Last month, CMS announced that the SHFFT (Surgical Hip/Femur Fracture Treatment) program will be mandatory for facilities and surgeons participating in CJR. The fundamentals of striving for excellence in care and value in CJR are intact, it’s just applying the model to another indication. Just like total joints, participating providers and facilities will be reimbursed with a bundled payment for the entire episode of care for hip fracture patients. Meet clinical and cost metrics, you are rewarded with additional reimbursement. Fail, you must pay. It aims to correct one of the root causes for why healthcare costs have spun out of control – lack of alignment between surgeons and hospitals who jointly provide care. The program starts July, 2017.
We tried to avoid a blog involving politics, but for obvious reasons, it’s almost impossible in the world of healthcare. The fact of the matter is that big change seems to be on the horizon for US Healthcare. Will ACA be completely repealed or will key parts remain? Will the VA be privatized or revamped and remain a government organization? The whole thing has us thinking a lot and we’ve come to the conclusion that what works is staying. We tweeted an article a few days ago on the success CJR has had: better outcomes, less revisions, and an overall 20% drop in the cost of the episode of care. Remove the program and you are asking all Americans to open their wallets more than last year to care for CMS beneficiaries – not exactly a mantra America bought on election night. Strip away party affiliations and ideologies and the fundamental problem we are trying to fix in US Healthcare still exists – a lack of physician and facility alignment. Programs like CJR, and subsequently, SHFFT, address these problems and with proven success, there’s no way incumbency will throw this head start to the wayside.
Value, outcomes and patient experience are the rules of the new game in healthcare, and that holds true regardless of which party is at the helm. Programs with proven success in driving down the cost of care while creating better outcomes are here for good. Whether you think America needs to be made great again, or you think it’s never fallen from greatness, it’s undeniable that efforts our country makes to play the new game well for the benefit of all of us is the new normal and we’re all better off for it. Now get back to work, or “You’re Fired!”.