How To Prepare For Comprehensive Care For Joint Replacement (CJR) | Ann Conrath, LMSW, MSW | RxEconsult

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How To Prepare For Comprehensive Care For Joint Replacement (CJR) Category: Healthcare Models by - January 26, 2016 | Views: 28709 | Likes: 0 | Comment: 0  

2. Establish Provider and Consultant Partnerships

A critical partnership to establish is with orthopedic surgeons. Surgeons are the ones who establish initial patient relationships, establish initial care pathways, and have significant influence on necessary post-acute care. To succeed in CJR, care protocols should be standardized throughout the entire episode. Hospitals need to develop a strategy to align their CJR goals, strategies, and incentives with orthopedic surgeons, regardless of whether the surgeons are employed by the hospital or are from independent practices.

Post-acute care providers are also an important part of a patient’s care plan as associated charges are included in the bundle within the 90-day post-discharge period. It is important to identify high-quality downstream providers that understand the goals of CJR and are willing to work with the hospital to co-develop and implement care protocols for LEJR beneficiaries consistent with the goals of the CJR model. Hospitals should start building such relationships and expectations now. 

 While partnerships with orthopedic surgeons and post-acute care providers are clearly essential, other partnerships may seem optional (although I would argue they are just as important). Should a hospital not have the internal capacity to implement all aspects of CJR (requiring outsourcing of certain job responsibilities), now is the time to evaluate and determine efficient suitable solutions. Hospitals may need to establish contracts for:

  • Data analytics
  • Care navigation solutions
  • Strategic consultants to:
    • Establish protocols and manage spending
    • Create engagement and alignment among doctors, case managers, administrators, and clinical team

 Now is the time to locate and vet potential partners. How is this done?  

3. Release a Request For Proposal (RFP) or Request For Information (RFI)

Once a hospital has decided they need some outside help, such as consultants or third-party providers, an RFP or RFI should be crafted to find the best collaborators. An RFP or RFI needs to be specific, describe exactly what is needed, and be written with carefully crafted questions that elicit relevant responses from top performing partner organizations. A hospital wants to find partners who can provide the specific services it needs and who will become an asset to the team.

 Once an RFP or RFI has been crafted and released, RFP and RFI submissions need to be reviewed to identify the best partners for CJR success. For any potential partner, hospitals need to make sure the partner brings expertise and the capacity to work with the hospital’s specific needs, and has an experienced team to bring the services, insights, and analyses required. While there may be many new businesses popping up to fill this service gap, CJR hospitals should strongly consider partners with a proven track record of engagement and success in administering necessary services in other CMS bundled payment programs.



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