A shared saving approach to healthcare is one of the top opportunities in value-based care, neurosurgeon Praveen Reddy, MD, said on an upcoming episode of the “Becker’s ASC Podcast“.
Question: What are key trends that you’re paying close attention to today?
Dr. Praveen Reddy: One thing I’m paying attention to is the response by payers and Medicaid on how some procedures are reimbursed. I’m very passionate about value-based care or shared savings agreements. I think a lot of spine procedures can be done in an ambulatory setting, and we can save substantial costs. I had to do a capsule project, and I realized we can actually save about $16 million on an average in a year, by relocating point of care from hospital to an ASC.
Another space I’m kind of very keen on looking at is that about 30 cents of the dollar is spent on post-acute care. We’ve got to make a very concerted effort as physicians to avoid admissions and infection to reduce cost of care.
Q: What are the key areas of value-based care that you see the biggest opportunities?
PR: One is to tackle accountable care organizations and be responsible for a certain population. Basically you make a determination whether this patient needs six weeks of therapy. Does it make sense to do an epidural injection? Is this a self-resolving problem? Have a board certified neurosurgeon watching what’s happening with the patients so that we’re not spending unnecessary and at the same time making sure patient outcomes are all maintained.
From an ACO standpoint, or with large commercial payers, you can have a shared savings agreement in a market like Houston. I take care of patients on the north and northeast sides of Houston. The rest of Houston is the control population, and I am the study population. If I’m able to save expenses at the same time maintaining quality of care, the savings I think should be saved was shared with providers and systems involved. That’s one modality.
Another modality is having an upfront shared savings agreement with all payers. You’re responsible for the quality that you can either look at upside and outside risk or, you know, I think everywhere, risk model is probably an option, which you should look at. Even the payers have a clear appetite moving in that direction.
