How to Prepare for Value-Based Care in Spine

We’re seeing it everywhere – the transition from fee-for-service to value-based care is here. With the early transition starting in joint replacement surgery via CJR hospitals, spine surgeons will likely be the next to experience this shift. In our opinion, the question is not how to survive value-based care, but rather how to thrive in the new ecosystem where value is grounded in data.

The great thing is that many of the lessons we’re learning with THA/TKA can be directly applied to Spine.

5 Tips to be Ready

1) Standardize your care pathways.

When all care pathways from pre-op to discharge are the same, the cost variance of caring for a patient decreases. Standardization also enables comparisons across departments and organizations.

2) Understand the cost of your implants.

Did you know that a spine fusion has dramatic variations in implant cost? It’s critical that surgeons have real-time, intraoperative access to the cost of implants.  Keeping a constant cost profile will be critical when bundled payments take effect.

3) Set pre-op indications for surgery & stick with them.

Put simply, your department should have a clear, consistent set of indications for surgery.  This decreases the variation between each treatment and ultimately leads to a more systematic approach to care. Better quality control makes the ability to compare outcomes possible.

4) Collect patient-reported outcomes.

Value-based care takes into consideration both costs and outcomes. Utilizing a system to collect patient-reported outcomes that is not disruptive to the clinic is key to building a scalable, long-term solution. It’s important to remember that if decreasing costs comes with decreased outcomes, you’re not providing value.

5) Analyze your cost and outcome data on a regular basis.

It’s great to collect cost data and patient-reported outcomes, however, if you’re not looking for the bright spots or problem areas, you won’t be able to improve the value of the care you provide.