Q: How much is demand for outpatient total joints expected to increase?
Mr. Uba — It's expected that about 3 million patients will undergo outpatient hip and knee replacements by 2030. Already, between 10 and 12% of our total knee cases are being done in the surgery center. We're waiting, along with everyone else, for Medicare to remove knees from the inpatient-only list. I keep hearing that's going to happen this year, but, then again, I also heard that last year. There's a groundswell of evidence to support the safety and efficacy of same-day joint replacements and it's becoming the standard of care within our community, so it doesn't make sense for Medicare to keep it on the list for much longer. When it finally does come off, demand will increase even more. We have a lot of Medicare managed care in our market, so even if pure Medicare decides not to pay for the procedures at a substantial rate, the local payers will likely be more than happy to have us perform them on an outpatient basis.
Q: What benefits do bundles payments provide?
Mr. Uba — It's interesting that the bundled payments we've negotiated with payers have put pressure on the rest of the providers in the community to lower their episode of care cost for joint replacements. The payers are using our program as a model to approach hospitals and physician groups to say, "Look, these guys can do procedures at this cost. Why can't you?" That has precipitated a huge amount of dialogue in the market about how to improve the cost of care and has created tangential benefits in terms of our relationships with hospitals within the community. Payers are also trying to incent joint surgeons to join our program and we've recently credentialed 4 more docs. Our volume will increase even more once they get up to speed.
"We have a great handout that we'll distribute at OR Excellence. It's a playbook that contains everything you need to know about running a joints program, from perioperative protocols to patient education materials."
Q: How are you continuing to increase case volumes?
Mr. Uba — We're starting to get repeat customers — patients who've had one knee done and now want the other side replaced. Individuals who've heard about what we offer from former patients are also approaching us to see if they're eligible to have their knees done. We continue to have our marketing and patient education engines working. One of our most successful strategies involves patient education seminars, where surgeons discuss how to deal with hip and knee pain, and bring up joint replacement as a possible treatment option. We're consistently getting well over 100 people at each seminar. Ten to 12% of attendees schedule appointments with one of our surgeons within 24 hours.
Q: Why are you returning to OR Excellence?
Mr. Uba — We really enjoyed our experience at last year's conference. It's exciting to talk about what we do and we like to share our insights on how same-day joints can be done, and done well. We also like to get feedback from the audience about what they're doing, what their goals are, where they are in their program's evolution and what payers are like in their markets. We're planning a truly interactive format for this year's conference in order to get those fresh perspectives.
Q: What do you have planned for this year's conference?
Mr. Uba — We have a great handout that we'll distribute at OR Excellence. It's a playbook that contains everything you need to know about running a joints program, from perioperative protocols to patient education materials. Facilities can generally figure out the clinical aspects of these cases, but the reimbursement piece is getting a lot of attention among interested providers. They want to know how to approach payers and how to develop a profit-generating bundled payment. We'll definitely hit on those topics during the workshop.