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IPG Appoints New Board Member Vince Coppola

ATLANTA, Georgia (August 5, 2016) – The Board of Directors of IPG yesterday announced the election of Vince Coppola to their Board. Mr. Coppola joined the company in March of this year and currently serves as the President and CEO.

“We are extremely pleased to welcome Vince to the Board,” said Dennis Antinori, Chairman of the Board for IPG. “In the relatively short time Vince has been with the organization, he has made a significant impact, and that coupled with his strategic vision for the Company makes him a valuable asset to the group. We look forward to his contributions not only as President and CEO, but as an integral member of the Board.”

Prior to IPG Mr. Coppola served as President and CEO, and board member of Triad, a surgical and pain management company. After leading the company to significant growth and profitability, Coppola stayed on as CEO with the company after the acquisition by MedSolutions in 2013 to assist in a successful integration and its continued growth. Mr.Coppola’s previous experience includes serving in Executive leadership positions with Blue Shield of California, United Health Group, Cigna, JPMorgan, and General Electric.

“I am honored to be expanding my role at IPG and joining the Board,” said Vince Coppola, President and CEO with IPG. “We have a significant opportunity to further expand our leadership position in the Device Benefit Management market and I look forward to leading the company into that next level of success.”

About IPG

IPG is the leading provider of Device Benefit Management solutions, working with the top health plans and their provider partners across the country to improve quality and reduce costs for surgical procedures through optimization of the most effective site of care and device selection, resulting in more affordable high-quality care to consumers. For more information about IPG, call us at 866.753.0046, or visit us on the web at www.ipg.com.

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IPG Named 18th Fastest Growing Private Company At The 2016 Georgia FAST 40 Awards

IPG Named 18th Fastest Growing Private Company At The 2016 Georgia FAST 40 Awards

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“We are honored to be recognized by the Georgia Fast 40 for the growth we have been able to achieve to date. At IPG, we continue to work with our health plan customers and physician partners to improve quality and reduce costs for surgical procedures through optimization of the most effective site of care and device selection.  By aligning incentives and giving our health care partners the right tools, we have been able to have a positive impact in a large and expensive area of health care, resulting in high quality care for members while lowering health care costs,” said Vince Coppola, President and CEO for IPG. “As the healthcare industry continues to evolve and more of these implantable surgical procedures are moving to the lower cost, high quality setting, our model will continue to help our payer clients and partnering facilities and physicians bring more affordable, high-quality care to their patients.”

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IPG Appoints Julie Roberts as COO

ATLANTA, Georgia (June 10, 2016) – IPG, the recognized industry-leading provider of Device Benefit Management solutions today announced that it has appointed Julie Roberts to its leadership team as the company’s Chief Operating Officer, effective June 13. In her role as COO, Roberts will look to bring her vast health care expertise to improve our operational and business management capabilities to the benefit of our customers and the overall growth of the business.

Prior to her appointment, Roberts spent eight years with Blue Shield of California as a senior executive, where she ran the Individual and Family Plan business unit and focused on network programs and strategy. Most recently, she served as a consultant to Surgical Care Affiliates (SCA) where she led the value based care team working closely with key physician and payer partners at multiple surgical centers. Roberts also held key leadership positions at Dignity Health, Pepsi-Cola, in management consulting, and as a U.S. Naval Officer. Roberts earned a Bachelor of Science degree at the United States Naval Academy, and received her MBA in Strategy and Marketing from the Kellogg School of Management at Northwestern University.

“Julie’s wealth of experience in working with health plans and surgery centers is the perfect fit for IPG in serving our two key constituents, and we are excited to have her join the team,” said Vince Coppola, President and CEO for IPG. “As the company continues to evolve to meet the growing market needs, Julie’s track record of success will be truly valuable in driving optimization of our operations and connectivity with our clients. We welcome her leadership and innovation at IPG.”

IPG experienced over a 60% growth rate last year, and is continuing that momentum partnering with all of the major payers across the country to successfully drive down health care costs while, at the same time, ensuring quality of care for consumers.

“IPG is a fast growing, fast paced, and innovative company that is truly working to improve the cost and delivery of healthcare,” said Julie Roberts. “I’m thrilled to join the team and incredibly energized to help lead the company to its next phase of growth tied with internal and external operational excellence.”

