The Inflated Cost of Joint Replacements in the U.S.

Posted by Amy Babington on Apr 23, 2014 6:33:28 PM

According to the International Federation of Health Plans 2013 Comparative Price Report, the average price for a knee replacement in 2013 in the United States was $25,398. This includes a range from the 25th percentile of $16,298 to the 95th percentile of up to $51,128. When compared to other countries included in the report, the amount is an outlier and demonstrates the tremendous cost of health care in the United States. 

The gap in price is similar when looking at hip replacement costs in the United States:

  • $26,489 on average;
  • $16,622 in the 25th percentile and;
  • $53,644 in the 95th percentile.
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Topics: healthcare costs, post-acute care, knee replacement, joint replacement, hip replacement

The Prescription for Home Health: Innovation

Posted by Bill Porter on Apr 17, 2014 11:34:39 AM

January 1, 2014 marked the start of many proposed Medicare cuts to Home Health Agencies’ reimbursement.  The plan is a 14% reduction over the next four years. Not surprisingly, there has been uproar from these organizations, who point to the tremendous value they create for the US Health Care market.

Some experts believe Home Health has actually saved the US $2.8B over the last three years by enabling shorter stays in Hospitals / SNFs and reduced readmissions.  The average Home Health visit is $145 versus the average $373 per night in a Skilled Nursing Facility (SNF) or $1,805 in a Hospital. Not only is it much cheaper, patients enjoy the experience.  After all, what’s better than being in the comfort of one’s home – 80% of Home Health patients rated their experience as a 9 or 10 (out of 10).

Home Health’s ability to unlock value is fairly clear, however, like most everything else in US Health Care it is over-utilized and inefficient.  As we at FORCE Therapeutics have written about, US Health Care has reached a point where costs absolutely MUST be reduced.  Because we have come to the brink, no one is safe from cuts (save for Primary Care Physicians, who there are not enough of and will probably see steadily increased pay and opportunity). 

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Topics: innovation, Accountable Care Organizations, ACA, BPCI, Skilled Nursing Facility, Home Health,

How Digital Health Care Is Changing Patient Behavior

Posted by Amy Babington on Apr 11, 2014 2:42:59 PM

In our mission to help people recover from musculoskeletal injuries, we’re constantly learning from peers who are also reshaping the way people engage and take control of their health care needs to improve outcomes. In the case of Omada Health, their Prevent program helps people with prediabetes combat a major chronic disease risk by helping people make lifestyle changes.

We particularly admire Omada’s focus on behavior change. According to the company, behavior change outcomes require several influential factors beyond just a process that follows validated protocols including: 

  • positive social support from peers
  • guidance from a trusted health professional
  • easy-to-digest information
  • a carefully orchestrated timeline
  • rich, dynamic media 

At FORCE, we believe a similar framework applies to the online video-based exercises programs we’ve created to bring rehab to the home. With exercises prescribed by their surgeon, patients on our platform receive oversight from their care team, and are held accountable to record their compliance to the program.

For prediabetes care and musculoskeletal care alike, giving the patients the digital tools, knowledge, and support they need enables the behavior changes to combat their health care needs.


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Topics: patient engagement, digital health, behavioral changes

Bundled Care: Top of Mind for Thought Leaders in Healthcare

Posted by Amy Babington on Apr 4, 2014 5:18:10 PM

The concept of bundled care is gaining awareness in the changing landscape of U.S. healthcare. By offering a single fee for an episode of care, “bundled care” or “bundled payments” is a dramatic change from the traditional fee-for-service (FFS) model where each service (office visit, X-ray, surgery, skilled nursing facility) is paid for separately and quantity of care is incentivized over the quality of care. 

