Comprehensive Care for Joint Replacement Model

Brett Smith, M.D., M.S.
Hip & Knee Replacement Specialist
Andrews Institute for Orthopaedics & Sports Medicine
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 Q: What is the Comprehensive Care for Joint Replacement Model (CJR) and how Baptist Health Care and Andrews Institute is involved?
Brett Smith, M.D., M.S.: Andrews Institute and Baptist Health Care got involved early on in the CJR program. It's been amazing. The initial thought was to save money for the system in terms of Medicare and eventually private insurers, but really it's much bigger than that; we're taking better care of patients. The outcomes are better, our readmission rates are lower. The complications are lower. It's just been a huge benefit to the patient. Really the secondary gain is the financial impact which was the initial intent of the program – but really it's turned out to be the best thing for the patient.
 Q: How does CJR impact patients?
Brett Smith, M.D., M.S.: It's pretty much all about rapid recovery. We have found out from the programs that started this whole process that the faster the patient gets back to their normal life the better off they are in terms of reducing complications. So physical therapy is involved, the hospital is involved and the real focus is in the patient the family and outpatient therapy.
 Q: How does CJR impact Medicare?
Brett Smith, M.D., M.S.: So the first year in the program Andrews Institute and Baptist Health Care and our total joint program ended up saving a lot of money for the system (that being Medicare and Medicaid), and in return we got some of that money back and as a bonus for doing such a great job. We were the only health system in the area to receive an ‘excellent’ rating in the year one results.
 Q: Talk about the future of the CJR program and how that will impact health systems.
Brett Smith, M.D., M.S.: Before this program we thought we're doing a pretty good job. We came into this excited but nervous, and we found out that we were up to par with reducing complications, but we had little things we could change and alter and make it better for the patient and better for the system. As I said before, you know, the best part about this is in the last year of the program, I can think of one readmission and that's it. For one patient out of my 450 cases a year, it's pretty amazing and it’s exciting.


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