About IPG

As the Device Benefit Management leader, IPG delivers a customized, data-driven approach to enable their health plan partners to manage their surgical and implant costs more effectively. Providing true end-to-end solutions for the healthcare industry, IPG serves as a strategic capability for health plans to manage cost and risk in a unique way that drives collaboration between the plan, their healthcare providers, manufacturers and physicians to ensure that patients receive increased access to affordable and innovative life-saving and life-enhancing device-intensive medical therapies. Additionally, IPG’s award-winning analytics platform for implantable procedures delivers transparency to impact the entire health care transaction process and all sites of care. Continued expansion of IPG’s surgical cost management platform will help health plans to deploy programs that will improve their ability to manage risk and deliver actionable information to everyone involved in a patient’s surgical procedure to drive lower costs and high-quality care for consumers. For more information about IPG, call us at 866.753.0046, or visit us on the web at www.ipg.com.

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IPG Receives $15MM in Mezzanine Debt Financing from Silicon Valley Bank

ATLANTA, Georgia (May 3, 2016) – IPG, the recognized industry-leading provider of Device Benefit Management™ solutions, announced today that they are expanding their long-time partnership with Silicon Valley Bank (SVB), the bank of the world’s most innovative companies and their investors, to include $15MM in Mezzanine Debt financing. The new facility will enable the replacement of an existing $10MM facility on more favorable terms.

With a primary focus on large, fast-growth device intensive markets, such as cardiology, neurology, orthopedic and spine, IPG is privileged to partner with the top five leading health plans in the country, assisting in lowering their implantable device costs and driving the surgical procedure to the most cost efficient site of service. IPG is solving the problem of price variability, high markups, and utilization and trend increases that have historically plagued health plans’ implantable device management and continues to bring a unique level of transparency and intelligence that extends their involvement in device selection to significantly impact those related costs.

“After a year of phenomenal growth where IPG increased revenues by 66%, we are continuing to invest in infrastructure and new products to support our ever increasing health plan clients,” said Vince Coppola, President and Chief Executive Officer for IPG. “This additional working capital provided will enable us to more quickly bring additional products to market that continue to drive down the cost of healthcare for our clients and their network. SVB, with their suite of products, continues to be a primary driver in providing for our funding needs for the continued growth of our business.”

“We’re pleased to continue our partnership with IPG as they expand and scale their portfolio of surgical and implantable device management solutions,” said Dale Kirkland, Managing Director for Silicon Valley Bank in Atlanta. “Our aim is to provide the IPG team with the right financing, connections and global services that they need to move their business forward quickly.”

About Silicon Valley Bank

For more than 30 years, Silicon Valley Bank (SVB) has helped innovative companies and their investors move bold ideas forward, fast. SVB provides targeted financial services and expertise through its offices in innovation centers around the world. With commercial, international and private banking services, SVB helps address the unique needs of innovators. Learn more at svb.com.

About IPG

As the Device Benefit Management™ leader, IPG delivers a customized, data-driven approach to enable their health plan partners to manage their surgical and implant costs more effectively. Providing true end-to-end solutions for the healthcare industry, IPG serves as a strategic capability for health plans to manage cost and risk in a unique way that drives collaboration between the plan, their healthcare providers, manufacturers and physicians to ensure that patients receive increased access to affordable and innovative life-saving and life-enhancing device-intensive medical therapies. Additionally, IPG’s award-winning analytics platform for implantable procedures delivers transparency to impact the entire health care transaction process and all sites of care. Continued expansion of IPG’s surgical cost management platform will help health plans to deploy programs that will improve their ability to manage risk and deliver actionable information to everyone involved in a patient’s surgical procedure to drive lower costs and high-quality care for consumers. For more information about IPG, call us at 866.753.0046, or visit us on the web at www.ipg.com.

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IPG Board Names Vince Coppola as President and CEO

ATLANTA, Georgia (March 30, 2016) – IPG, the recognized industry-leading provider of Surgical and Implant Cost Management solutions today announced that its Board of Directors named Vince Coppola as the company’s President and Chief Executive Officer, effective March 31. As President and CEO, Vince will look to advance the company’s growth and evolution, while further building out its customer base and product portfolio.

