right from the start and compare
how it would differ if it allowed
for more flexibility in designating
who could initiate the episode of
care. They must prepare to pres-
ent that information to the next
Administration and Congress at
the first available opportunity.
There will be chances to make
course corrections based on hard
data.
Healthcare leaders must also compare the care patients receive in
inpatient and outpatient facilities. How are they managed pre- and
post-surgery? What is the effective time to recovery? Those are
incredibly important issues. If outpatient facilities that provide a
lower price point are more effective at managing patients and have
better demonstrated outcomes, but are specifically excluded from
Medicare reimbursement, evidence of how well same-day joint
replacements work in the private sector needs to be shared.
The total cost of episodes from the payer's perspective must be
known so there can be serious discussions about how to modify the
current program and, more broadly, why CMS shouldn't continue to
exclude outpatient providers who match or exceed total joint care
provided at the acute care facilities.
OSM
Mr. de Brantes (francois.debrantes@hci3.org) is the executive director of
Health Care Incentives Improvement Institute in Newtown, Conn.
J A N U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 7
Where hospitals send
patients to recover
following surgery
ultimately causes
the variations seen
in the total cost of
joint replacements.
