First Choice Healthcare Solutions On Forefront of Value-Based Orthopaedic and Spine Care
By Space Coast Daily // March 9, 2017
BREVARD COUNTY, FLORIDA – According to the Centers for Medicare and Medicaid Services (CMS), hip and knee replacements are the most common inpatient surgery for Medicare beneficiaries and can require lengthy recovery and rehabilitation periods.
In 2014, there were more than one million total hip and total knee procedures performed in the U.S. – with nearly half covered under Medicare at a cost of more than $7 billion for hospitalizations alone. CMS’ average costs for a single episode of care involving hip and knee replacements ranges from $16,500 to $33,000 across geographic areas.
As part of a drive toward innovation and in its effort to support better and more cost-efficient care for patients undergoing hip and knee replacements, effective April 1, 2016 CMS implemented the Comprehensive Care for Joint Replacement Model (CJR), a five-year model that will test bundled payment and quality measurements for an episode of care associated with hip and knee replacements.
Outcomes-Based Payment Model
CJR is an outcomes-based payment model which mandates that care is considered, delivered and measured as an “episode,” not as a fragmented array of services. The CJR episode of care model is a major shift in how care is managed and reimbursed and is designed to encourage hospitals, physicians and post-acute care providers to work together to improve the quality and coordination of care from initial hospital admission through treatment and recovery spanning approximately 90 days.
This singular reimbursement change challenges care providers to re-think their entire approach to caring for hip and knee replacement patients.
Sixty-seven metropolitan statistical areas across the U.S. are now mandated to participate in the CJR system, including eight regions in the State of Florida: Gainesville, Miami-Fort Lauderdale-West Palm Beach, Naples-Immokalee-Marco Island, Orlando-Kissimmee-Sanford, Pensacola-Ferry Pass-Brent, Port St. Lucie, Sebastian-Vero Beach and Tampa-St. Petersburg-Clearwater.
Every year during the approximate five performance years of this program, CJR providers will receive separate episode target prices for total hip and knee replacements.
In accordance with the model, all providers and suppliers are paid under the usual payment system rules and procedures of the Medicare program for episode services throughout the year.
At the end of a model performance year, actual spending for the episode (total expenditures for related services under Medicare Parts A and B) is compared to the Medicare target episode price for the responsible provider.
Depending on the participant provider’s quality and episode spending performance, the provider may receive an additional payment from Medicare or be required to repay Medicare for a portion of the episode spending.
Early results of the program reveal that there has been a measurable drop in costs due to noted declines in patient length of stays in participating hospitals, discharges to skilled nursing facilities in favor of home health alternatives and hospital readmissions due to a decrease in post-surgical complications.
Kris Jones, Vice President of Medical Operations at Melbourne-based First Choice Healthcare Solutions, noted, “Although the CJR program is not yet mandated in Brevard County, we believe it is only a matter of time, particularly given the reported cost savings that the program continues to achieve on a national basis.
To reach First Choice Medical Group call 321-802-5820 or visit MyDoctor321.com/SCD
As such, First Choice has and will continue taking measures to remain at the forefront of value-based Orthopaedic and Spine care offerings in 2017 and for years to come. For us, coordinated, cost-conscious care is business as usual.”
Jones added that First Choice continues to demonstrate that coordinated care of its patients by its multi-disciplined care team – from diagnosis through treatment to recovery – helps to materially improve recovery times and avoid preventable complications and costs.
In fact, she stated, “Innovative, collaborative care is a fundamental tenet that underpins how we deliver superior, patient-centric care at our Medical Centers of Excellence; and it is why our practices have continued to grow, thrive and prosper.”
First Choice Healthcare Solutions currently operates First Choice Medical Group, The B.A.C.K. Center and Crane Creek Surgery Center with five convenient clinical locations in Melbourne, Viera and Merritt Island, as well as the outpatient surgery center in Melbourne.
Collectively, the practices offer state-of-the-art musculoskeletal care and treatment by a world class team of surgeons and medical specialists, imaging services, physical therapy, ambulatory surgical facility services and on-site provision of durable medical equipment and supplies.
To save costs, expedite treatment and improve patients’ overall care experiences, First Choice has developed defined clinical interlocking protocols that engage evidence-based medicine; collaborative care; minimally invasive surgical intervention, when required; and leading edge medical record technology to optimize care of patients served by First Choice Medical Group and The B.A.C.K. Center.
According to Jones, “Our care platform equips our providers with an array of powerful tools and capabilities that empower them to achieve the best possible treatment and recovery for our patients, while affording our patients and their families access to the best, most convenient Orthopaedic and Spine care possible.”
Centers of Excellence
First Choice’s Medical Centers of Excellence also employ dedicated patient advocates on their staff to help ensure that every patients’ care experience is always a positive one.
Chris Romandetti, CEO and President of First Choice, stated, “Later this year, First Choice intends to be among the first comprehensive healthcare platforms in Brevard County to offer the government, major health plans and large self-insured employer groups bundled payment programs for a broad range of Orthopaedic and Spine related surgical procedures, including total hip and knee replacements. In doing so, we believe we will be able to ultimately lower the total cost of episodes of care up to 15 percent for these payor organizations while achieving optimal care outcomes for our patients.”
First Choice Medical Group’s providers include Dr. Anthony Lombardo, Dr. Richard Harrison, Dr. Kenneth Sands, Dr. Raymond DeLorenzi, Dr. Richard Newman and Dr. Donald Vliegenthart.
FCMG operates clinical offices at Marina Towers located at 709 South Harbor City Boulevard, Suite 100 in Melbourne; and at 7000 Spyglass Court, Suite 220 in Viera.
The B.A.C.K. Center care team includes internationally recognized back and neck surgeons Dr. Richard Hynes, Dr. Devin Datta and Dr. James Billys; interventional pain experts Dr. Hicham Merheb and Dr. John Sasano; Dr. S. Farhan Zaidi, a leading Physical Medicine doctor and Dr. Susan Ville who specializes in Chiropractic Orthopaedics and acupuncture.
The practice sees patients at two locations: 2222 South Harbor City Boulevard in Melbourne and 650 S. Courtenay Parkway in Merritt Island.
Crane Creek Surgery Center, one of the top ambulatory surgery centers in the nation as ranked by Becker’s ASC Review, is co-located in the same building with The B.A.C.K. Center’s main office in Melbourne.
Now Accepting New Patients
Both First Choice Medical Group and The B.A.C.K. Center are accepting new patients. Appointments may be scheduled by calling 321-802-5820 or visiting www.mydoctor321.com/SCD.
Career Opportunities at First Choice
Interested in career opportunities at First Choice? Resumes should be emailed to email@example.com. First Choice Healthcare Solutions and its practices, all equal opportunity employers, are currently seeking qualified, experienced candidates for the following posts: Director of Marketing, Physician Assistants, Decision Systems Support Analyst, Accounting Manager, Physical Therapists, Physical Therapy Assistants, Occupational Therapists and Schedulers.
To reach First Choice Medical Group call 321-802-5820 or visit MyDoctor321.com/SCD