Coppola most recently served as President and CEO of Triad, a musculoskeletal care management company. After leading the company in significant growth and profitability, Coppola stayed on as CEO with the company after the acquisition by MedSolutions in 2013 to assist in a successful integration and its continued growth. Coppola’s previous experience includes serving as the Vice President of Strategy and Business Development at Blue Shield of California, where he developed strategies to increase the company’s market position and competitiveness. Earlier, he served as Senior Vice President, Corporate Development of Magellan Health Services where he developed and executed a plan to successfully expand into Radiology and Specialty Pharmacy.  Coppola also held leading positions at United Health Group, Cigna, JP Morgan Chase and GE Capital.

“This is an opportune time for Vince to become IPG’s Chief Executive Officer, and we are delighted to have him join the team. Vince not only brings a high level of healthcare and payer experience integral to our business, but brings specific experience in the health care services arena and a proven track record of rapidly and successfully growing the companies he has been associated with,” said Dennis Antinori, Executive Chairman of the Board for IPG. “Vince truly stood apart as a leader, with his extraordinary ability to connect vision, people and innovation to drive strategy and success, and we look forward to his leadership at IPG.”

IPG experienced over a 60% growth rate last year, and is continuing that growth and momentum partnering with all of the major payers across the country to successfully drive down health care costs while ensuring quality of care for consumers.

“I wanted to be a part of a company that has the capabilities to drive quality and value for all healthcare stakeholders. Today, I am even more convinced that IPG is that company,” said Vince Coppola. “Over the past 10 years, the vision and leadership of the company have built IPG into one of the most innovative companies in healthcare and the clear leader in the surgical and implant cost management business.  The opportunity that lies ahead for IPG is enormous, and the ability to lead this next chapter is both humbling and exhilarating. I am focused on accelerating the innovation and execution that our customers need from us. Their success will continue to drive us and I am confident in our ability to win, and honored to lead this great company.”

Coppola will be based at the IPG headquarters in Alpharetta, GA.

About IPG

As the Surgical and Implant Cost Management leader, IPG delivers a customized, data-driven approach to enable their health plan partners to manage their surgical and implant costs more effectively. Providing true end-to-end solutions for the healthcare industry, IPG serves as a strategic capability for health plans to manage cost and risk in a unique way that drives collaboration between the plan, their healthcare providers, manufacturers and physicians to ensure that patients receive increased access to affordable and innovative lifesaving and life-enhancing device-intensive medical therapies. Additionally, IPG’s award-winning analytics platform for implantable procedures delivers transparency to impact the entire health care transaction process and all sites of care. Continued expansion of IPG’s surgical cost management platform will help health plans to deploy programs that will improve their ability to manage risk and deliver actionable information to everyone involved in a patient’s surgical procedure to drive lower costs and high-quality care for consumers. For more information about IPG, call us at 866.753.0046, or visit us on the web at www.ipg.com.

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LANDING: Aetna Georgia Successfully Driving Reduction in Cost of Care

Aetna Georgia Successfully Driving
Reduction in Cost of Care

Working together with IPG to Shift Performance of Total Joint, Spine
and other High Acuity Procedures to an optimal Cost and
Quality Setting for their Members.

In this case study, we will tell you how Aetna, specifically the Aetna-GA market worked successfully with IPG, in conjunction with Kearny Street Consulting, Pinnacle Orthopaedics and several of their leading ASC partners to implement a targeted plan to shift outpatient procedures to an optimal cost and quality setting.

MARKET OPPORTUNITY

Health plans are faced with finding new ways to contain medical expenses on behalf of their membership. One key area driving those expenses is surgical procedures, more specifically those surgeries requiring an implantable device, such as knee replacement and rotator cuff surgeries just to name a few.

Not only has the utilization of those procedures gone up, but so have the relative costs. US demand for implantable medical devices is forecast to increase 7.7% annually to $52 billion in 2015, with orthopedic implants forecast to rise 8.8% annually. The spinal surgery device market is expected to grow at a Compound Annual Growth Rate (CAGR) of 4% from $6.5 billion in 2011 to $8.7 billion in 20181.

In addition, a mere 15% of implant procedures are performed in an ambulatory surgery center (ASC) outpatient setting. On average, there are over 2,000 unique Site of Care eligible procedures and almost 500 implant-related Site of Care procedures capable of being performed in an ASC environment2. Recently, more complex procedures such as total joint replacements and spine procedures are safely and more affordably being performed in ASCs. However, due to fee differentials, many of these procedures are redirected away from an ASC location to hospitals or HOPD’s. The higher cost associated with the procedure being redirected away from ASCs are passed onto the health plan, employers and members.

