Better Care for Employees, Better Value for Employers
Externally Validated Results Patient Experience
Quality
99th percentile In many industries, “Likelihood to Recommend” is a key indicator of customer satisfaction. For 33 consecutive quarters HSS has scored in the 99th percentile on this question compared to like hospitals in the Press Ganey Database.1
2013, 2014, 2015, and 2016 Guardian of Excellence Award recipient for outstanding patient experience scores.2
#1
27 %
CareChex® — an information service of Quantros, Inc., ranked Hospital for Special Surgery No. 1 in the Nation for Medical Excellence in both Major Orthopedic Surgery and Joint Replacement for three consecutive years (2014, 2015, 2016).3
27% better than national average for Hip/Knee all-cause readmissions rate (3.3% for HSS, 4.5% for national average)4
7 years HSS goes above and beyond mandated protocols to prevent infections post surgery. We have had significantly lower infection rates than the N.Y. State average for hip replacement for seven consecutive years.5
Culture
HSS is the 1st hospital in N.Y. State and one of only 37 hospitals in the U.S. to achieve the Magnet® designation for nursing excellence four consecutive times.7
Healthgrades, the leading online resource helping consumers find the right physician and hospital, has recognized HSS with 5-star quality ratings in total hip replacement, back and neck surgery, and spinal fusion surgery.6
HSS has 6.1x as many Engaged employees to Disengaged employees, vs. 4.7x on average in Gallup’s Hospital Database.8
Sources: 1. Press Ganey Database; 2. Press Ganey, 2013–2015; 3. CareChex National Quality Rating Database, FY10–FY14; 4. MedPar Data via Hospital Compare, July 2012–June 2015, 30-Day All-Cause Unplanned Risk-Standardized Readmission for Total Hip & Knee Arthroplasty; 5. NYS DOH Hospital-Acquired Infections Reports, 2008–2014; 6. Healthgrades 2017 Report to the Nation; 7. American Nurses Credentialing Center: 2002, 2007, 2011, 2016; 8. Gallup Hospital Database, 2015
For 150+ years, HSS has specialized in the largest and fastestgrowing category of healthcare. The results are unequivocal: superior focus yields superior quality, and superior quality correlates to lower total cost of care. On the following pages we’ll look at: The Outsized Impact of Orthopedics
#1
for Orthopedics
Musculoskeletal problems are the single largest and fastest-growing driver of many employers’ healthcare spend. The Benefits of Focus Focus has earned HSS a seventh consecutive national #1 ranking in adult orthopedics by U.S.News & World Report Best Hospitals ranking (2016–2017). Higher-Quality Care Results in Lower Total Cost With more accurate diagnosis and the ability to predict, measure and anticipate problems, both common and complex, HSS delivers unmatched quality and value, which ultimately results in lower total cost to employers. Patients Report Success HSS helps patients from all walks of life, from all 50 states and more than 100 countries, get back to what they need and love to do — more reliably, efficiently, and happily. That made HSS the first hospital in the U.S. Olympic Committee’s National Medical Network, and the choice of 20 elite athletic teams. With more than 1,400 patient-submitted success stories, HSS.edu/BackInTheGame is the largest forum of its kind in the world.
The Outsized Impact of Orthopedics The Impact Felt by Employers
Musculoskeletal problems are the single largest and fastest-growing driver of many employers’ healthcare spend. Working with a healthcare provider that can effectively manage these problems leads to better outcomes and lower total healthcare costs.
16
%
Musculoskeletal conditions are the largest spend for most employers and, on average, account for 16% of employers’ overall healthcare spending.1
5.6 12 8
%
Musculoskeletal conditions are the fastestgrowing healthcare spend for most employers at 5.6% per year.1
%
Employers report that, on average, 12% of their employees miss work each year due to musculoskeletal conditions.2
Days
Employees with musculoskeletal conditions miss, on average, eight days of work each year due to those conditions.2
2
Sources: 1. Huse DM, Marder WD: “What are the leading drivers of employer healthcare spending growth?”, Truven Health Analytics, April 2013; 2. National Health Interview Survey, Adult Sample, 2012
The Benefits of Focus
HSS is entirely dedicated to musculoskeletal diagnosis and care. Singular focus pays off with real value by reducing an employer’s spend and delivering better care and experience to employees.
