News
Release
For more information, contact: For Immediate Release
September 27, 2005
Tom Lessig
Director Marketing and Business Development
Cincinnati Sportsmedicine and Orthopaedic Center
794-8463
Orthopaedic Surgeon Chosen for UnitedHealth Scientific Advisory Board: National Approach to Establish New Quality Outcome Measures for Orthopaedic Care
[Cincinnati, OH]— Dr. Frank R. Noyes, Chairman and CEO of Cincinnati Sports Medicine and Orthopaedic Center and an internationally recognized knee surgeon, has been asked to serve by UnitedHealth Networks on a new national board of orthopaedic specialists. The Musculoskeletal Scientific Advisory Board has the mission to study, evaluate and make new recommendations on the standards of care given to patients with orthopaedic spine, trauma, joint and other musculoskeletal disorders. Dr. Noyes will join twelve other orthopaedic specialists from throughout the United States and the final recommendations on the type and quality of orthopaedic care provided by thousands of orthopaedic specialists throughout the UnitedHealth Networks States is expected to have far reaching effects.
Dr. Noyes stated “ I have been asked by many different insurance companies to provide recommendations on orthopaedic treatment, but this represents the first national effort that I am aware of that has the appropriate approach, man-power and proper direction to be successful in its mission.” Dr. Noyes stated that too often in the past insurance companies took the approach of limiting required care, playing the so called “numbers game” in limiting access or required studies that actually hurt patients in the long run. This approach looks at the other side of equation, namely the end result of a good quality outcome of treatment and asks the question how do you achieve this outcome. The Board will evaluate the necessary steps and treatment algorithms that should be followed including diagnostic tests to achieve a successful outcome for specific musculoskeletal problems. Given the number and complexity of orthopaedic problems Dr. Noyes cautioned that it is not possible to have a set algorithm in the treatment of every bone and joint disorder, however there are clear treatment outliers beyond standards of deviation that can be readily identified. Dr. Noyes indicated that his statements represent his personal opinions and he does not speak for UnitedHealth Networks.
Dr. David Bradford, Chairman of the Department of Orthopaedics at the University of California, San Francisco will chair the group of thirteen orthopaedic specialists representing all aspects of orthopaedic care provided throughout the United States. UnitedHealth Networks insures over 15 million lives in 48 states and is a major insurance provider in the tri-state area.
Dr. Frank Noyes is a nationally and internationally recognized specialist for the treatment of sports medicine and knee disorders and is also the medical director of the Noyes Knee Center. He has written more than 200 published articles and textbook chapters and patients travel from throughout the United States, Europe and Middle East to consult and undergo surgical treatment at the Noyes Knee Center. He was asked to serve on the Board due to his years of publishing clinical outcome studies which document with numbers and objective results the success of orthopaedic treatments. Dr. Noyes stated, “No longer will patients and industry blindly accept that the best treatment approaches are being utilized, rather the modern day of asking for documented outcomes including success and complications has arrived. Patients and industry must have the data to “know the score” and evaluate the quality of care provided.”
Dr. Noyes recently delivered a national address at the American Orthopaedic Society of Sports Medicine Annual Meeting in San Francisco on March 13, 2004. The subject of the address “Why is it so hard to do the right thing” discussed the future importance of national societies, physicians groups and individual specialists in establishing treatment outcome guidelines that can be continually updated and monitored to know how patients respond to the treatment that has been provided. He discussed how throughout the United States there are in fact a number of individual physicians who have established methods within their practice that monitor patient outcomes and that in the future this will be the norm. An important future problem for all specialties is the lack of clinician-scientists trained to perform quality treatment outcome studies that will devote the added time and have the added expertise to conduct clinical studies.
Dr. Noyes indicated that from a personal standpoint he sees many different marketing approaches taken by individual physician groups and hospitals with the tri-state area claiming to be centers of excellence but without the published outcomes in peer reviewed medical journals to support the claims. He stated that “ the public is now aware that the plethora of advertising in newspapers and on television of being the best, with little to support the claims, is now recognized by the public to be self-serving and sometimes deceptive and in fact will be highly counter productive for the future. What is required is true objective data of patient treatment outcomes that patients trust.
Many experts have acknowledged that it is difficult for industry and patients to evaluate issues related to successful patient treatment outcomes due to the complexity of the issues involved. What is novel about the approach that UnitedHealth Networks is taking is to establish standards of care that are well accepted across the entire specialty of orthopaedics and then evaluating the extent to which this level of care is provided to patient groups. Dr. Noyes stated that there are now rather straightforward methods and strategies he believes are available to evaluate the level of care provided to patients. He acknowledged that the task is difficult which explains why it has not been done before however to do nothing is to perpetuate the mediocrity of the current system in which no or limited information of this type is available.
The magnitude of the responsibility in evaluating and setting standards for orthopaedic care provided by specialists within UnitedHealth Networks is demonstrated by the fact that 35 million people suffer with problems affecting bone, joints, spine, arthritis from trauma, work related injuries, athletic injuries or other problems. Insurance reimbursement of orthopaedic and spine treatments represents the highest financial expenditure even above reimbursement for cancer or heart disease.
Dr. Frank Noyes gave examples of the different types of outcome measurements that are available. There are now a number of published studies in highly respected orthopaedic journals that detail exactly the types of outcomes and importantly associated complications and reoperation rates for the most prevalent orthopaedic treatment problems. These publications set a standard of care that should be achieved not only at major centers or universities but throughout the orthopaedic community. For example, Dr. Frank Noyes recently published a study of 443 surgical cases of anterior cruciate knee ligament surgery with a 95% success rate and a 1% complication rate. This high success rate with a low re-operation rate is one benchmark along with other published studies that forms a basis for the evaluation process.
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