“The IPG-Pinnacle model is a great success story that we are replicating across Georgia and other Aetna markets to promote the appropriate coverage and reimbursement structure that supports eligible procedures, like total joints and spine cases to be delivered in the optimal cost and quality setting. Working with IPG allows us to identify those eligible facilities, surgeons and procedures that can be done in a more affordable setting thereby helping us manage our surgical costs to the benefit of our members.”

Alfred Ross
Director of Network Management
Aetna

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CASE STUDY: Aetna
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LANDING: Pinnacle Orthopaedics, Aetna and Kearny Street Consulting

Pinnacle Orthopaedics, Aetna &
Kearny Street Consulting

Working together with IPG to Enable Performance of
Total Joint & Spine Procedures in an Optimal Cost and Quality Setting.

financial-independence-icon

Payer Reimbursement

Procedure coverage and reimbursement for higher acuity procedures

procedure-increase-icon

Procedure Increase

Conservative estimate of 20+ new
high acuity cases annually (1-2 per month)

increased-margins-icon

Increased Margins

Significant increase in revenue and profit margins ($2,500-$3,500 per case)

increased-cash-flow-icon

More Profit Less Outlay

Increased profitability without the need for upfront cash outlay

MARKET OPPORTUNITY

There was a time when procedures such as total joint replacements were thought to be too complex and risky to be performed in ambulatory surgery centers (ASCs). Today, those facilities have proven that with a highly trained surgical staff, a well-thought-out perioperative plan, and a motivated patient, these procedures can be done successfully in an ASC – and for about half of what they would cost in a hospital.

The primary obstacle that most ASCs like Pinnacle Orthopaedics face is getting the right reimbursement for the procedures to make them viable revenue sources. Pinnacle was initially out-of-network, and the majority of their contracts did not have a provision for implants. This limited the number of cases they could take to the ASC.

In this case study, we will tell you how Pinnacle Orthopaedics worked successfully with IPG, in conjunction with Aetna and Kearny Street Consulting, to enable their physicians to perform total joint replacement and other more complex surgical procedures at their facility.

“The IPG-Pinnacle model is a great success story that we are replicating across Georgia and other Aetna markets to promote the appropriate coverage and reimbursement
structure that supports eligible procedures, like total joints and spine cases to be delivered in the optimal cost and quality setting. Working with IPG allows us to identify those eligible facilities, surgeons and procedures that can be done in a more affordable setting thereby helping us manage our surgical costs to the benefit of our members.”

Alfred Ross
Director of Network Management
Aetna

GET THE FULL CASE STUDY

Complete The Form Below For Instant Access
CASE STUDY: Pinnacle
Sending

Aetna Georgia Successfully Driving Reduction in Cost of Care

Aetna Georgia Successfully Driving
Reduction in Cost of Care

Working together with IPG to Shift Performance of Total Joint, Spine
and other High Acuity Procedures to an optimal Cost and
Quality Setting for their Members.

In this case study, we will tell you how Aetna, specifically the Aetna-GA market worked successfully with IPG, in conjunction with Kearny Street Consulting, Pinnacle Orthopaedics and several of their leading ASC partners to implement a targeted plan to shift outpatient procedures to an optimal cost and quality setting.

CLIENT CHALLENGE

As one of the nation’s leading diversified health care benefits companies, Aetna serves an estimated 46.5 million people with information and resources to help them make better informed decisions about their health care. Headquartered in Atlanta, Georgia, the Aetna-GA constituent serves over 550,000 members.

At the time the IPG program was rolled out within Aetna, there was limited transparency and predictability around surgical and implants cost in the Georgia market. Aetna was exposed to increased procedure inflation due to the demographic shift and baby boomer impact, and faced the need to manage and reduce risk exposure under the Accountable Care Act (ACA). They were also exposed to annual medical cost increases due to the dramatic differences in cost of care between settings and providers.

“The IPG-Pinnacle model is a great success story that we are replicating across Georgia and other Aetna markets to promote the appropriate coverage and reimbursement structure that supports eligible procedures, like total joints and spine cases to be delivered in the optimal cost and quality setting. Working with IPG allows us to identify those eligible facilities, surgeons and procedures that can be done in a more affordable setting thereby helping us manage our surgical costs to the benefit of our members.”

