MitigatingRisk|ImprovingPatientCompliance|EnhancingPatientOutcomes

PinnacleOrthopaedicsLunch

www.dvtnow.com/www.rangeofmotion.us

RangeofMotionatrustedlocalpartner

Patientsareleavingthehospitalsooner

Continuetodrivethehealthcareindustrytowardmore“in-home”medicalsolutionsand“sameday”procedures.

CostPressures1MedicarehasdeemedDVTa“NeverEvent”;thus,ifapatientacquiresaDVTwithin30dayspostoperatively,thehospitalisresponsiblefortreatmentcost

NeverEvents 4

Post-Surgical

PatientsareatthehighestriskforDVTwhilerecoveringathome

2

Costreductionprogrambasedonsurveydata.DVTpreventionisoneofthefactorsusedtocalculatehospitalperformancecreatingtheneedforabettercontinuumofcare

ValueBasedPurchasing 3

OutcomeBasedValue

andDVTriskcanlastfor30plusdayspostdischarge.RangeofMotionisaproductagnosticproviderofmechanicalDVTprophylacticdevicesthathelppreventpost-operativeDVTformoderatetohighriskpatients,whilemaintainingfocusonpatientoutcomeandvalueMarch14,2016

It’snottheprocedurebeingperformed,it’sthepatient’sriskfactors

ByperformingasimpleriskassessmentyourpatientscanbeprotectedfromlifethreateningDVT,whichreducesthephysiciansliabilityandresultsinbetterpatientoutcome

AccordingtoJCAHOallfacilitiesshouldbedoingaDVT/PEriskassessmentonallpatients

AssessingPatientRisk

75% ReductioninDVT/PEwithuseofpharmaceuticalsandmechanicalprophylaxis

Intermittentpneumaticcompressionisaseffectiveaspharmacologicalwithnobleedingorsideeffects

AACPandAAOSagreethataspirinisnotanappropriatesoleoptionforpreventionofVTE

5x Lessexpensivethanmanyanticoagulants

1. Source:TheCochraneLibrary2008,Issue4.“Combinedintermittentpneumaticlegcompressionandpharmacologicalprophylaxisfor thepreventionofvenousthromboembolisminhigh-riskpatients(Review)

IntermittentPneumaticCompressionismorecost-effectivethanPharmacological• Pharmacologicaltherapycancostasmuchas$1800permonthperpatient• Pneumaticprophylaxishasfeeschedulesoflessthan$350

Anticoagulant TypicalDose TypicalCost/Day TypicalCost/Monthly

Enoxaparin/Lovenox 40-90mg $30- $70 $900- $2100

Warfarin/Coumadin 3-6mg $3- $6 $90- $190+INRtesting

Fondaparinux /Arixtra 2.5mg $50- $100 $1500- $3000

75% ofDVTsoccurinthefirst48hoursfollowingaTHA/TKA

postoperativedayisdemonstratedtohavethehighestpeakofDVTincidencesaccordingtostudies

10recommendnumberofdaysofDVTprophylaxisfollowingmajororthopedicsurgeryaccordingtoCapriniguidelines

5th

CostReductionprogrambasedonsurveydata• 20%clinicalprocess• 30%patientexperience• 30%outcome• 20%efficiency

DVTprevenation isoneofthefactorsusedtocalculatehospitalperformance

NeverEvents• MedicarehasdeemedDVTa“NeverEvent”thus,ifapatient

acquiresaDVTwithin30dayspostoperatively,thehospitalisresponsiblefortreatmentcosts

• BlueCross,UnitedHealthcare,Cigna,andAetnahavealladoptedtheMedicarenevereventsguidelines

• $50,937*perpatient• *MedicareestimatedcosttotreataDVT

ThecostofnevereventsNeverEventCostUsing AnticoagulantsAlone NeverEvent SavingsAddingMechanicalProphylaxis

TotalNumberofKnees/HipsPerformedatFacilityPerYear

300 TotalNumberofKnees/HipsPerformedatFacilityPerYear

300

%ofDVTIncidence WithAnticoagulantProphylaxis

2%- 15% %ofDVTIncidenceWithAnticoagulantandROMMechanicalProphylaxis

1%- 3.7%

NumberofPatients 6- 45 NumberofPatients 3- 11

DVT/PEHospitalStayCost $50,937/Patient DVT/PEHospitalStayCost $50,937/Patient

AnnualNon-ReimbursedExpensetoTreat VTEPerYear

$305,622 - $2,292,165 AnnualNon-ReimbursedExpensetoTreat VTEPerYear

$152,811- $560,307

SavingsAddingMechanicalDVTProphylaxis$152,811- $1,731,858

1)CMSFactSheet“CMSProposesAdditiontoListofHospitalAcquiredConditionsforFiscalYear2009”2)THA/TKAfromevidence-basedclinicalstudiesonpost-operativeDVTincidencewithprophylaxisafterTKA/THA3)NewDVTincidence%usingROMsolutions basedonclinicalstudies

OrthopedicSurgeon’sOffice Hospital/ASC

RehabFacility BundledOfferings

OrthopedicSurgeon’sOffice

} Preventlife-threateningDVT} Moreofferingsfewervendorsinyouroffices} Betterpatientoutcomes} 90%compliancevs25%withpharmaceuticals} Nolostorbrokenproductstoworryabout} 24/7/365patientservice} Reducedliability} Increasedrevenueduetolowerreadmissionsandaveragecostperepisode

OrthopedicSurgeon’sOffice

} SignAssignmentofBenefits

} PrescribetakehomeDVTtopatientattimesurgeryisscheduled} Applysleevesandcompletebillingsheet} SendpaperworktoROM} NotifyROMifsurgerydatechanges

} Stockproductordelivertopatient} HaverepchecktheSCDstockweekly} BillPatient’sinsuranceforproduct} Callpatientwithin72hrs ofreceivingbillsheet

BundledOfferings

} GoHomeDVT

} CPM} Crutches} PostOp-Brace} ColdTherapy

} GoHomeDVT} CPM} Walker} 3-1BedsideCommode} ColdTherapy

ProductAgnostictoFitNeedsandBudgets

Weownourcontracts

Plusmanymore!

19yearsservingourcommunity

#1providerofMechanicalDVTpreventioninGeorgia

24/7/365customersupport

BrooksHarvard770.402.0718brooks.harvard@rangeofmotion.us

THANKS

10%-30%

Willdiewithin1monthofdiagnosis

900KTotalnumberofpeoplethatmaybeeffectedbyDVT/PEeachyearinAmerica

25%OfpeoplewhosufferfromPE,death isthefirstsymptom

Ofpopulationhasoneofseveralgeneticriskfactorsknownasinheritedthrombolysis

8%http://www.cdc.gov/ncbddd/dvt/data.html