Johnson & Johnson Medical Devices Companies Value-Based Solutions Help Health Systems Address Proposed Mandatory CMS Plan for Episode Payment Models

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WEST CHESTER, PA – August 3, 2016 – The Johnson & Johnson Medical Devices Companies are helping health systems across the US achieve better outcomes, efficiencies and higher patient satisfaction through its proven DePuy Synthes Geriatric Fracture Program. DePuy Synthes pioneered the Geriatric Fracture Program for the past decade, and now, it has the potential to assist hospitals to address the Centers for Medicare & Medicaid Services (CMS) newly proposed mandatory coordinated care/episode payment programs.

The new CMS proposal includes mandatory episode payment models for surgical hip/femur fracture treatment (SHFFT), acute myocardial infarction (AMI) and coronary artery bypass graft (CABG). The proposed payment arrangements are models that compensate providers for an episode of care during the inpatient stay and for 90 days after discharge, not the individual components of care. The proposed rule was published yesterday in the Federal Register.

As a leader in the market for delivering solutions to treat patients with hip fractures and with experience in helping health systems navigate the Comprehensive Care for Joint Replacement Model (CJR), DePuy Synthes is in a unique position to support the hospitals in the 67 metropolitan statistical areas that may now have to expand the CJR program to also include hip fracture patients.

Hip fractures due to osteoporosis are a major public health burden. Approximately 258,000 people aged 65 and older were admitted for hip fractures in 20101. The estimated lifetime cost for all hip fractures in a single year is $20 billion2. And, the prognosis of hip fracture among the elderly is very poor with increased mortality, nursing home stays and loss of independence.

“The CMS proposal accelerates the drive toward a more integrated, value-based health care system in the US,” says Tim Schmid, Chief Strategic Customer Officer, Johnson & Johnson Medical Devices Companies. “By its very design, the Geriatric Fracture Program significantly elevates the ability of hospitals to meet the goals of the Triple Aim by improving patient outcomes, reducing costs and enhancing the patient experience. The Geriatric Fracture Program has a proven track record in more than 150 hospitals. Several hospitals that have implemented the program have gone on to receive certification by The International Geriatric Fracture Society.”

The Geriatric Fracture Program is part of a broader suite of solutions from the Johnson & Johnson Medical Devices Companies that helps health systems provide value. These solutions focus on operational integration and efficiency, continuum of care, and patient engagement and experience. The Geriatric Fracture Program provides a team-based approach to treating patients from the time they arrive in the emergency department through discharge and helps hospitals improve patient care through an organized effort including everything from early surgical intervention (within 24 hours of fracture) and management of co-morbidities to evidence-based care pathways, prevention of delirium, early supported discharge and multi-disciplinary fracture program.

The Geriatric Fracture Program is comprised of four distinct components that complement the proposed episode payment program and how hospitals will be measured by CMS:

  • • Opportunity assessment to determine the facility’s readiness to implement the program.
  • • Implementation support to ensure smooth implementation and a standardized pathway.
  • • Program materials to assist in all aspects of implementation.
  • • Performance dashboard to help collect data and metrics.

Coordinated programs for the management of geriatric patients with hip fractures have a proven track record in addressing morbidity, mortality3, and costs. Some studies have demonstrated statistically significant reductions in length of stay4, post-operative delirium5 and in-hospital post-operative falls6.

In addition to the Geriatric Fracture Program, through an exclusive relationship with MedTrak Inc., DePuy Synthes offers hospitals CareSense Pathways, a system that educates, monitors and communicates with patients to guide them through their course of care. Hospitals that have implemented this program have been able to demonstrate improvements in post-acute care for hip fracture patients by using care navigation and deploying nurses to conduct follow-up visits with patients after discharge from the hospital.

About Johnson & Johnson Medical Devices Companies
Having made significant contributions to surgery for more than a century, the Johnson & Johnson Medical Devices Companies are in the business of reaching more patients and restoring more lives. The group represents the most comprehensive surgical technology and specialty solutions business in the world, offering an unparalleled breadth of products, services, programs and research and development capabilities directed at advancing patient care while delivering clinical and economic value to health care systems worldwide.

About DePuy Synthes Companies
DePuy Synthes Companies of Johnson & Johnson provides one of the most comprehensive portfolios of orthopaedic and neurological solutions in the world. DePuy Synthes Companies solutions, in specialties including joint reconstruction, trauma, neurological, craniomaxillofacial, spinal surgery and sports medicine, are designed to advance patient care while delivering clinical and economic value to health care systems worldwide. For more information visit, Follow us on Twitter @DePuySynthes.

1. Smith et al. Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc. 2015 Oct;63(10):2029-35.
2. Smith et al. Increase in Disability Prevalence Before Hip Fracture. J Am Geriatr Soc. 2015 Oct;63(10):2029-35.
3. Grigoryan KV, Javedan H, Rudolph JL. Orthogeriatric care models and outcomes in hip fracture patients: a systematic review and meta-analysis. Journal of orthopaedic trauma. Mar 2014;28(3):e49-55.
4. Literature Review, March 2015

  • • Collinge CA, McWilliam-Ross K, Beltran MJ, Weaver T. Measures of clinical outcome before, during, and after implementation of a comprehensive geriatric hip fracture program: is there a learning curve? Journal of orthopaedic trauma. Dec 2013;27(12):672-676.
  • • Dy CJ, Dossous PM, Ton QV, Hollenberg JP, Lorich DG, Lane JM. The medical orthopaedic trauma service: an innovative multidisciplinary team model that decreases in-hospital complications in patients with hip fractures. Journal of orthopaedic trauma. Jun 2012;26(6):379-383.
  • • Khasraghi FA, Christmas C, Lee EJ, Mears SC, Wenz JF, Sr. Effectiveness of a multidisciplinary team approach to hip fracture management. Journal of surgical orthopaedic advances. Spring 2005;14(1):27-31.
  • • Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of a comanaged Geriatric Fracture Center on short-term hip fracture outcomes. Archives of internal medicine. Oct 12 2009;169(18):1712-1717.
  • • Miura LN, DiPiero AR, Homer LD. Effects of a geriatrician-led hip fracture program: improvements in clinical and economic outcomes. Journal of the American Geriatrics Society. Jan 2009;57(1):159-167.

5. Literature Review, March 2015

  • • Marcantonio ER, Flacker JM, Wright RJ, Resnick NM. Reducing delirium after hip fracture: a randomized trial. Journal of the American Geriatrics Society. May 2001;49(5):516-522.
  • • Vidan M, Serra JA, Moreno C, Riquelme G, Ortiz J. Efficacy of a comprehensive geriatric intervention in older patients hospitalized for hip fracture: a randomized, controlled trial. Journal of the American Geriatrics Society. Sep 2005;53(9):1476-1482.
  • • Milisen K, Foreman MD, Abraham IL, et al. A nurse-led interdisciplinary intervention program for delirium in elderly hip-fracture patients. Journal of the American Geriatrics Society. May 2001;49(5):523-532.
  • • Deschodt M, Braes T, Flamaing J, et al. Preventing delirium in older adults with recent hip fracture through multidisciplinary geriatric consultation. Journal of the American Geriatrics Society. Apr 2012;60(4):733-739.

6. Stenvall M, Olofsson B, Lundstrom M, et al. A multidisciplinary, multifactorial intervention program reduces postoperative falls and injuries after femoral neck fracture. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. Feb 2007;18(2):167-175.