Good morning, I’m John Ventura, one of the founders of Spine Care Partners. We are a limited liability corporation incorporated in December 2010 and has thus far been self funded; our guiding principles are accountability, sustainability and excellence. Our initial focus is upon the establishment of spine centers as a component of large physician organizations.
As a health care consulting company assisting physician organizations in establishing a Spine Center, Our goal is to get the right patient to the right treatment at the right time while increasing the spine care market share for our partners and managing the costs associated with spine pain; Our care pathway is based in NCQA quality standards and Lean Six Sigma process management; Part of our training is linked to our marketing: providing a patient centered, evidence based pathway for primary care physicians (those who see majority of spine patients initially) to utilize in determining need for referral to spine center; This increases referrals to spine center and creates strong alliance with physicians in the community;
Our spine center model has been tested in a hospital based setting in the challenging state of MA (where national health care is beginning) and we have published an overview of our pathway and the beneficial clinical and financial outcomes associated with this model;
And here are some of the positive clinical and financial outcomes realized from the implementation of our model; Jordan hospital spine center, located in Plymouth MA, operates under the NCQA LSS management strategies of SCP; subsequent data reveal 1400 new patients for spine center for first full year of operation; created strong alliance with physicians in the community; by effectively managing the 80% effectively, increased traffic through spine center, which indirectly then increases advanced care (MRI, PM, surgery); surgical fast track days greatly increase the surgical yield for the spine surgeon, maximizing their time efficiency (in their office they may need to see 20 spine patients to generate 1 surgery, in our fast track clinic, they may only need to see 5 patients to generate a spine surgery, all the while appropriately triaging patients so that no unnecessary imaging, pain management or surgery is performed;
Why is our model important: it answers some disturbing trends hospitals are forced to deal with; There is a trend to reimburse based upon condition, much like DRGs of the past, which necessitates utilizing a clinically and cost effective model of care; a prominent hospital administrator suggested to me that 20% of hospitals will close their doors or merge over the next 5 years; RACs = recovery audit contractors who look to recoup what they deem to be inappropriate payments to hospitals
We are over managing spine care; higher costs with higher disabilty we’ve seen 423% increase in opiate use; 220% increase in spinal fusion 307% increase in MRIs 629% increase in ESIs And none of these increased costs have been proven to improve quality of care (this is exactly why NCQA has chosen back pain as one of its initial quality improvement programs)
SCP hospital based spine center provides excellence in a sustainable, accountable model; We have developed a process driven It is high value care: quality based algorithm, lean six sigma process management, excellent clinical and patient satisfaction outcomes, rapidly increased volume of patients, free of provider bias, appropriate care at the appropriate time The Jordan Hospital Spine Center has operated in the black since its inception; Our model is sustainable, no matter the direction health care is taking
Thank you very much for your attention, I look forward to your comments and questions.