Alfred Ross
Director of Network Management
Aetna

MARKET OPPORTUNITY

Health plans are faced with finding new ways to contain medical expenses on behalf of their membership. One key area driving those expenses is surgical procedures, more specifically those surgeries requiring an implantable device, such as knee replacement and rotator cuff surgeries just to name a few.

Not only has the utilization of those procedures gone up, but so have the relative costs. US demand for implantable medical devices is forecast to increase 7.7% annually to $52 billion in 2015, with orthopedic implants forecast to rise 8.8% annually. The spinal surgery device market is expected to grow at a Compound Annual Growth Rate (CAGR) of 4% from $6.5 billion in 2011 to $8.7 billion in 20181.

In addition, a mere 15% of implant procedures are performed in an ambulatory surgery center (ASC) outpatient setting. On average, there are over 2,000 unique Site of Care eligible procedures and almost 500 implant-related Site of Care procedures capable of being performed in an ASC environment2. Recently, more complex procedures such as total joint replacements and spine procedures are safely and more affordably being performed in ASCs. However, due to fee differentials, many of these procedures are redirected away from an ASC location to hospitals or HOPD’s. The higher cost associated with the procedure being redirected away from ASCs are passed onto the health plan, employers and members.

CLIENT STRATEGY

Once Aetna incorporated IPG as a strategic partner in helping them meet their Surgical Cost of Care goals, Aetna-GA and IPG successfully teamed with partnering facilities and physicians to identify and redirect eligible procedures to lower cost settings while maintaining comparable patient outcomes.

Opportunity Identification & Program Prioritization
Utilizing the deep expertise and proprietary data analytics from IPG, Aetna-GA was able to get more clarity around the pricing and utilization of their implant related procedures; identify eligible procedures that could be shifted from inpatient to ASC or HOPD to ASC; and to prioritize their efforts toward the most impactful cost of care savings opportunities. This was accomplished while maintaining the highest quality standards and delivering benefit to their facility partners and members.

Strategic Approach to Reimbursement & Program Impact
The primary obstacles that most ASCs like Pinnacle Orthopaedics face are getting the right reimbursement for the procedures to make them viable revenue source and having the financial infrastructure to be able to perform those procedures profitably. Pinnacle was initially out-of-network, and the majority of their contracts did not have a provision for implants. These factors limited the number of cases they could take to the ASC. In collaboration with IPG and Kearny Street Consulting, Aetna and Pinnacle were able to construct a program that was mutually beneficial to both of them.

“We knew that we could offer a big savings to Aetna from what they were paying, and yet, still have a reasonable rate for Pinnacle to cover their costs within their surgery center. We also believe the quality is better within the surgery center because of the more focused approach versus the mass approach at the hospital outpatient surgery center.”

Dave Smith (President)
Kearny Street Consulting

LONGER-TERM STRATEGY
Over the next 6-12 months, IPG will be actively tracking and delivering the projected results of the Georgia program to Aetna. Simultaneously, they will identify and prioritize new opportunities to roll out what was successfully done with Pinnacle Orthopaedics at other facilities within Aetna-GA and across the country. One crucial aspect of this will be to evaluate eligible procedures and providers, and to develop a physician and facility recruitment program.

“Currently partnering with Aetna in some capacity in 19 markets, part of our go-forward will be to expand implementation and impact of the core surgical cost management program across the country and then identify additional opportunities for them to address not only their implant and surgical costs, but their total surgical costs. This will be integral in helping them achieve high quality and cost effective care delivery, while driving down costs for their members.”

Jay Ethridge
President and CEO
IPG

CLIENT RESULTS

Since the initial implementation of the IPG program, Aetna has started to see significant surgical cost savings through the targeted shift of procedures to lower cost, high quality settings.

For example, at a fraction of the cost to Aetna, Pinnacle Orthopaedics is successfully performing uni-knee procedures and will start to do total joint replacement procedures under the IPG program by the end of December 2015. They have begun negotiations through IPG and Kearney Street Consulting with Aetna and others to begin doing spine procedures in early 2016. Pinnacle’s goal is to gain experience and demonstrate better quality outcomes and patient satisfaction at lower costs to Aetna and their patients.

