Mark Huslig – Joint Replacements + Bundled Payments: What Every Therapist & Nurse Needs to Know for Optimal Treatment and Reimbursement

Outline

NAVIGATING LOWER EXTREMITY ARTHOPLASTY AND COMPLEX CARE

KNEE ARTHROPLASTY: WHY NOT ALL TOTAL KNEES ARE SURGICLALY BALANCED

• Manage extensor mechanism complication
• Manage the stiff knee
• Etiology of post-op extension and flexion deficits
• Unicompartmental knee arthroplasty (UKA) outcomes
• Long fixation components for valgus stress knee replacements
• Muscle activation patterns during walking and associations with TKA tibial implant migration
• CPM (Continuous Passive Motion) and implications under bundled payments
• Use of cryoneurolysis in multimodal pain management protocol
• Psychological comorbidity factors associated with non-compliance
• Restriction for return to sport

HIP ARTHROPLASTY: HOW TO AOVID DEFICITS AFTER THA

• Direct anterior approach’s effect on readmissions rates
• Reversible thalamic atrophy
• Avoid hip instability and limb length discrepancy
• Gait asymmetry
• Spinal instrumentation and impact on hip dislocation
  • THA patients with fixed spinopelvic alignment from standing to sitting at higher risk
  • Lumbar fusion involving the sacrum increases dislocation risk 8-fold
• Effects of piriformis tendon repair failure
• Electormyographic analysis implications
  • Effects on gluteus medius and gluteus maximus
• Restriction for return to sport

EVERYTHING YOU NEED TO KNOW ABOUT BUNDLE PAYMENTS

• Breaking down Bundled Payments for Care Improvement initiative (BPCI) and Comprehensive Care for Joint Replacement (CCJR)
• Breaking down Medicare’s role in value-based reimbursement
  • Is your area of the country in the selected Metropolitan Statistical Areas outlined by Medicare?
  • How your regional location affects the cost variation in Medicare spending for total joint replacements?
• Impact on post-acute care practice settings

POTENTIAL PAYOFF FROM BUNDLING

• How to case cost analysis in bundled payments
  • What’s the relationship of implant cost to total surgical case cost?
• Latest on performance benchmarking
• Why hospital quality scores matter
• How to create orthopedic physician report cards
• What is allowed by Medicare in gain-sharing with hospitals
• Minimize narcotic use with patients
• The latest news in how CMS will pay for post-acute rehab services
• The role of tele-rehab in total joint cases

KEYS TO IMPROVE PATIENT OUTCOMES

• Tools used in risk stratifying patients prior to surgery
• Quality tools and templates
• What outcome reporting does Medicare require
• The American Joint Replacement Registry data to improve outcomes
• How to influence hospitals into collaborating and gain-sharing
• Medicare waivers under the bundled payment programs
• Beneficiary rights