In 2016, a group of joint replacement specialists had an idea that they could do knee and hip replacements in Greensboro in an outpatient surgery center instead of a hospital.  With advancements in hip and knee replacement surgery, we felt we could create a program that would improve not only the patients’ outcomes but their experience as well.  We formed Delta Joint Management which included all of the joint specialists from the various practices and used commercial insurance bundled payments and in-office case management as our initial platform. It proved to be very successful, and we are now doing more than 1400 joint replacements a year in the ASC. During the pandemic, we added medicare joints and typically use a shadow bundle to shift the site of service from the hospital to the ASC.  In addition, we are also expanding the program to include other orthopedic procedures such as knee and shoulder arthroscopy, shoulder replacement, and more.

After a couple of years of shifting joint replacements to the ambulatory surgery center, we received a lot of inquiries about what we were doing, so we decided to form a consulting company, Valere, which is the Latin word for value.  We have been in over 25 markets, helping others begin outpatient joint replacement programs.

During and after the pandemic, with the rising cost of commercial insurance for employers to cover their employees, we began to receive inquiries from employer groups wanting direct-to-employer pricing models and transparent pricing structures. More and more businesses are choosing the self-insured option and so we have now begun to work in that space as well.