MPOWERHealth is an Addison, Texas-based entity that created a clinically integrated network for musculoskeletal care, which consists of a number of orthopaedic surgeons in the Texas market. Click here to learn more.
TOA recently sat down with Adam Bruggeman, MD – MPOWERHealth’s chief medical officer – to learn more about the network.
TOA: What was the impetus behind creating this network of orthopaedic surgeons and other physicians who work in musculoskeletal care?
Adam Bruggeman: MPOWERHealth had been working to support independent orthopaedic surgeons in the OR for more than a decade when the company started to see a shift in the industry in late 2017. The combination of payor and provider consolidation, technology advancements and legislative pressures along with the move from fee-for-service to value-based payment models made it challenging for independent orthopaedic surgeons to maintain autonomy and remain competitive. The market also began demanding transparency into quality and efficiency to prove value, which is almost impossible without access to the proper tools and infrastructure needed for value-based care.
Led by CEO and Founder Scott LaRoque, MPOWERHealth formed a physician network and expanded MPOWERHealth’s role in helping its customers deliver value-based care, improve quality, and drive better outcomes and efficiencies in the rapidly evolving healthcare industry. Scott’s vision stays true to the company’s mission to empower independent orthopaedic surgeons. Through our investment in evidence-based analytics infused with the experience of more than 400 highly trained experts, we provide a solution that drives better financial and quality outcomes. Our combination of expertise, curated data and leading analytics solves challenges for independent orthopaedic surgeons and builds connections between cost and care that advances revenue for long-term growth.
The vision of our physician network is to create a modern, best-in-class clinical integration program that realizes efficiency and quality goals for patients by enabling enhanced accountability and patient-care coordination, while maintaining the historically valued entrepreneurial independence of musculoskeletal medical practices.
In doing so, our physician network aims to deliver financially advantageous efficiencies and leverage cutting-edge clinical and business best practices.
TOA: This is focused on a musculoskeletal clinically integrated network (CIN). What does that entail?
Adam Bruggeman: The MPOWERHealth physician network focuses on bone health, hand and upper extremity, foot and ankle, hip and knee, neurology, sports medicine, spine, physical medicine and rehabilitation, and pain management.
TOA: How do you determine which quality factors are appropriate to measure for a CIN?
Adam Bruggeman: Our clinically integrated network focuses on quality measures that optimize patient outcomes, deliver the highest quality care at a predictable price and with an outstanding patient experience. And of course, you can’t manage what you can’t measure. A sampling of what we look at includes:
- In-patient length of stay.
- Creates an increase in cost for the facility and the surgeon for ongoing care post-operatively.
- Re-admission rate.
- Results in negative outcome for the patient.
- Results in additional post-acute spend for multi-day bundle.
- Patient satisfaction.
- Can result in increased referrals to the program.
- Can result in poor reputation of the program.
- Next site of care location.
- Can quickly result in a financially busted bundle.
- Can result in negative outcome for the patient.
- Mortality rate.
TOA: Does MPOWERHealth believe that the CIN alone will be adequate to help keep surgeons in private practice? Or will this network expand into offering other types of services for the participating physicians?
Adam Bruggeman: Often, utilizing services to optimize practices, drive efficiencies, improve patient experience and provide infrastructure at scale is unattainable and/or unsustainable for the independent physician. The MPOWERHealth CIN creates value through a comprehensive ecosystem to help generate savings and drive efficiencies through value-based incentive structures, direct-to-employer contracts, group purchasing, clinical services and practice optimization solutions.
TOA: How have employers, health plans, and other stakeholders responded to the CIN?
Adam Bruggeman: We have been in heavy conversations with payors over the past two years and have received extremely positive response. Independent musculoskeletal physicians provide healthy competition to the marketplace when we have the necessary tools and infrastructure to drive quality and cost savings.
TOA: What are the next steps for this CIN?
Adam Bruggeman: We’re engaging with employers to collaborate and optimize health plans for musculoskeletal care, and we’re working with them to better understand their employees’ musculoskeletal needs in order to develop relevant programs and solutions.