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.