From April to December of 2015, Aetna-GA has experienced:

GREATER THAN

$.3 MILLION

in Savings activated to-date through:
  • Protection on medical expense trends
  • Reduction in surgical and implant procedure spend
  • Cost containment and control over exposure to over utilization and high cost outliers
  • Enforcement of Medical Policy through Facility Cost Management and Claims Integrity

31

Facilities live with the IPG program
in the Georgia market

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Significant Savings through movement
of eligible care to optimal cost
and quality settings

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Improved network strategy and
market share growth

$2.7M

$2.7M in estimated Site of Care
shift savings opportunity

IPG PROGRAM BENEFITS

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PAYER BENEFITS

  • Contain medical expense trend in both device and surgical procedure costs
  • Limit risk exposure
  • Direct clinically appropriate procedures to the most cost-effective setting
  • Provide strategic reimbursement design guidance
  • Promote market competition and expand access to consumers
  • Increase transparency into implantable device cost and utilization
  • Monitor and manage to fully realize medical expense savings on an ongoing basis

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PHYSICIAN BENEFITS

  • Increased volume & acuity of cases
  • Promotion of outpatient total hip, knee and shoulder procedures to prospective patients
  • Predictability in scheduling
  • Personalized and integrated care coordination and delivery
  • Manufacturer choice & broad coverage
  • Quick patient turnover

patient-icon

PATIENT BENEFITS

  • Efficient & continuous process
  • High patient satisfaction and continuity of care
  • High patient saftey focus
  • Lower out-of-pocket expenses
  • Lower infection rates
  • Optimal patient care & patient outcomes

FACILITY BENEFITS

A key barriers which IPG resolves for Aetna’s facility partners is the considerable cash outlay by the facility for implants. IPG handles the financial responsibility for replenishment of the implants, and the facility does not have to outlay the cash for their implant-related procedures. This has enabled facilities like Pinnacle Orthopaedics to bring in more, higher dollar procedures, resulting in financial profitability for the centers and lower costs to their patients and Aetna.

  • Help assuring financial, clinical and operational readiness to perform total joint replacement and other high acuity procedures
  • Access to Payer Partnerships to allow for shift to higher acuity, more profitable cases
  • Increased revenue and profit margins
  • Reporting of IPG Program Operations to Pinnacle Governing Body
  • Prompt Payment
  • Improved cash flow for the center by avoiding upfront cash outlay for implants

“Not having to outlay the cash for these procedures with the IPG program was a huge consideration for us in being able to perform these higher acuity, higher dollar cases.”

Donna Fisher
Chief Administrative Officer
Pinnacle Orthopaedics

Pinnacle Orthopaedics, Aetna and Kearny Street Consulting

Pinnacle Orthopaedics, Aetna &
Kearny Street Consulting

Working together with IPG to Enable Performance of
Total Joint & Spine Procedures in an Optimal Cost and Quality Setting.

financial-independence-icon

Payer Reimbursement

Procedure coverage and reimbursement for higher acuity procedures

procedure-increase-icon

Procedure Increase

Conservative estimate of 20+ new
high acuity cases annually (1-2 per month)

increased-margins-icon

Increased Margins

Significant increase in revenue and profit margins ($2,500-$3,500 per case)

increased-cash-flow-icon

More Profit Less Outlay

Increased profitability without the need for upfront cash outlay

MARKET OPPORTUNITY

There was a time when procedures such as total joint replacements were thought to be too complex and risky to be performed in ambulatory surgery centers (ASCs). Today, those facilities have proven that with a highly trained surgical staff, a well-thought-out perioperative plan, and a motivated patient, these procedures can be done successfully in an ASC – and for about half of what they would cost in a hospital.

The primary obstacle that most ASCs like Pinnacle Orthopaedics face is getting the right reimbursement for the procedures to make them viable revenue sources. Pinnacle was initially out-of-network, and the majority of their contracts did not have a provision for implants. This limited the number of cases they could take to the ASC.

In this case study, we will tell you how Pinnacle Orthopaedics worked successfully with IPG, in conjunction with Aetna and Kearny Street Consulting, to enable their physicians to perform total joint replacement and other more complex surgical procedures at their facility.

CLIENT CHALLENGE

Opening their doors in 2011, Pinnacle Orthopaedics is a single specialty orthopedic and pain management center. This independent Ambulatory Surgery Center, located in Woodstock, Georgia, has two operating rooms and one procedure room. The facility supports fifteen orthopedic surgeons who utilize the center.

