Vol. 1 July 2019

This is the first edition of a periodic newsletter from the OrthoForum Board to all members.  As the OrthoForum has grown it has become increasingly harder to keep everyone informed of the many activities of our organization.  We hope this newsletter, that’s being called “Forum Focus”, will help fill the communications gap and keep everyone abreast of what’s happening across the organization.

This inaugural edition is dedicated to sharing the results of the recent Board planning retreat.  We trust that you will find it informative.  Please let us know what you think of this format and provide us any suggestions for future newsletters.  The Board is excited about the future of the OrthoForum.  It remains committed to assisting all members to thrive in the uncertain future of healthcare.

Board Planning Retreat Summary

As a follow-up to the member survey completed in February and presented at the Annual Conference in early March, the OrthoForum Board met on May 10, 2019 to convert the findings of the survey into a strategic plan for the coming few years.  Although the survey indicated there is definite interest in new strategic initiatives, the clear message was that the founding principles of benchmarking, networking and innovation are still the primary focus of the members.  So, the Board has developed a work plan that emphasizes the improvement of our core services while beginning to explore other more strategic initiatives and affiliations that could further benefit the membership.  Throughout the planning retreat, it was noted that none of these goals can be met without both significant OrthoForum staff resources in coordination with committed volunteers from the member groups.  This constraint remains a challenge and will largely determine the timing and success of these ideas.

Mission, Vision and Value Statements

The MVV Statements created in 2015 remain largely valid and applicable to our organization.  But, the Board did make some changes as noted:

  • Revised based on member survey and Board input (attached)
  • Changes reflect more emphasis on networking and collaboration and less on practice management expertise

THE ORTHOFORUM

Mission, Vision, and Values

Revised on May 10, 2019

Mission:

Equip large, independent orthopaedic groups to thrive in the ever-changing healthcare environment through benchmarking, collaboration, innovation, shared services, and strategic positioning

Vision:

Advance the independent practice of orthopaedics and become a driver of successful innovation in healthcare delivery

Values:

  • Independent physician-owned practice of medicine
  • Active physician participation
  • Innovative business development through group collaboration
  • Data-driven management through benchmarking and sharing of best practices
  • Advocacy of shared objectives
  • Leveraging the size and number of member groups

Organizational Update

As an organization, the OrthoForum continues to improve its infrastructure to support the member groups.  In particular, it continues to evaluate the amount and type of staff resources that are needed to meet our service commitment and advance our strategic initiatives.

  • Board Changes
    1. Becky Farmer, CEO of the Center for Sports Medicine in Chattanooga, TN, was nominated to replace Dean Brown as ROF representative (Becky has since been elected by ROF members)
    2. Publish newsletter – 3 times per year starting with this retreat summary
    3. All Board members will sign a conflict-of-interest statement to ensure they are transparently representing the interests of the membership in their governance roles

 

  • Branding of OrthoForum
    Throughout its history the OrthoForum has intentionally not pursued any promotion or marketing of itself.  The Board believes it is time to review that stance and seek ways to strategically promote our brand and position in the industry.

    1. Create a branding program to increase the exposure and better explain the Forum
    2. The program will have both internal and external aspects
    3. Seek proposals from PR firms to support and develop the concept
    4. Purpose is to better take advantage of the collective influence of the OrthoForum brand to benefit every member

 

  • OF Office Improvements
    1. New staff person (Vanessa Helgerson) has been added to handle member services
    2. CRM software package to be purchased to better manage member contacts
    3. Will continue to conservatively add resources recognizing the significant growth of the organization and the needs presented by this strategic plan

Core Services

As noted in the Summary, the Board reviewed all of the existing services that represent the essence of the OrthoForum.  Yet, in each instance, there were aspects of the offerings that could be enhanced or improved.

