Medtronic Launches Outcome-Oriented Orthopedic Model

Medtronic plc has announced the launch of Medtronic Orthopedic Solutions, a comprehensive offering for total joint replacement episodes of care that it says is designed to drive clinical and economic outcomes.


A combination of factors has driven the development of Medtronic Orthopedic Solutions, notably the high costs associated with hip and knee replacements, along with the growing emphasis on improving patient outcomes. The program specifically addresses the Centers for Medicare & Medicaid Services (CMS) recently implemented Comprehensive Care for Joint Replacement (CJR) model – a bundled payment initiative that holds approximately 800 hospitals accountable for the quality of care they deliver for hip and knee replacements.

So how does it work? The concept is to offer a consultative program designed to help providers meet CJR requirements by reducing system costs while addressing patient satisfaction and outcomes; it will support providers from pre-surgical planning through the 90th day post discharge. In addition, Medtronic is launching a value-based total knee arthroplasty system at the American Association of Knee and Hip Surgeons Annual Meeting (AAKHS), which is currently taking place in Dallas. The Total Knee Arthroplasty System will be widely available in the first half of 2017.

CMS targeted hip and knee replacements because they are the most commonly performed inpatient procedures for Medicare patients and often entail lengthy recoveries. More than 400,000 procedures took place in 2014, with hospital costs of $7 billion. The key factor is the significant variance in complication rates and overall costs across hospitals and geographies. CJR aims to improve patient care by encouraging hospitals, physicians, and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery, and financially rewarding hospitals for providing cost effective and high quality care, while levying penalties for poor outcomes.

Developed in partnership with leading physicians who have successfully implemented bundled payment programs, Medtronic Orthopedic Solutions is designed to create tailored solutions that improve quality and patient experience, while lowering costs across the care continuum. These solutions encompass Care Pathways, Patient Monitoring (with Medtronic Care Management Services), the Medtronic Total Knee Arthroplasty System, and Bleeding Control (with the Aquamantys System – combines radiofrequency energy and saline to provide hemostatic sealing of soft tissue and bone).

Company comments

“Medtronic is here to help speed the adoption of value-based healthcare in orthopedics by helping hospitals drive down costs while keeping outcomes top of mind,” said Geoff Martha, EVP and president of Medtronic Restorative Therapies Group. “Our technological and operational efficiency know-how – along with our insight into the various points along the care continuum – helps us develop effective solutions, tailored to client needs. And we back this up by sharing potential savings with our customer, which means we get paid if our program is successful in reducing episode costs for customers. This is about more than just offering implants or individual technologies and services; it’s about partnering with all stakeholders throughout the entire episode of care to enable patient-centered care at the best value.”

Physician comments

“CJR represents a completely new approach to healthcare with bundled payments rewarding the best outcomes, which will ultimately improve patient care,” said Joseph A. Bosco, M.D., an orthopedic surgeon in New York, NY. “But to succeed, hospitals need new solutions to streamline the delivery of care and evaluate outcomes. The way CJR works, target episode prices will be set in comparison to large regions, so there will be a premium to figuring things out very quickly.”

“Quality, lower-cost implants are a very attractive option as we seek to improve patient’s lives while also providing value-driven healthcare,” said Richard Scott, M.D., professor of Orthopedic Surgery, Emeritus, at Harvard Medical School and formerly chief of Joint Arthroplasty at The New England Baptist Hospital and co-designer of Medtronic’s total knee arthroplasty system. “We designed Medtronic’s total knee arthroplasty system to be simple, versatile and intuitive without unnecessary complexity and inventory. The goal is to benefit everyone – first and foremost the patients, but also the surgeons, hospitals and payers who are providing their care.”

Medtronic intends to report results from the Medtronic Orthopedic Solutions business as part of its Spine division within the Restorative Therapies Group.

Source: Medtronic, plc

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