A managed-service organization formed three years ago to help small orthopedic practices in Spokane survive in a managed-care marketplace has taken on a new name and is studying the idea of opening its own surgery center here.


The organization, Inland Orthopedic MSO LLC, changed its name at the beginning of the year to Inland Orthopedic Institute to reflect its plans to do more than just manage health insurance contracts and administer claims, says CEO Douglas Crafton.


Its plans include studying the possibility of constructing an ambulatory surgery center where outpatient orthopedic surgeries could be performed. The facility the group envisions would include surgical suites and offices where member doctors could locate their practices, and it could cost $6 million to $7 million to build, Crafton says. The institute reasons that it would be more cost effective for the institutes nine member practices to build a single surgery center collectively than for each to build one of its own. Crafton says equipping a single surgical suite would cost about $500,000. A shared facility also would have a higher volume of surgeries, making it more viable, he says.


Inland Orthopedic is only studying the potential for an ambulatory surgery center now and could decide to erect such a center on its own or develop one with a general partner such as a local hospital or national health-care-provider chain like HealthSouth, Crafton says. The chairman of Inland Orthopedics board of directors, Dr. Scott Redman, says Inland Orthopedic first must determine if an enhanced ambulatory surgery facility is needed here, and if the organization can maintain or improve care cost effectively by opening one.


In addition to studying the potential for a new surgery center, Inland Orthopedic also plans to focus on marketing and professional education for its members.


Crafton says the organization, which includes 40 Spokane orthopedic physicians, will undertake a concerted effort to market the orthopedic services offered here, which now include complex surgeries that previously were only available in the state in Seattle-area university research hospital settings. For example, he says, Spokane now has two fellowship-trained hand surgeons and four surgeons with fellowship training in spinal surgeries who can provide services that werent available here just a few years ago. Crafton says he hopes Inland Orthopedic can help spread awareness about orthopedic care here, just as the Heart Institute of Spokane has spread awareness of cardiology services and cardiac health in the local market.


Redman says the institute can market the services of its members across the entire Inland Northwest, something that the individual practices, such as the four-doctor practice of which he is a member, dont have the time or resources to do.


Inland Orthopedic also could give small practices a chance to be involved in research that they couldnt do individually, he says, adding that Inland Orthopedic could seek grants and do outcome studies more like the Heart Institute does.


Inland Orthopedic already sponsors educational forums for its member doctors, Crafton says. In the forums, outside experts and local doctors offer presentations to help orthopedic physicians stay abreast of current information and learn of new techniques or procedures.


Other goals of the institute include possibly offering insurance contract managed services for orthopedic practices outside of Spokane or other musculo-skeletal specialties such as chiropractic or podiatry practices, and establishing an electronic medical-records system for all the practices that are part of Inland Orthopedic.


While taking on these new endeavors, Inland Orthopedic will continue to perform the managed-service tasks it was formed to handle here, Crafton says. For instance, Inland Orthopedic manages capitated contractsunder which member physicians agree to handle all orthopedic work for a patient group on a fixed, per-patient retainerfor 95,000 patients, and provides third-party claims administration, Crafton says. Last year, it handled 12,000 claims, he says.