3. Prune what you don't need. For many years, orthopedic prac-
tices prescribed continuous passive motion (CPM) machines for post-
op patients. CPMs cradle the leg and take patients through the range
of motion while they're lying in bed or on the sofa. Well, guess what?
Years ago a study found that CPM didn't improve total knee patients'
range of motion. So we eliminated CPMs. from our value. It was an
added expense that added no value. Similarly, we used to prescribe
our patients continuous ice machines that pumped cold water over
their joints. When we found these were no more effective than a bag
of frozen peas, we switched to ice packs.
Our average length of stay for total joint replacement is shockingly
low: 1.16 days. Our patients don't need home health care, nor do they
need inpatient rehab or physical therapy.
Emerging reimbursement model
If you're not prepared, now's the time to plan to move to bundled pay-
ments for an episode of orthopedic care. The time is now to raise
quality while decreasing costs.
OSM
7 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 8
Mr. Raspa (robert.raspa@orthocarolina.com) is director of physician assis-
tant services and value-based programs at OrthoCarolina in Charlotte, N.C.