When the center first opened, they were mainly performing shoulder and hand surgeries, arthroscopic knee surgery, foot and ankle operations, and pain procedures. As the center matured, Pinnacle Orthopaedics looked to expand their scope of services to include more complex procedures like spine surgery and total joint replacements.

CLIENT STRATEGY

Equipment & Clinical Needs
Getting the facility appropriately set up to perform the joint replacement procedures requires planning. Pinnacle Orthopaedics formed a multi-disciplinary task force to include finance, clinical, utilization management, anesthesiology, physical therapy, home health and implanting physicians who met for about a year to establish the care delivery processes. Unfortunately, six to eight months into the process, Pinnacle Orthopaedics realized that although they were ready from a process, staffing, and equipment perspective, they didn’t have the right reimbursements with health plans in place. That’s where the expertise of IPG and Kearny Street Consulting came in.

“With the help of IPG and their relationship with Aetna, we were able to bring the two of them together (Pinnacle and Aetna) and put together a mutually beneficial program. We knew that we could offer a big savings to the payers from what they were paying, and yet, still have a reasonable rate for Pinnacle to cover their costs within their surgery center. We also believe the quality is better within the surgery center because of the more focused approach versus the mass approach at the hospital outpatient surgery center.”

Dave Smith (President)
Kearny Street Consulting

Reimbursement Needs
Kearny Street Consulting worked with Pinnacle Orthopaedics to evaluate their existing costs and reimbursement for the services they were providing to the health plan. Additionally, they performed an analysis, with IPG’s help, to determine the costs associated with performing new implant procedures they had not performed before, such as total joint replacements (hips, knees and shoulders).

Given that IPG had an established reimbursement schedule for implants with Aetna, this allowed Kearny Street Consulting to remove a large variable expense from their costs. With this information, Kearny Street Consulting was able to Violet_(transparent_background)work with Pinnacle Orthopaedics and Aetna to negotiate a fair reimbursement for their services.

“The IPG-Pinnacle model is a great success story that we are replicating across Georgia and other Aetna markets to promote the appropriate coverage and reimbursement
structure that supports eligible procedures, like total joints and spine cases to be delivered in the optimal cost and quality setting. Working with IPG allows us to identify those eligible facilities, surgeons and procedures that can be done in a more affordable setting thereby helping us manage our surgical costs to the benefit of our members.”

Alfred Ross
Director of Network Management
Aetna

Capital Outlay
One of the key barriers which IPG was able to resolve for Pinnacle Orthopaedics was the considerable cash outlay for implants. IPG handles the financial responsibility for replenishment of the implants, and the facility does not have to outlay the cash for their implant-related procedures. This has enabled Pinnacle Orthopaedics to bring in more higher dollar procedures, resulting in financial profitability for the centers and lower costs to their patients and Aetna.

“Not having to outlay the cash for these procedures with the IPG program was a huge consideration for us in being able to perform these higher acuity, higher dollar cases.”

Donna Fisher
Chief Administrative Officer
Pinnacle Orthopedics

CLIENT RESULTS

Pinnacle Orthopaedics is successfully performing unicompartmental knee procedures and will start to do total joint replacement procedures under the IPG program within the next month. Additionally, they have begun negotiations through IPG and Kearny Street Consulting with Aetna and others to begin doing spine procedures in early 2016. The spine surgeon who will be leading the program, Dr. Craig Chebuhar, is evaluating the facility’s equipment needs and has three spine cases already scheduled. Under the IPG program, Pinnacle projects a positive impact to their mix of business and profitability. With the aim of being designated a Center of Excellence by their payer partners, Pinnacle Orthopaedic’s goal is to gain experience and demonstrate better quality outcomes and patient satisfaction at lower costs to the payers and patients.