Benchmarking Changes and Improvements

  • Conduct a thorough review of the current benchmarking system and processes and redesign as needed:
    1. First phase will focus on the efficiency and effectiveness of the use of the tool including considering more frequent data extraction than just annually
    2. Second phase will focus on the analysis and design (or redesign) of the data gathering tool and processes with the goal to reduce the time and effort needed to submit the data; hopefully, the result will be a higher percentage of data extracted via electronic processes acknowledging that eliminating all manual entry is unlikely
    3. Third phase will combine the results of the first two steps to create an easier review and communication process with the practices regarding incomplete or outlier data; the end result of all of this is better data through an easier to use tool and one that is provided in a more timely manner (go-live date) than currently available
  • Evaluate current the software arrangement to ensure optimum performance for the future with three possible alternatives:
    1. Re-negotiate current arrangement with MedAxiom
    2. Select another software firm
    3. Contract with a software developer to replicate program while providing more flexibility and security
  • Make all benchmarking data (both OC and OF) available to all members on a blinded, optional basis
  • Consider ways to provide reports to limited combinations of members that could further help various groups compare themselves to other similar groups
  • Identify any other major data categories that may need to be added like CPT code analysis and reporting
  • Improve and enhance the ASC benchmarking
  • Add the specialty hospital benchmarking and then improve and enhance that data as well

OPA

  • Primary focus in 2019:
    1. Ensuring all owners are rostered and aligned with Vizient
    2. Growing the relationship with VHPC
      • Improved data and reporting
      • Enhanced contracts to replace Vizient in some instances
      • Group purchase of capital equipment
    3. Re-negotiating several direct contracts to take advantage of tiering discounts and committed volume buying
    • Secondary Focus in 2019
      1. Increasing OrthoMonitor use
      2. Exploring more service agreements
    • Future OPA possibilities:
      1. 3PL solution for drug warehousing and distribution
      2. “White label” manufacturing opportunities (discussed later in this document)
      3. Tackling implants recognizing the limitations re: physician preferences

Affiliations

The number of opportunities to affiliate both internally and externally are growing.   Here are the conclusions on each:

  • AAOE – Glenn Sumner, Mike McCaslin and Don Schreiner recently met with the AAOE Board.  At the meeting it was agreed that the OrthoForum would continue the following:
    1. Allow AAOE groups with 7 or more physicians to join OPA
    2. Collaborate on advocacy as the opportunities present themselves
  • AAOS – Continue collaborating on:
    1. Advocacy including attendance at the NOLC
    2. Potential affiliation with the American Joint Replacement Registry (AJRR) program
  • ASCA – Ambulatory Surgery Center AssociationOver the last year have established a healthy, ongoing relationship with ASCA; following are future opportunities:
    1. Allow AAOE groups with 7 or more physicians  to join OPA
    2. Collaborate on advocacy as the opportunities present themselves
  • Large Group Alliance – Board Member Karen Simonton reported on a recent meeting of the eight OrthoForum groups that have more than 100 physicians.  The Board agreed to continue to support this alliance with the following conclusions, which have been agreed upon by the affected large groups:
    1. There are clear issues groups of this size face that are unique and having a way to network about them is encouraged
    2. There may be some new initiatives that could benefit all Forum groups that the large groups could test and determine viability before rolling out to all groups…ie, this alliance could serve as a business incubator
    3. All major activities/initiatives of the Large Group Alliance will be transparent to the Board and planned in joint venture with the Board to ensure all OrthoForum members are properly represented
    4. The OrthoForum office will provide administrative and logistical support for the Alliance
    5. In addition to the OrthoForum staff, the Board will ensure that non-large group members are represented in developing any initiatives that the large groups are spearheading, but that are planned to be rolled out to all members
  • CPOMP (Congress of Physician-Owned Medical Properties)
    1. Started two years ago by CMAC and annual meetings have been held in 2018-19
    2. Purpose is to promote and educate physician practices regarding their medical real estate
    3. Includes all physician specialties, but has been dominated by orthopaedics
    4. Advisory Committee has been established with several OrthoForum groups being represented; allows independence from CMAC and better manages CPOMP activities
    5. Because of the complexity of managing medical real estate, the OrthoForum Board has decided to largely cede the education and discussion of this subject to CPOMP; was felt that the OrthoForum simply could not spend enough time in its meetings to adequately provide the needed information
    6. In the future OrthoForum will support CPOMP and encourage member groups to seek their education of medical real estate from this group
  • OrthoConnect
    1. OrthoConnect is in its third year of operation and now has 50+ members, all independent orthopedic groups between 7-19 physicians; average size is 14
    2. Board approved OrthoConnect to participate in several of the benefits of OrthoForum including ASC, PT and Specialty Hospital meetings; Advocacy and OPA
    3. Board’s position is that to achieve our mission we need to assist smaller groups with similar philosophies to remain viable