Higher Surgical Volume Leads to Higher Quality
Research has proven again and again that providers who focus and see the most of a particular condition get the best results. Hospitals and surgeons performing more Total Joint Replacements than their lower volume peers demonstrated better outcomes. 37% Mortality
26% AMI
45% Pneumonia
58% Infection
15% Pulmonary Embolus
Source: Katz JN et al., J Bone Joint Surg Am, 2001; 83: 1622–1629. Lyman, S et al., “The Potential Effect of Regionalization Strategies on Care Delivery for Elective Total Joint Replacement,” The Journal of Arthroplasty 30 (2015) 1–6
HSS Performs More Orthopedic Surgeries Than Other Top National Hospitals
HSS performs substantially more orthopedic procedures than other top national hospitals, with more than 100 surgeons performing more than 30,000 surgeries.
30,345
6,054
2,676
HSS Total Annual Volume
HSS Inpatient Medicare Volume
Other Leading National Hospitals Inpatient Medicare Volume
19,703
Volume of All Other Procedures
2,093
Volume of All Other Inpatient Procedures
3,961 10,642
Total Joint Replacements
Total Joint Replacements
1,832
Volume of All Other Inpatient Procedures
844
Total Joint Replacements
Source: HSS Internal Data, CMS MedPAR, Quantros, Inc., Oct 2014–Sept 2015, Orthopedic Surgical Volume
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Higher Quality Results in Lower Total Cost of Care
Value is equal to Quality plus Service over Cost, over the course of an episode of care. And quality starts with getting the diagnosis right and avoiding unnecessary care. When the diagnosis does call for s urgery, quality means doing the right procedure, avoiding unnecessary complications, and getting people back to performance as quickly as possible. HSS has found a way to anticipate, measure, and minimize potential problems, both common and complex, day in and day out. That is why patients can be assured they have the best chance of a successful outcome at HSS.
The Right Diagnosis & Treatment
It all starts with an accurate diagnosis and helping patients choose the appropriate treatment. We’re experts in getting it right the first time. Surgery benefits many patients with orthopedic conditions, but it’s not right for all patients. Many patients are told they need surgery and come to HSS for a second opinion. Among them:
30%
were recommended a non-surgical alternative, helping the patient avoid a costly, possibly unnecessary surgery.
Source: HSS internal data pilot, 2016
Fewer Complications
HSS ranks in the 99.9th percentile nationally in Major Orthopedic Surgery based on avoided complications. Source: CareChex® — an information service of Quantros, Inc. FFY2012–FFY2014 MedPAR data, Medicare only
8.1% 8.4% 4.8% 5.0% 4.8% 4.8% 3.1% 1.2% HSS 4
National Leaders
NYC Leaders
Source: CareChex National Quality Rating Database, Medicare FFY2014. Major Orthopedic Surgery (spine, hip, knee, arm, hand, shoulder)
Fewer Infections
1.4% 0.9%
1.0%
0.9%
0.4%
HSS
NYC Leaders
Source: NYS DOH Hospital-Acquired Infections Report 2013, hip replacements, all payer, risk-adjusted. National data not publicly available
Higher Discharge to Home
78%
75%
71%
HSS
70%
61%
NYC Leaders
Note: Higher is better Source: SPARCS 2013 (Public Use, De-identified), hip & knee replacements, commercial payers, risk adjustment not available. The New York State Department of Health makes no representation, warranty or guarantee relating to the data or analyses derived from these data. National data not publicly available
Fewer Readmissions
3.3%
HSS
3.9% 4.2%
National Leaders
5.0%
5.4% 4.4% 3.8% 4.0%
NYC Leaders
Source: Hospital Compare, 30-day readmission rate July 2012–June 2015, hip & knee replacements, Medicare only, risk-adjusted
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Lower Total Cost of Care The Right Diagnosis & Treatment
HSS’s focus on quality reduces the total cost over the course of an episode, by getting it right the first time and minimizing the risk of setbacks and expensive complications.
