Feature July 21, 2021 John Bernot, MD

Surgeon’s guide to maximizing payments under BPCI Advanced

Start maximizing practice revenues under the BPCI Advanced payment model by focusing on pre-op education and communication.

value based care models

Three years into the Bundled Payments for Care Improvement Advanced (BPCI-A) program, revenue gains for orthopedic surgeons have started to stagnate.

Conveners have been effective in reducing post-acute readmissions in the first 90 days after surgery. However, that’s only addressing half the equation. Your practice is likely missing the boat on the front half of the savings opportunity. 

There are no bundled savings to realize or fee-for-service payments when your patients are a no-show or you must cancel surgery because they did not follow pre-op instructions. 

Even worse, you’re likely losing money. One study has found same-day cancellation of an orthopedic surgery costs a facility $2,779.1

Continue reading to learn more about the forgotten component in your BPCI-A strategy and how focusing on pre-op task adherence can help you maximize revenues under alternative payment models. 

The forgotten component in your BPCI-A strategy 

Educate, educate, educate. 

What your patients do (or don’t do) leading up to surgery might be what’s preventing your practice from realizing the true financial rewards under the BPCI-A payment model. 

Pre-op task adherence can improve patient outcomes while also reducing same-day cancellations and no-shows.

Your patients may not feel comfortable asking questions, or they may have anxiety before surgery. Therefore, it’s essential that you are proactive in communicating educational materials to them.

Here are just five of the many common questions your patients may have in the weeks leading up to surgery. Are you providing enough patient education to ease their worries? 

  1. What happens if I continue to take my medication after I was told to stop?
  2. When should I stop eating before my surgery?
  3. When should I wash with the antibacterial Hibiclens solution?
  4. What will the incision look like? 
  5. Can I drive myself home from surgery?

Turn your focus to pre-op

With the help of educational outreach, care teams and conveners have been effective in reducing post-op readmissions that result from preventable complications. This work has led to increased revenues in the transition to value-based care. 

Surgeons and their care teams should see the work of communicating pre-op education as complementing what conveners are doing after surgery. In an ideal world, you could bolster the current suite of post-op services by concentrating on pre-op education, with the end goal of increased revenues by reducing same-day cancellations and no-shows.

Increase bundled payment revenues

Ensuring your patients are ready for surgery, both medically and emotionally, is necessary to reduce same-day cancellations and no-shows.

Effective communication that builds patient self-efficacy through pre-op education is critical if your practice seeks to increase revenues under bundled and other alternative payment models.  

Learn how Ayva can improve pre-op patient education so that your practice can start increasing revenues under BPCI-A. 

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