthcare freelance
writer based in California.
www.ormanager.com
References
Ahmed, T. Fee-for-Service vs ValueBased
Care: The Differences You
Should Know. StreamLine Health.
September 20, 2023.
Byrd V, Verdier J. Collecting, Using,
and Reporting Medicaid Encounter
Data: A Primer for States. CMS. October
19, 2011.
Comprehensive Care for Joint Replacement
Model. CMS. April 1, 2016.
Condon A. 30K " unnecessary " spine
surgeries performed in 1st year of
pandemic: study. Becker's Spine
Review. May 23, 2022.
FY 2024 Hospital Inpatient Prospective
Payment System (IPPS) and LongTerm
Care Hospital Prospective Payment
System (LTCH PPS) Proposed
Rule - CMS-1785-P. CMS. 10 April
10, 2023.
Licholai, G. Combating The Growing
Rate Of Unnecessary Surgeries.
Forbes. August 2, 2023.
Patient Reported Outcome Measures.
American Academy of Orthopaedic
Surgeons. 2023.
Patient Reported Outcomes (PRO)
Data Collection and Submission:
Updates for Performance Years 6
- 8, Comprehensive Care for Joint
Replacement Model. CMS. August
18, 2021.
Rawal P, Quinton J, Hughes D,
Fowler F. The CMS Innovation
Center's Strategy to Support
High-quality Primary Care. CMS.
June 9, 2023.
Studio, Q.D. Opioid reduction initiative.
Abdominal Core Health Quality
Collaborative (ACHQC). Accessed
February 2024.
THA/TKA PRO-PM Methodology. QualityNet
(CMS). 2024.
Young J. The HOUSES Platform: Science
and Technology of Social
Determinants of Health (SDOH). OR
Business Management Conference.
February 2024.
https://streamlinehealth.net/fee-for-service-vs-value-based-care/ https://www.cms.gov/research-statistics-data-and-systems/computer-data-and-systems/medicaiddatasourcesgeninfo/downloads/max_pdq_task_x_encounterdataprimerforstates.pdf https://hbr.org/2021/09/lessons-from-the-mayo-clinic-on-using-data-to-improve-surgical-outcomes http://www.cms.gov/priorities/innovation/innovation-models/cjr https://www.beckersspine.com/spine/54371-30k-unnecessary-spine-surgeries-performed-in-1st-year-of-pandemic-study.html http://www.cms.gov/newsroom/fact-sheets/fy-2024-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective https://www.forbes.com/sites/greglicholai/2023/08/02/combating-the-growing-rate-of-unnecessary-surgeries/?sh=16522afc603c http://www.aaos.org/quality/research-resources/patient-reported-outcome-measures https://achqc.org/patients/opioid-reduction-initiative https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/Webinar%20PRO%20Data%20Submission%2008%2018%2021.pdf http://www.cms.gov/blog/cms-innovation-centers-strategy-support-high-quality-primary-care#:~:text=CMS%20has%20set%20a%20goal https://achqc.org/patients/opioid-reduction-initiative https://qualitynet.cms.gov/inpatient/measures/THA_TKA/methodology http://www.ormanager.com

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