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w w w . i n s i g h t o n b u s i n e s s . c o m M a r c h 2 0 1 6 • I NSIGH T | 23 of NOVO Health, an independent administration network. NOVO Health is a representative organization that helps participating organizations align resources as independent physician groups who want to offer a lower cost, high quality patient experience to self-insured companies. "NOVO Health brings these specialties together without the need of a hospital administration or any other big overhead structure, and allows the employers of the valley to leverage that benefit from a contracting basis," Kienert says. Building a model W orking together with its partners has enhanced the patient experience that OSI wanted to create. e organization learned that it didn't have to own everything to control the outcome, Kubiak says. "I inherited this medical mall with tenants that had different profit-loss statements, different businesses," Kubiak says. "So from the start I had to figure out how does everyone get along, how we could align with each other without controlling each other or owning each other. It means you've got to get really good at communication. You've got to get really good at collective problem-solving." At Plexus, other companies would try to imitate its successful model by piecing together engineering and prototyping companies, Kubiak says. "We called it the Frankenstein design because all the parts were there, and it looked like it would work, but you tried to use it and they didn't talk to one another," Kubiak says. "We kind of had that Frankenstein design here. It needed to be joined up. So that's what kind of sparked an interest in me. I saw an industry-changing concept here." Kubiak says there is room for more partners, but the goal is to replicate the model in multiple locations rather than expanding the campus much more. "I don't want to slip back into the model of a very difficult- to-navigate system, from a patient's perspective," Kubiak says. "Part of what they love is how small this feels." Price bundling & direct contracting S urgical costs were once managed by a confusing standard. "Insurance companies say they will pay multiples of Medicare," Kubiak says. "So if Medicare is 1, they'll pay you 1.3 or 1.5 times Medicare." With the help of Aaron Bleier, another former Plexus employee who is now OSI's financial manager, OSI reset its pricing based on industry standards and an acceptable profit margin. e insurance company didn't know what to do. "ey said, 'What's the multiple of Medicare?'" Kubiak says. "I said, 'I don't know, but you can figure it out. Just take my prices and divide them by your standard. ere's your multiple.'" at new way of costing resulted in a better pricing system for patients, who were leaving OSI highly satisfied — until they received the bills, which came in a number of envelopes and were confusing. "Anybody in retail would say your last touch has got to be a beautiful sendoff. So, here our last touch was the financial part, and that was a wreck," Kubiak says. So OSI decided to bundle prices for total hip and knee replacements so patients knew the cost — including surgery, a stay at the Recovery Inn, all follow-up physical therapy appointments — for everything. "Today, we have 60 bundles," Kubiak says. "We have 48 orthopedic procedures and 12 spine procedures. I don't believe there's anybody else that's got more." e bundling idea evolved into a direct contracting plan with employers. OSI has about 20 company clients who have opted in to plans that guarantee prices for employees. By the end of the year, Kubiak hopes to have partnerships with at least 100 companies. "Historically, the cost of health care has been borne by employers, and now to a greater extent their employees," says Dr. Lohrbach. "We realize if we can go to these self-insured employers or midsize employers who self-fund their own programs, they can recognize a substantial cost savings." It's a model that other specialty clinics are interested in trying. Kienert of Fox Valley Hematology & Oncology says while it's harder to offer bundling with cancer treatment, his organization plans to offer bundled pricing for certain types of breast cancer treatment. "Some of the major cutting edge cancer centers have tried it on a limited basis and we're going to join their number," Kienert says. FVHO also is working on emulating OSI in the direct contracting model. "We've also shamelessly copied (OSI's) patient experience initiatives, everything from the feel and sense of the atrium and the welcome areas to patient wait times," Kienert says. "We use them as a frequent reference for some of the major projects that we undertake." FVHO also is a partner with OSI, along with Neuroscience Group and NeuroSpine Center of Wisconsin, in the formation OSI's partners » Advanced Physical Therapy & Sports Medicine » Fox Valley Hematology & Oncology* » Great Lakes Orthotics » Neuroscience Group* » NeuroSpine Center of Wisconsin* » The Osteopathic Medicine & Physical Therapy Group of Northeast Wisconsin » Eduro *Part of NOVO Health with the Orthopedic & Sports Institute of the Fox Valley