Illinois Sports Medicine & Orthopedic Surgery Center (ISMOSC) recently completed its 500th total or partial joint replacement surgery. Focused primarily on total knee and total hip replacements, the Morton Grove-based ambulatory surgery center (ASC) completed its first total joint replacement (TJR) procedure in late 2015, following thorough advance planning and a strong contractual agreement with Blue Cross and Blue Shield of Illinois.
A 100% physician-owned ASC, ISMOSC leadership began working with Regent Surgical Health as a management consultant early in the center’s development and engaged a member of Regent’s leadership team to participate in their TJR program due diligence efforts.
“The concept of doing outpatient joint replacement surgery was not novel when we started,” says Larry Parrish, Administrator at ISMOSC. “It was being done in other parts of the country, so we scheduled a site visit with a representative from Regent to see how it was done.”
This early research helped ISMOSC prepare for procedural success as they simultaneously worked to line up contracts with commercial payers that would support TJR financially. In fact, Parrish attributes much of ISMOSC’s TJR case growth to the center’s advanced planning: helping surgeons get comfortable doing the procedures on an outpatient basis, mapping out a thorough patient selection process, training staff, and lining up a skilled home health partner to ensure quality post-operative care.
“The other thing was excellent outcomes. We’ve had virtually no post-op infections, complications, or hospital admissions because we have highly skilled surgeons and anesthesiologists, as well as a very effective home health partner that provides the first couple days of in-home nursing and physical therapy services. Patient selection is a very important aspect of our success story,” Parrish says. “Outpatient TJR isn’t appropriate for a high-risk patient or someone who doesn’t have good post-op support at home. There were a lot of things that had to be considered.”
Parrish says the most significant obstacle prior to launching a TJR program at ISMOSC was getting an amended contract with Blue Cross and Blue Shield of Illinois, the center’s dominant commercial payer, to reimburse the new procedure.
“This procedure is most optimal for a younger, healthier patient population, therefore you’re looking at commercial payers — not primarily Medicare beneficiaries,” Parrish explains. “So, the challenge initially for us was to get buy-in from Blue Cross and Blue Shield of Illinois. But once we convinced them that we have high caliber, well-trained surgeons doing this and that we were going to be very restrictive about patient selection, we won their confidence and they agreed to enter into an amended contract with us. And then our other commercial payers followed suit.”
Volume grew rapidly over four years based on excellent patient outcomes, and ISMOSC hopes to reach the next milestone of 1,000 TJR surgeries in even less time.
“We now have four surgeons that are fully engaged in doing joints here and a fifth that’s done a handful,” says Parrish. “A rather unexpected benefit is that we’ve had patients who have referred our surgeons to other patients because their experience has been great. These positive experiences have led other patients to return for their second joint replacement. The high degree of patient satisfaction that we have achieved and positive word of mouth have been very helpful with our growth.”
Parrish says ISMOSC is poised for continued growth due to its excellent outcomes, as well as Medicare’s recent decision to cover total knee procedures in the outpatient setting.
“One of the things that I’m most proud of is how enthusiastic our staff members have been and the significant role that they play in the success of this program,” Parrish concludes. “It’s very exciting to see a patient within 5-6 hours of their arrival up and walking with a new knee, a new hip. So for all the benefits that the physician partnership has derived, that the individual surgeons have derived, and that the patients certainly have derived, for me the most meaningful thing is to see our staff embrace a new service and do such a great job.”
Learn more about ISMOSC by clicking here.