BICMD Surgical Bundle Spotlight

Case Study: Streamlined Orthopedic Care for Faster Recovery

In the challenging realm of workers’ compensation, successful outcomes depend on more than just treating physical injuries. They require seamless coordination, timely intervention, and high-quality care. Through its partnership with the Hospital for Special Surgery (HSS) and other similar institutions around the country, Best In Class MD’s (BICMD) Bundled Surgery Program is setting a new standard for orthopedic care. This case of a shoulder injury exemplifies how BICMD’s expert-driven approach benefits all stakeholders—patients, providers, and payors.

Background: Injury and Initial Management

The injured worker, a construction professional, sustained a shoulder injury after being struck by a falling beam. He was referred immediately to a local treating BICMD provider and managed initially with non-operative care, including physical therapy and a steroid injection. After four months of persistent pain and limited improvement, his local treating provider recommended surgery.

Recognizing the need for an expert opinion, the workers’ compensation carrier engaged BICMD to review the case and facilitate placement at a Center of Excellence. A BICMD specialist confirmed that surgical intervention was medically necessary. Through BICMD’s Bundled Surgery Program, the surgery was scheduled at HSS within two weeks of the surgical referral—dramatically reducing delays and ensuring a smooth transition to definitive care.

The Surgery: Excellence at HSS

The injured worker underwent shoulder surgery at HSS. Known for its world-class orthopedic care, HSS ensured a precise and successful outcome through its highly specialized approach.

Why HSS Stands Out:

• Unmatched Expertise: Ranked #1 in Orthopedics for the last 15 years in a row and performing over 32,000 musculoskeletal surgeries annually, HSS boasts the lowest complication and readmission rates in the U.S.
• Evidence-Based Practice: The surgery leveraged HSS’s cutting-edge techniques, maximizing precision and reducing recovery time.
• Outcome-Driven Care: HSS’s transparent and predictable episode-based payment model ensures value for patients and payers alike.

Recovery: Early and Effective Rehabilitation

A key feature of the Bundled Surgery Program is its focus on post-operative recovery. Physical therapy began just two days after surgery, a critical factor in achieving optimal outcomes. BICMD’s care coordination ensured the worker’s rehab plan was in place before surgery, preventing any gaps in care.

Key Recovery Milestones:

• Rapid Improvement: The worker experienced significant gains in shoulder mobility and strength within weeks of starting therapy.
• Return to Work: The worker was able to return to modified duty within 6 weeks.
• Patient Satisfaction: He reported feeling supported throughout the process, citing the
  seamless transition from surgery to rehab as a major factor in his positive experience.

Benefits for All Stakeholders

For the Injured Worker:

BICMD and HSS provided the worker with timely access to expert care, ensuring a smooth recovery journey. The coordination of services—from initial expert review to post-op therapy—gave him confidence and a sense of control over his recovery.

For Providers:

HSS surgeons and rehab specialists operated within a framework that prioritized efficiency and transparency, enabling them to focus on delivering the best possible care.

For Payers:

The Bundled Surgery Program ensured cost predictability, reducing administrative burdens and eliminating unnecessary delays. By minimizing recovery time, the program also reduced wage-loss costs and lead to expedited claim resolution.

A New Standard in Orthopedic Care

This case demonstrates how BICMD’s Bundled Surgery Program redefines orthopedic care in the workers’ compensation space. By combining expert medical opinions, world-class surgical care, and streamlined care coordination, the program delivers superior outcomes for all stakeholders.

The Results at a Glance:

• Surgery Turnaround: 2 weeks from referral to operation.
• Rehabilitation Start: 2 days post-op.
• Return to Modified Duty: 6 weeks post-surgery.
• Patient Experience: Highly satisfied with care coordination and outcomes.

Interested in partnering with BICMD for superior workers’ compensation solutions?
Contact us!