Regional Meetings

  • Develop group rotation process for regional meetings with implementation in 2020, but on a voluntary basis to:
    1. Allow more groups to become acquainted with each other
    2. Introduce new ideas and perspectives
    3. Keep the meetings and networking meaningful
    • Agenda Content
      1. Keep agendas consistent
      2. Eliminate outside speakers, using them for the Annual Conference only
      3. Find new ways to incorporate as many groups as possible in sharing experiences, processes, and initiatives (as explained in Mike McCaslin’s recent email)

Annual Conference

  • Feedback from attendees at the San Antonio meeting was very positive
  • Board agreed the format was good with emphasis on current trends and use of multiple outside speakers
  • Possible suggestion for 2020 is assembling a panel of primary care physicians to gain their perspective on industry changes

Advocacy

  • All agreed that the Advocacy Committee is very effective and the new subcommittee arrangement is working well
  • Investigate the concept of a specialty ACO in collaboration with AAOS and through discussions with CMMI

ASC Meeting

  • Just completed the second year meeting in Dallas in early June; attendance and interest were substantially up from 2018
  • Expand and improve benchmarking data set….this year’s meeting incorporated best performers
  • Continue to emphasize group purchasing opportunities
  • Advocacy subcommittee for ASC’s was begun in 2019

Therapy Services Meeting

  • As with ASC, the first meeting in November, 2018 was well attended
  • Focus was on operational and management issues
  • Good suggestions were made for improving benchmarking data set
  • 2019 meeting will be held in September at Amelia Island, FL and OrthoConnect will be invited

ASC & Therapy Services 

  • To maintain the success of the first ASC & Therapy Services meetings, it was recommended that consideration be given to creating steering committees to oversee the interests of each group; concept will be discussed at both meetings and input solicited
  • Possibly create quarterly conference calls for each group similar to CFO Roundtable

Specialty Hospital Meeting 

  • There are 13 OrthoForum groups and 5 OrthoConnect groups that have ownership in an orthopaedic specialty hospital; in addition 3 non-Forum/non-Connect groups are interested in participating in the meeting for a potential total of 21 hospitals
  • Based on the feedback expressed from many of these groups, it was decided to hold a meeting in September to explore common interests and issues of specialty hospitals
  • Three CEO’s have volunteered to lead the meeting planning efforts; will use ASC benchmarking tool for first year and create a work group to modify tool going forward
  • All future activity will be determined from input at this first meeting

CFO Roundtable 

  • Quarterly conference calls are being held to identify and discuss issues and interests of CFO’s
  • So far, leadership and participation has been solid

Expanded Services

Several services that are related to ones already being offered were included on the Member Survey.  Based on the Survey feedback the Board discussed each one and concluded the following:

Physician Recruitment 

  • Continues to be a service rated highly by the members, and have had some limited success in matching candidates to member needs
  • Service has proven to be tough to implement due to the amount of resources needed, so have submitted RFP to three recruiting firms to partner with us as an alternative way to fill the resource gap; proposals due by end of June
  • Will decide on the direction of the service upon the completion of the RFP process

Pharmacy Benefits Management 

  • Significant interest from member groups that are self-insured for health coverage to determine ways to reduce cost of employee pharmacy benefits, especially with the recent cost escalation of specialty drugs
  • Will form a task force to review the problem and seek a solution that can leverage our collective buying power
  • Will likely do a pilot with a couple of groups to determine potential

Certified Services

The concept of certified services is to establish a resource directory of both internal and external services that members could access to fill a need in managing their practices.

