Teri Kuffel, Esq.
the business aspects of our industry. Apparently, that is becoming more and more important to survive.” “I am extremely excited about the Prosthetics 2020 initiative and am very eager to have the opportunity to participate in the lower-extremity prosthetics registry,” says Yates. “If we, as a field and as individual organizations, cannot show the value and effectiveness of our work in terms of outcomes for patients, we will continue to face ever-increasing challenges in the environment that is fast-changing around us.”
Shifting Power
help participants assess the changing market’s effect on their business models. (Read more about participants’ reactions on page 20.) The migration of $2 trillion to value-based health care was among his first predictions. He advised O&P leaders to think about bundled-care payments and where O&P services fall. “In a fee-for-value world, there is episodic care, there’s condition care, and there’s population care,” he said. “[Knowing which care category best describes O&P services] is going to be a very important call when you think about value.” Health economist and consultant Alan Dobson, PhD, co-founder of Dobson-DaVanzo, took a deeper dive into CMS’s goal of shifting half of Medicare payments away from the traditional fee-for-service model by 2018. “They are going as hard as they can… this is serious enterprise,” he said of the effort. “I would submit to you that whoever comes in the next administration is going to look around, they are going to see this amazing bit of activity that has taken place the last few years, they’re not going to like all of it, but they’re going to use a lot of it because it will be the only tools they
will have to reduce health-care utilization and take a whack at preserving the Medicare program.” The complexity and overlapping nature of government-led programs to date will demand stakeholders—including O&P providers— demonstrate their value, Dobson said. This means describing how they improve population-based health, explaining their clinical prowess, and proving functional outcomes. Participants also recognized this need for a differentiated value proposition.
Michael Lovdal, PhD
“This was my second year attending the conference, and I think both years have provided business owners with an incredible insight as to the future of O&P. That not only helps us prepare for the future, but it helps us plan our individual course for our unique businesses,” says Teri Kuffel, Esq., vice president of Arise Orthotics & Prosthetics Inc., who also presented during the event. “Because I am not a clinician, I have a different perspective— now more-valued than in the past—on
Another prediction from Lovdal is that power will shift from the federal level to states and cities as a result of exchanges, Medicaid expansion, and other factors. As a result, involvement at the state and local levels is going to become more important. This shift was echoed in presentations from Kuffel; Jeff Collins, chief financial officer for Cascade Orthopedic Supply Inc. and treasurer of the AOPA Board; and others during the conference. Lovdal pointed to several factors that should be carefully tracked in terms of local initiatives trumping federal impact: the uninsured rate among the nonelderly; Medicare Advantage contracts with four or more stars; state health-care practice restrictions; current status of exchanges and Medicaid expansion; and cities with health innovation initiatives. “[State and local dominance] worked very well in certain big sectors of the U.S. economy, like agriculture,” he said. “If we let it work in health care, we actually may be beneficiaries of it.” “Because of my role as the government affairs director for the North Carolina Orthotics and Prosthetics Trade Association (NCOPTA), I have felt this change coming in a very real way for some time now,” says Ashlie White, director of operations for Beacon P&O, who attended the event. “I believe that business owners and practitioners are going to have to look more carefully at the local and state government activities. Lovdal suggested that we do a better job self-regulating as a profession, to identify the waste, fraud, and abuse, in a concerted effort to O&P ALMANAC | FEBRUARY 2016
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