Johnson & Johnson Medical Devices Companies have announced its Orthopaedic Episode of Care Approach,* a comprehensive offering under the CareAdvantage capabilities, designed to help health systems and surgeons reduce costs and increase quality to drive improvements in orthopedic care and achieve the goals of value-based alternative care models. These models include the Centers for Medicare & Medicaid Services (CMS) Comprehensive Care for Joint Replacement (CJR) and the Surgical Hip and Femur Fracture Treatment (SHFFT) Models, under which orthopedic surgeons will be measured by Medicare on performance during the episode.
 
The offer draws on the unique capabilities of CareAdvantage from the Johnson & Johnson Medical Devices Companies, and provides a holistic approach to help providers offer better care. The Orthopaedic Episode of Care offer includes a new Shared Performance Agreement option designed to help reduce average episodic hip and knee implant patient costs.
 
There is an increasing focus on alternative payment models for orthopedic episodes of care. These models advance the goal of improving quality for Medicare beneficiaries and encourage collaboration throughout the full episode of care. CJR is a bundled payment arrangement for 67 U.S. markets for total hip or total knee replacement surgeries, which are among the most common surgeries covered by Medicare. The SHFFT model is also a bundled payment arrangement for hospitals and clinicians that provides care to patients who receive surgery after a hip fracture. Approximately 258,000 people aged 65 and older were admitted for hip fractures in 2010.¹ The estimated lifetime cost for all hip fractures in a single year is $20 billion.²
 
"Reducing costs, enhancing patient outcomes and increasing patient satisfaction are core to our focus on helping health systems committed to delivering value-based care across a variety of therapeutic settings. In orthopaedics, where episode of care models are changing how reimbursement is aligned to performance, delivering on the Triple Aim is particularly important," said Tim Schmid, chief strategic customer officer at Johnson & Johnson Medical Devices Companies. "Our Orthopaedic Episode of Care Approach builds on our breadth of experience in hip and knee replacements and hip fracture episodes of care, to help hospitals and surgeons realize better clinical and economic outcomes in these orthopedic procedures. Providers now have an invested partner to help manage episodic costs and drive better, more predictable outcomes for patients."
 
The Orthopaedic Episode of Care Approach includes the following CareAdvantage capabilities:

• Digital Care Navigation (CareSense, provided by MedTrak Inc., a third-party vendor), a cloud-based platform designed to help hospitals engage, educate, communicate with and guide patients through their episode of care.
• PATIENT ATHLETE, a program designed to help patients prepare for and recover from orthopedic surgery, using science-based principles from the Johnson & Johnson Human Performance Institute.
• Episode Performance Improvement (supported by third-party vendor Value Stream Partners), to help deliver orthopedic bundle administration support, including episode data and analytics.
• Infection Risk Management, providing evidence-based practices aimed to address risk factors for bloodstream infections (BSIs) and surgical site infections (SSIs), including patient resources to facilitate optimal wound healing post-surgery.
• Hip Fracture Care, an evidence-based care improvement program to help standardize care and reduce variability in a complex and costly geriatric patient population that facilitates interdisciplinary care and clinical standardization to reduce variation, improve outcomes and optimize care.

 
To help decrease knee and hip episodic costs for health systems, the Johnson & Johnson Medical Devices Companies are offering a Shared Performance Agreement option.** This includes the application of Digital Care Navigation and PATIENT ATHLETE capabilities, and will cover a portion of the target savings if they are not achieved. This is part of a long-term commitment to supporting health systems' performance that includes other offerings such as support for knee, hip and shoulder implants in case of revision within 90 days.
 
"As the market adopts more and more alternate payment models like orthopaedic bundled payment programs, improving patient outcomes while driving costs down is vital to maintaining Willis-Knighton's status as one of the country's leading health systems," said Chris Mangin, physical medicine director at Willis-Knighton Health System. "Willis-Knighton is pleased to partner with the Johnson & Johnson Medical Devices Companies. We have realized value in many arenas because they understand our unique needs and help in implementing tailored solutions that seek to put the patient first and improve efficiencies across an entire episode of care."
 
Johnson & Johnson Health Care Systems Inc. provides contracting, supply chain and business services to commercial customers and intermediary partners of U.S.-based Johnson & Johnson companies, including hospital systems, health plans, distributors, wholesalers and the U.S. government.
 
*CareAdvantage from the Johnson & Johnson Medical Devices Companies and the Orthopaedic Episode of Care Approach are offered through Johnson & Johnson Healthcare Systems Inc.
 
The Johnson & Johnson Medical Devices Companies comprise the surgery, orthopaedics, and cardiovascular businesses within Johnson & Johnson's Medical Devices segment.
 
** Contracted through Johnson & Johnson Healthcare Systems Inc. or DePuy Synthes Sales Inc.

References:                                                       

1. Smith et al. Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc. 2015 Oct;63(10):2029-35. 

2. Smith et al. Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc. 2015 Oct;63(10):2029-35.