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Modern Healthcare finance reporter Tara Bannow talked with Kevin Fleming, Providence St. Joseph Health's vice president of orthopedics and sports medicine, at the Healthcare Financial Management Association's annual conference in Las Vegas in June. They discussed the conference's main theme, value-based care, and the creation of the Renton, Wash.-based not-for-profit health system's Orthopedics and Sports Medicine Institute, as well as how his clinical team manages physician choice around expensive hip and knee implants. The following is an edited transcript.
MH: Talk a little about the creation of the institute and its goals.
Fleming: The work began in 2013. I joined the organization in 2014. They started with some of the key service lines: cardiovascular, neurosciences, cancer, musculoskeletal and orthopedic services. Next came women and children's, and digestive health.
Our highest inpatient service is joint replacement. We have worked with our physicians as we move toward the ambulatory environment. Sports medicine is a part of it, both surgical sports medicine but also primary-care sports medicine.
Rheumatology--which aligns very closely with orthopedics in a lot of programs around the country--when connected well can lead to some synergy.
What we try to do is have our clinicians work together across geography to elevate what they can collectively decide is the best practice. I think everybody is looking to provide the highest-value care possible, optimizing clinical outcomes and keeping costs--both to the health system and to payers--as low as possible.
When you have a broad geography like we do, 50 hospitals and multiple communities, things are being done differently. There's variation. So we've tried to bring people together to find those approaches, tactics, care pathways, ways to connect with patients that are delivering the best outcome.
Whether it's working on a pathway for patients in an ambulatory environment or working with the best way to align the school districts and athletic trainer programs, we are threading that needle by letting our physicians lead us and guide us, but we, as a health system, are empowering them with information.
MH: How do you manage physician preference items and variation?
Fleming: What we've tried to do is work with our physicians when those contracts come up for renewal, giving them data and letting them see the comparisons. There...