Old Volume-based Model:

Compensation based on Surgical Volume

  • Only responsible for the surgical procedure and timely discharge
  • Not penalized for re-admissions
  • Satisfaction does not influence reimbursement

Conclusion: High readmission rates, excess costs, clinical risks



Managing the Surgical Episode

Moving to Value-based care

A Hospital’s Challenge

New Value-based Model:

Compensation based on a successful Surgical Episode

  • Responsible from “Pre-hab” through restored health
  • Penalties for readmission by CMS
  • Poor outcomes and patient satisfaction will negatively influence reimbursement & market share

Conclusion: Cost, quality & patient satisfaction matter



14 out of 20 points

ValidCare's INFLUENCE on the CJR Bundled Quality Reporting Scale

ValidCare Network Services

Are you ready to deliver Value-Based Surgical Care?

Surgical providers must put infrastructure and care coordination in place to achieve mandated value based care, or face the risk of losing patient populations and revenues.

ValidCare services help our customers:

  • Align the economic interests of the physicians, hospitals, and other care givers
  • Improve care coordination from “pre-hab” through “re-hab”
  • Engage patients to capture real-time clinical & functional outcomes
  • Measure, benchmark & report network performance
“There is an urgent need for healthcare technology and data gathering to be designed around patient and provider needs… Those in healthcare who want to keep their data in a silo or not use standards that allow for collaboration should pick a new business model.”
Andy Slavitt, CMS Acting Administrator

What’s new in the news

Powering Value-Based Care – ValidCare™ Expands Offering and Impact

Centennial, CO., October 17, 2016  – ValidCare, the industry’s premier surgical patient experience network announces today the expansion of their proprietary digital health platform to include surgical CareTracks™ for patients undergoing lower extremity total joint (i.e., total hip and total knee), spine and general surgical procedures.
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April Fools? CJR incentivizes Hospitals to be PRO’s at Surgical Patient Experience

April 1st marks the start of the five-year, Comprehensive Care for Joint Replacement (CJR) mandatory bundled payment model from the Centers for Medicare and Medicaid Services (CMS) for Medicare patients undergoing hip or knee joint replacement surgery. Hospitals in 67 MSAs will join their peers currently participating in the Bundled Payment for Care Improvement (BPCI) initiative.
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