  • The services could include the following:
    1. Internal resources – ie, groups or individuals that are within the Forum that have developed an expertise in a particular area and would be willing to share with other members
    2. External resources – a list of vendors/firms that have been used by Forum members that would be vetted for performance
    3. Document catalog – collection of practice documents related to policies, manuals, processes, etc. that could be shared with other members
    • A task force of volunteers will be established to investigate the feasibility of this concept

Affiliate Member Status

Several private practice orthopaedic groups around the nation have ownership in a specialty hospital and have structured their operation as either direct employees of the physician controlled hospital or have ancillaries embedded in the hospital.  In both instances, the groups are controlled by the physicians but have used the economics of their hospital to enhance the practice performance.  Historically, this has rendered their benchmarking data as meaningless on a comparable basis.  Two of these groups (Crystal Clinic, OSS Health in Pennsylvania) desire to be a part of the Forum.  The following will address this interest:

  • The Board discussed and approved an Affiliate Member status that would allow the groups to attend the annual meeting
  • A number of details still need to be worked out (dues structure, regional meetings, data, etc.), but Glenn and Mike have approval to move this concept forward

Future Initiatives

As the industry evolves the members of the OrthoForum have an opportunity to leverage their collective size and market leverage to create opportunities that the organization has not pursued to date.  These are initiatives that will require significant collaboration and trust among the interested groups.

It should be noted that there are no specific timetables with any of these opportunities.  A time schedule for each will be developed as the initiatives are organized and addressed.

Direct Employer Contracting Network

As demonstrated by the Walmart experience, we know that a growing number of self-insured employers are seeking more cost-effective healthcare options for their employees, particularly through bundled payment solutions for high dollar procedures.  A network consisting of OrthoForum members (and perhaps supplemented by OrthoConnect members) could be a powerful response.  Here are the basic steps to evaluating and developing this strategy:

  • Encourage individual member groups to continue reaching out to employers in their local area and request the members report their experiences
  • Identify the various firms and brokers (like Healthcare Bluebook) that are connecting employers to providers
    1. Assess which are successful and why
    2. Test the concept of regional networks linked to a national network with these groups
    3. Determine the participation requirements (including data needs) of each program
    4. Seek opportunities for pilot arrangements
    • By pursuing this idea proactively hopefully, we can influence the design of the program including the care management that best benefits our members
    • Utilize the existing Value-Based Care Committee (adding members as needed) to study and advance this concept

Data Aggregation Company

Benchmarking has been one of the three pillars of the OrthoForum from its inception.  Today the need for even more group performance data is clear.  But, the types of data needed and reliable ways to collect them remain elusive.  Nonetheless, we believe we must begin this process.  Developing a company to collect, report and own the data seems to be a wise undertaking that can be initiated to include:

  • Identify the types of priority data needed and then developing an incremental approach to aggregating them
  • Explore system options to store and manage the data
  • Conduct a RFP process to identify the best option to meet our needs
  • Create a company to own the data and manage the data system
  • Potentially, use the Large Group Alliance to spearhead and test the system
  • Board will coordinate with the Large Groups to ensure the entire Forum membership is appropriately served

Specialty ACO

Through a collaboration with the AAOS, the OrthoForum is evaluating how it could submit a proposal to CMMI for a pilot project for a specialty ACO.  At this juncture, this concept doesn’t even exist in the marketplace.  But, CMMI has indicated an interest in exploring the idea and we’re collaborating with the AAOS to develop a proposal.  Again, this would allow the OrthoForum to design a program that is favorable to our interests.  Work on this concept is being coordinated through the Advocacy Committee.