As a way to alter the incentives, Medicare's Bundled Payment for Care Improvement Program (BPCI) offers hospitals and post-acute care providers the opportunity and incentive to work together and be rewarded for efficiency, quality, and coordination of care. Under the program, CMS compensates participating providers through a single payment for providing a set of services for an episode of care to Medicare patients. With BPCI models 2,3, and 4 announced on 2/18/14, post-acute care providers can apply by 4/18/14 to receive bundled payments for up to 48 different clinical condition episodes that will end 30, 60, or 90 days after hospital discharge including major joint replacement of the lower extremity (knee & hip replacements) as well as stroke care, and coronary bypass surgery to name a few. With CMS setting the tone, many organizations are poised to explore bundled payment options. 

In a recent Becker’s Hospital Review article, Booz & Co. cites their recent thought pieces on Bundled Healthcare, to help hospital executives as they explore bundled models.  

The article highlights four factors of bundled offerings that hospital executives should consider: 

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The Shift to Value-Based Care: Takeaways from a recent inpatient study

Posted by Amy Babington on Mar 26, 2014 1:01:00 PM

A recent study by Kaufman Hall, Where Have All the Inpatients Gone? A Regional Study with National Implicationsexplores the progress being made as the U.S. healthcare system moves from fee-for-service to a value-based care model. The study evaluates hospitals and physicians in the Chicagoland area capturing inpatient and outpatient data across a population of over 8.5M people.

The shift is identified by the fact that stakeholders “are working to reshape care delivery and lower costs while improving quality, outcomes, and access for consumers.” At FORCE Therapeutics we are participating in the shift by reshaping the way patients recover from musculoskeletal injuries by moving recovery to the home setting.  


We identified a few interesting takeaways from the study that corroborate the shift to value-based care:

  • Inpatient utilization rates are declining:
    • The inpatient utilization rate per 1,000 in the greater Chicago area declined in almost every hospital service line from 2010-2012
  • Prevalence of Medicare patients in the shift:
    • In the service lines for Orthopedics and Spines/Backs, inpatient utilization rates declined by 7% and 11% respectively from 2010-2012 for the 75+ age group – indicating that Medicare patients particularly are experiencing the shift from inpatient care to outpatient care as fundamental changes in healthcare are implementented
  • ACO's contributing to shorter hospital stays:
    • LOS (Length of Stay) for ACSA (Ambulatory Care Sensitive Admissions) utilization dropped by 3.9% using an ACO (Accountable Care Organization) model vs. the traditional care model (-2.4%)

Kaufman Hall’s inpatient/outpatient data suggest the shift to value-based care is well underway by transferring care out of the hospital and instead coordinating care to the community and home settings. As the authors point out, “the days of comfort with fee-for-service as the predictive revenue model are over.” At FORCE, we are taking an active role in the shift to value-based care to help patients recover in their most comfortable setting: the home.  




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Topics: value-based care, musculoskeletal, Accountable Care Organizations, Medicare, ACOs, fee-for-service

Key insights from OrthoForum 2014

Posted by Bronwyn Spira on Mar 13, 2014 5:43:38 PM

Michael Sheerin, SVP of Operations at the Rothman Institute of Orthopaedics gave the keynote address at OrthoForum in Dallas last week. He presented an overview and focus on how The Rothman Institute is modifying their rehab delivery to meet Episode of Care needs. He also discussed the use of patient navigators to triage multiple patients post-discharge and to identify those at-risk for readmission post total joint replacement. Mike West, CEO of the Rothman Institute, is innovating ways to manage the huge variability in post-acute rehab costs, mostly driven by primary discharge setting. The utimate payback for patients is expedited recovery and return to work. 


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Joint Replacement Revolution: the soaring incidence of TKA

Posted by Bronwyn Spira on Feb 19, 2014 11:43:00 AM

Total Knee Replacement or Arthroplasty (TKA) has come a long way since its inception in 1968. Some might argue that TKA is one of the most successful surgical procedures performed today. Surgeons have access to personalized custom-fit implants made of more durable materials (oxidized zirconium or crosslinked polyethylene) and often employ robotic and navigational technology to insure precision during TKA procedures.

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Topics: Evidence-based practice, Exercise videos, digital health, healthcare costs, health tech, doctor recommended apps

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