  • Successful coverage & reimbursement for total joint and other implantable procedures from Aetna and other key payer partners
  • Successful performance of unicompartmental knees and total knee replacement procedures
  • Optimization of patient care and patient outcomes

facility-icon

IPG PROGRAM BENEFITS

  • Help assuring financial, clinical and operational readiness to perform total joint replacement and other high acuity procedures
  • Access to Payer Partnerships to allow for shift to higher acuity, more profitable cases
  • Increased revenue and profit margins
  • Seamless IPG Program Operations reported to Pinnacle Governing Body
  • Improved cash flow for the center by avoiding upfront cash outlay for implants

physician-icon

PHYSICIAN BENEFITS

  • Increase in volume & acuity of cases
  • Promotion of outpatient total hip, knee and shoulder procedures to prospective patients
  • Personalized and integrated care coordination and delivery
  • Manufacturer choice & broad coverage
  • Quick patient turnover
  • More predictability in scheduling

patient-icon

PATIENT BENEFITS

  • High patient satisfaction and continuity of care
  • High patient safety focus
  • Lower out-of-pocket expenses
  • Lower infection rates
  • Optimal patient care & patient outcomes
  • Individual patient focus
  • Efficient & continuous process
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IPG Announces Appointments of Ken Goulet and Steve Nelson to the Board of Directors

ATLANTA, Georgia (January 6, 2016) – IPG, the recognized industry-leading provider of Surgical and Implant Cost Management solutions is pleased to announce the appointments of Ken Goulet and Steve Nelson to its Board of Directors. Their addition to IPG’s Board strengthens the team of seasoned professionals and investors, including Sequoia Capital and Camden Partners.

IPG has experienced significant revenue growth and profitability over the past year, due to expanded customer adoption and proven results of their Surgical and Implant Cost Management programs. Through partnerships with the leading payers across the country, IPG solutions can impact over 50% of the commercial covered lives in the US. In combination with this existing reach and a new diverse suite of cost management products and services, IPG is well positioned for profitable growth and success.
“I am delighted and honored to have Ken and Steve join the Board. The addition of two such prominent individuals to the Board reflects the confidence of our partners in the proven success and future of the company,” said Dennis Antinori, Executive Chairman of the Board for IPG. “As we strive to expand our solutions to drive affordability and quality of care, their wealth of business experience, expertise, and knowledge of the healthcare environment will most certainly help accelerate the company’s future success.”

Ken Goulet brings with him 35 years of proven experience as a senior-level healthcare executive growing and leading large health plan organizations, including managing multi-billion dollar P&L and consumer-focused organizations. Most recently, Goulet served as the Executive Vice President of Anthem Inc., and President of the company’s Commercial and Specialty Business division, growing the business to the largest Commercial Business Division in the United States. Prior to serving in a variety of executive leadership roles at Anthem, Mr. Goulet spent 23 years at CIGNA Corporation where he held a number of management, sales and operations positions.

“As a former IPG customer, I can certainly validate the solid value of the IPG solutions and support the objective of their model to ultimately drive more affordable, high quality care for consumers.” said Ken Goulet. “I am thrilled to join the IPG team and look forward to helping support IPG’s continued business growth as they continue to evolve into a major player in the healthcare industry.”

Steve Nelson brings significant executive management, payer, and entrepreneurial experience to the IPG Board, including over 12 years as a board member of BlueCross BlueShield of North Carolina, serving as Chairman for the past 4 years. During that time, Nelson helped BCBSNC senior management lead the transformation of the healthcare system in North Carolina – including “new models of care,” and the formation of Mosaic Health Solutions. Nelson is Co-Founder, was launch CEO, and became the first Chairman of Carbon3D, a venture backed company playing a pioneering role in additive manufacturing and 3D printing.

“I have a passion for transformational companies that are looking to change their markets in new and fundamental ways by focusing on cost, quality and value, and I am truly invigorated by the current success, financial backing, and enormous potential of the IPG model,” said Steve Nelson.

About IPG

As the Surgical and Implant Cost Management leader, IPG delivers a customized, data driven approach to enable their health plan partners to manage their surgical and implant costs more effectively. Providing true end-to-end solutions for the healthcare industry, IPG serves as a strategic capability for health plans to manage cost and risk in a unique way that drives collaboration between the plan, their healthcare providers, manufacturers and physicians to ensure that patients receive increased access to affordable and innovative lifesaving and life-enhancing device-intensive medical therapies. Additionally, IPG’s award winning analytics platform for implantable procedures delivers transparency to impact the entire health care transaction process and all sites of care. Continued expansion of IPG’s surgical cost management platform will help health plans to deploy programs that will improve their ability to manage risk and deliver actionable information to everyone involved in a patient’s surgical procedure to drive lower costs and high quality care for consumers. For more information about IPG, call us at 1-866-753-0046, or visit us on the web at www.ipg.com.