ASC White Labeled Products

Over the last several years there have been some discussions and interest from various OrthoForum groups about working with machine shops to manufacture some of the products used in our ASCs and then sold to our members under an OrthoForum “white label” branding.  Reimbursable implants (like interference screws and suture anchors) that are now off-label have been mentioned as well as non-reimbursable items like guide wires, drill bits, and some screws.

  • Research the market for possible manufacturing partners
  • Investigate the activity already begun by some individual members to assess the applicability to the entire Forum
  • Survey the membership regarding interest in types of items to manufacture and offer
  • Create and utilize a task force to investigate this idea

Volunteer Opportunities

All of the projects and initiatives in this plan will require member involvement to investigate and advance.  Thanks to all the people who already are helping with one of these strategies.  But, there will be some new opportunities to assist on various Expanded Services or Future Initiatives.  If you have an interest in participating in any following projects please contact Glenn Sumner at gsumner@theorthoforum.com.

  • OrthoForum branding campaign
  • Pharmacy benefits management
  • Certified services
  • Direct employer contracting
  • ASC white labeled products

Dates to Remember

8/1-3/19
Asheville OrthoForum, Omni Nashville Hotel (Nashville, TN)

8/22-24/19
Western OrthoForum, Ritz-Carlton Laguna Niguel (Dana Point, CA)

9/12-14/19
OrthoForum Therapy Services Meeting 2019, Ritz-Carlton Amelia Island (Amelia Island, FL)

9/19-21/19
Atlantic OrthoForum, The Ballantyne (Charlotte, NC)

9/25-26/19
OrthoHospital Meeting 2019, JW Marriott New Orleans (New Orleans, LA)

9/26-28/19
Reynolds OrthoForum, JW Marriott New Orleans (New Orleans, LA)

2/27-29/20
OrthoForum Annual Conference 2020, JW Marriott Phoenix Desert Ridge Resort and Spa (Phoenix, AZ)

Meet the OrthoForum Team

Glenn Sumner

As CEO, Glenn is responsible for leading the overall OrthoForum organization.  He primarily works with the Board, spearheads new initiatives and helps coordinate the content for our various meetings.

Dave Stridde

As COO, Dave is responsible for overseeing the business operations of the OrthoForum organization.  Dave works with Glenn and the Board to ensure that the organization has appropriate staffing, infrastructure and policies in place to deliver the core offerings and implement any new initiatives.  Dave is also the Director of the OrthoForum Purchasing Alliance (OPA).

Tina Cakmes

As Director of Conferences, Tina oversees all aspects of conference planning and management. She serves as a liaison between the OrthoForum and hotel contacts to organize and implement successful programs. This includes contract negotiation, conference logistics, and onsite conference management. In addition, Tina works with the OrthoForum team on sponsor acquisitions.

Stacey Bodkins

As Project Manager, Stacey focuses primarily on initiatives directed by the Board of Directors and Executive team. She works with members, planning committees and the OrthoForum team to manage and implement special projects, including membership surveys, recruitment, and process improvement. In addition, Stacey is the Operations Manager at the OrthoForum Purchasing Alliance, where she oversees daily operations, member enrollment, price parity and contract connections.

Rachel Riley

As Conference and Communications Manager, Rachel focuses primarily on conference planning and support. She works with members and sponsors to ensure a seamless conference program from start to finish, which includes oversight of conference communications, handling of conference materials, and onsite conference management. In addition, Rachel works with our lobbying and design partners on the OrthoForum’s advocacy newsletter, Advocacy Insights.

Vanessa Helgerson

As Member Success Manager, Vanessa is responsible for meeting registration and member relations. She works with members to streamline the registration process and provide administrative support, including website access, member group on-boarding and management of continuing education. In addition, Vanessa works in a supporting role with our conference team.