Our profession has endured a veritable sea change in the past five years, impacting what prostheses and orthoses are available to our patients, as well as how and at what rate our services are paid for by payers. What do the next five years hold in store—what will prosthetics be like five years from now, and what can be done to permit us to help participate and shape that future?
It is clear that evidence, outcomes, and research are keystones. All three were front and center in last month’s AOPA Futures Leadership Conference. A new program, initiated under the title, “Prosthetics 2020”, is a collaborative effort to operate as an adjunct to AOPA’s ongoing ‘Survival Imperatives.’ Prosthetics 2020 is a partnership open to interested companies who want to take a strong, proactive role in shaping the drivers of prosthetic patient care five years down the road. If you share a commitment to protect, fortify, and enhance the recognized, scientifically-substantiated value of prosthetic care in the minds of payers, patients and the general public, you will want to consider making an investment to be part of Prosthetics 2020.
AOPA will be managing this effort with the assistance of a small expert Steering Committee to be appointed by AOPA’s President. We are inviting interested AOPA member companies to join in the effort. The program will include establishing an AOPA Medical Advisory Board to help us in identifying the essential endpoints of measuring value in prosthetic care, and in conveying our scientific messages to payers, both in government and in the private commercial insurance community. We envision that new prospective clinical research studies will need to be developed and funded, to be conducted by the best and the brightest in the prosthetic research world. New rock solid science may well portend new payment models and better reimbursement.
Companies considering participation need to recognize that the mission of Prosthetics 2020 goes well beyond AOPA’s annual dues. Each participating company will be required to commit to an initial financial commitment of $35,000, and it would be anticipated that participating companies would need to provide in the range of $35,000 per annum for the next three years largely to sustain the Medical Advisory Board. In the event that the project results in also funding one or more new prospective research studies in prosthetics, clearly additional financial outlays would be needed to fund any such research. Any AOPA member company, and especially those companies with strong engagement in prosthetics, can join in Prosthetics 2020 provided they are willing to contribute their fair share of the costs. This will entitle them to receive regular detailed reports as well as being invited to provide advisory input on the progress of the effort. While it is likely that representatives from a few of the participating companies may be among the members of the Steering Committee that AOPA’s President appoints to guide the project, that group needs to be comprised as a small, flexible, hard-working group. A small steering committee will be formed and will include a physician, researcher, representatives from one or two of the participating companies, and an AOPA leadership representative. All supporting companies will have input in an advisory role. The Steering Committee will meet, advance research proposals, coordinate with the Medical Advisory Board and make other recommendations/decisions, subject to the overall AOPA governance framework via the AOPA Board of Directors. General reports on the group’s progress will be shared in the form of updates to all AOPA members. The new framework is being undertaken first in the prosthetics profession, and based on its success; AOPA will consider the prospects for a subsequent parallel effort in the orthotics profession.
Making Prosthetics 2020 successful will depend on gathering a cohesive working group and substantial resources on a relatively long-term basis with the doors open to large and small, patient care and manufacturers, alike on a fair, consistent basis. In principle, key premises will be: (1) maintaining equal contributions from each participant, (2) recognizing that accomplishing the purpose of the Prosthetics 2020 initiative will require substantial financial support; and (3) there will need to be a participation agreement to address the long-term nature of the endeavor, termination, etc. For example, funding the Medical Advisory Board (MAB) alone will likely require over $100,000 per year. The likelihood is that there will be one or more prospective research studies evolve with costs likely to run into the mid six figures for each study.
While we need to balance all these factors, we also need to retain flexibility. One way we can do that is to suggest that as to patient care facilities and companies that are not engaged at all in the manufacture or prosthetic knees or feet (all manufacturer participants who have any products in either or both of these product lines need to have the same financial stake) we would be open to ‘pooled’ participation—for example, up to three companies may want to join together over multiple years to meet the annual participation fee.
Interested in helping to shape the future of the prosthetics profession? Feel free to contact AOPA President, Charles Dankmeyer, or AOPA Executive Director Tom Fise by end of business March 16.