Fewer Complications Fewer Infections Higher Discharge to Home
TOTAL COST
Fewer Readmissions Fewer Revisions
HSS
0.4%
NYC Leaders
HSS
26% of patients received a non-surgical recommendation when coming to HSS for a 2nd opinion after being HSS indicated for surgery NYC Leaders
Fewer Inf
Data not publicly available
0.4%
The Right Diagnosis NYC Leaders 1 & Treatment
0.9%–1.4%
Fewer Infections 3 Fewer Infections
0.9%–1.4%
HSS
0.4%
NYC Leaders
HSS
0.4% HSS 78% Fewer Infections NYC Leaders 0.9%–1.4% Fewer Infections 0.9%–1.4% Higher D NYC Leaders 61%–75%
78% Higher Discharge to Home
61%–75%
Higher Discharge to Home 4 HSS
78% 78% HSS 1.2% Higher Discharge to NYC Leaders 61%–75% Higher Discharge to Home Fewer Co 61%–75% National Leaders 3.1%–8.4% Note: Higher is better
HSS
Fewer Complications 2 NYC Leaders HSS 1.2% National Leaders
3.1%–8.4%
Fewer Complications
Fewer Readmissions 5
HSS 1.2% HSS 3.3% Fewer Complication National Leaders 3.1%–8.4% Fewer Complications National Leaders 3.1%–8.4% National Leaders 3.8%–5.4% Fewer Re HSS 1.2%
HSS
3.3%
“Research shows that if all patients scheduled for knee replacement were directed to National Leaders 3.8%–5.4% Fewer Readmissions high-volume hospitals with high-volume surgeons, it could save the U.S. healthcare system ~$2.5 billion to $4 billionHSS annually by3.3% the year 2030.” 6 HSS
6
3.3%
Leaders 3.8%–5.4% Fewer Sources: 1. HSS Internal Data Pilot, 2014–2015; 2. CareChex National QualityNational Rating Database, Medicare FFY2014. Major Orthopedic Surgery National Leaders 3.8%–5.4% (spine, hip, knee, arm, hand, shoulder); 3. NYS DOH Hospital-Acquired Infections Report 2013, hip replacements,Fewer all payer,Readmissions risk-adjusted. National data not publicly available; 4. SPARCS 2013 (Public Use, De-identified), hip & knee replacements, commercial payers, risk adjustment not available. The New York State Department of Health makes no representation, warranty or guarantee relating to the data or analyses derived from these data. National data not publicly available; 5. Hospital Compare, 30-day readmission rate July 2012–June 2015, hip & knee replacements, Medicare only, risk-adjusted; 6. Burket, Jayme, et al., “The Cost-Effectiveness of Total Knee Arthroplasty at High Volume Hospitals,” 2016. See sources on pages 4–5 for all remaining figures.
Readmission
Back in the Game
Many of our patients are in pain when they first come to HSS, and often are not able to function in the way they need. On average, these patients do much better after surgery at HSS, according to the information they report to the Hospital. Less downtime, more productivity.
Patients report improvement two years after Total Knee Replacement
Relief from pain:
Return to function:
Quality of life:
97.0
96.3
93.7
Source: HSS Arthroplasty Registry, 2007–2012
Patients report improvement two years after Total Hip Replacement
Relief from pain:
Return to function:
Quality of life:
99.4
98.8
97.8
Source: HSS Arthroplasty Registry, 2007–2012
Patients report improvement two years after ACL Reconstruction
Relief from pain:
Return to function:
Quality of life:
92.0
96.3
83.4
Source: HSS ACL Registry, 2009–2012
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Delivering the Care Our Patients Want
92% As is the case in other industries, “likelihood to recommend” is a leading indicator of success. Ninety-two percent of patients would recommend HSS, compared to 72 percent average among hospitals nationwide. Source: http:www.hcahpsonline.org. Centers for Medicare & Medicaid Services, Baltimore, MD 2013
The World Chooses HSS
120,000+ The number of patients served at HSS last year. Patients want the value we deliver.
1,400+ Number of patient-submitted recovery stories in the world’s largest online forum of its kind.
100+ The number of countries represented by our patient population. We work hard to offer care worth traveling for. Source: HSS internal data 2015; number of countries over last 3 years (2013–2015)
Where Top Athletes Go
20+
National, professional, and collegiate teams rely on HSS.
U.S. OLYMPIC NATIONAL MEDICAL CENTER
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How HSS and Optum Can Partner Can Partner with You with You
HSS offers employers a range of services to provide them with additional value and to deliver better results and convenience to employees. These services include facilitated access, onsite services, online second opinions, and employee education aimed at preventing and managing problems.
FACILITATED ACCESS
A History of Success
HSS ONSITE
2ND OPINION E-CONSULT
EMPLOYEE EDUCATION
“ At HNW we identify and partner with the best hospitals in the country. This is a small, select group. HSS has been one of these partners for close to a decade. They not only differentiate themselves with outstanding results, but also have a friendly, caring culture that starts in their executive offices and permeates throughout the organization. For 25 years I have worked with the best hospitals and only a handful have been able to create a culture to match their medical results.” William Rowley, Chairman & Founder, Healthnetwork Foundation
“ Patients rely on PinnacleCare for access to the best healthcare in the world. HSS is always a top choice for orthopedics and rheumatology because of their commitment to delivering better results while maintaining the highest level of personalized service for patients. We have relied on them as a Medical Center of Excellence since 2006. HSS is a leader in optimizing outcomes while working to reduce both clinical and cost inefficiency for both patients and partners. What is clearly best for the patient happens to yield better value — a win-win for everyone.” Miles Varn, M.D., Chief Medical Officer, PinnacleCare Private Health Advisory
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Hospital for Special Surgery 212.606.1000 / www.hss.edu