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because of the relationships needed between the surgeon and patients, who
have to feel confident that they're not only going to have a great outcome, but
that they're also going to have a comfortable and enjoyable experience, says
Nicholas J. Violante, DO. Be sure to iron out all the clinical details in a con-
trolled hospital setting before bringing cases to a surgery center setting. Once all
of the tools and protocols are in place, the surgery should be the easiest part.
• Prudent patient selection. Interest is growing and case volume has the
potential to increase, but that's a double-edged sword, says Dr. Stoeckl. Some of
the patients who want same-day joint replacement aren't candidates to have it
done. Approximately 15% of the patients he sees in clinic can have their proce-
dures done in the surgery center. You must be honest with patients who don't
qualify for having the procedure done in the same-day setting. A lot of boxes
need to be checked, and the surgeon needs to trust his gut.
• On getting paid. You need to assess payers in your market to determine if
they're ready to reimburse for total joints, says David Uba, MBA. Are they will-
ing to look at different methodologies? Are they comfortable with bundled pay-
ments? Can they administer bundled payments? Do they have analytical capabil-
ities that let them look at the cost of an episode of care and evaluate whether
what you're proposing to them is going to save them money, improve outcomes
and increase patient satisfaction?
OSM
