"The program is one of many things we do at Geisinger that is looking at the patient for their lifetime and their entire spectrum of health," he added. "We have the ability to leverage the entire continuum of care to keep people in their ideal health state."
Hip replacement surgeries have increased significantly in recent years. An estimated 310,800 total hip replacements were performed among inpatients aged 45 and over in 2010, a 55% increase from the 138,700 patients over 45 who underwent the surgery in 2000. The number of people younger than 65 receiving the surgery is also growing.
Geisinger Health Plan has 583,000 members.
The commitment by Medacta to risk-share in the cost of all follow-up care including all inpatient services is a first for the devicemaker.
Francesco Siccardi, executive vice president of Medacta International, said in a news release that the partnership "underscores Medacta's commitment to improving the patient experience while redefining the orthopedic 'product' to encompass not only the implant, but also accompanying surgical technique, education and instrumentation."
Suk said that for a devicemaker, Medacta's broad risk-sharing commitment is unique. "This is the first time our industry partner is going to share in half the risk of anything that goes wrong clinically, not just the implant. Now for the first time you have a medical industry partner saying 'we trust you so much as a clinical enterprise, we are going to stand behind your work as well.'?"
So far, one woman is enrolled in the program. Geisinger doesn't yet have an estimate of how many people will qualify for the offering or how much it will cost the system, Suk said.
"Historically, these programs haven't been a major drain on the system—they have been financially very successful and resulted in good outcomes," he said.
The new offering is an expansion of Geisinger's ProvenCare Total Hip program, which provides hip replacement surgery patients with a bundled cost that includes inpatient, follow-up care and any complications within 90 days post-surgery.
To qualify for the new program, the patient can't be a smoker or be overweight, but Suk said Geisinger typically enrolls those patients in programs to improve their health status before surgery anyway.
Hip replacement patients usually receive routine follow-up care for about a year after surgery. Patients are most vulnerable to complications the first six months or so post-surgery, Suk said. Infections can occur from the device, but the risk of complications decreases substantially a year after surgery.
"If anything happens, we are there for them (the patients) and can take care of the problem," Suk said.
Geisinger is currently exploring other musculoskeletal procedures that can also be included in the program as well as other conditions like wound or diabetic care.
