News Archive (2015)

Nationally Known Traumatologist Dr. Clifford Jones Joins The CORE Institute

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The CORE Institute Expands Into Louisiana

Phoenix, Ariz. (June 4, 2015) The CORE Institute, powered by Excellence Headquarters®, announced the addition of nationally acclaimed orthopedic trauma surgeon Clifford B. Jones, MD, FACS, who specializes in Trauma, Bone Health and Osteoporosis, adult and pediatric fracture care, infections, osteomyelitis, amputations, nonunions, malunions, pelvic fractures, acetabular fractures, periarticular fractures, spine problems, and foot and ankle trauma. He will care for patients in both The CORE Institute’s Arizona and Michigan clinics, allowing him to continue to treat his Michigan patients.


As a popular lecturer whose research has appeared in several highly regarded medical journals, Dr. Jones won an Achievement Award from the American Academy of Orthopedic Surgeons from 2012-15 for his contributions to education, research, and advocacy in orthopedics. Orthopedics This Week named him a Top U.S. Orthopedic Trauma Surgeon in 2012. In 2008, he also was a Distinguished Visiting Professor, at the Landstuhl Regional Medical Center in Germany, who was involved with education of the Military Surgeons and operating on our Wounded Warriors.


“The CORE Institute has quickly grown into one of the most respected and innovative musculoskeletal groups in the country,” said Dr. Clifford B. Jones. “I look forward to participating and contributing to their academic medicine program as well as continuing to develop their trauma program Nationally.”


“Dr. Jones has earned a national reputation as a leading traumatologist and we couldn’t be more excited that he chose to join our talented team at The CORE Institute,” said Dr. Jason Scalise, Vice Chairman at The CORE Institute. “While many orthopedic physicians know Dr. Jones for his research that has been recognized in several highly regarded medical journals or for the hundreds of lectures he has given, his patients know him for his personalized treatment plans to help each patient receive the best possible outcomes. It is with great excitement that we welcome him to the CORE team.”

Clifford B. Jones, MD FACS is a board certified and fellowship-trained orthopedic surgeon. He received his fellowship training in orthopedic trauma at the highly acclaimed University of Washington, Harborview Medical Center, which consisted of extensive surgery and research of spinal fractures, pelvic fractures, acetabular fractures, foot and ankle injuries, peri-articulator, and long bone fractures. He completed his orthopedic residency training at San Francisco Orthopaedic Residency Program in San Francisco; CA. Dr. Jones obtained his medical degree from the Indiana University Medical School. 

To schedule an appointment with Dr. Jones, or any of The CORE Institute providers, please call 1.866.974.2673.



The CORE Institute to Begin Seeing Orthopedic Patients in Southern Arizona on June 1, 2015

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Green Valley, Ariz. (May 13, 2015) Arizona’s largest orthopedic and neurology practice, The CORE Institute® powered by Excellence Headquarters®, will begin seeing its first orthopedic patients in Green Valley starting June 1. Earlier this year, The CORE Institute and Green Valley Hospital executed an orthopedic service line co-management agreement. Under the agreement, The CORE Institute will provide orthopedic physician call coverage and orthopedic service line management services at the new 50-bed full-service acute care facility located south of Tucson in Green Valley, opening June 1, 2015.

The CORE Institute also announced it officially opens its first Clinic in Southern Arizona at 4485 S I-19 Frontage Rd in Green Valley. Dr. Alex Verhoogen, board certified orthopedic surgeon with over 40 years of orthopedic experience will care for patients in Green Valley. He has expertise in general orthopedic practice including adult and pediatric fracture care, sports medicine and arthroscopy, and joint reconstruction surgery. Dr. Shane Hess, a fellowship-trained orthopedic surgeon will be joining the CORE team later this summer and will bring additional expertise in joint replacement surgery to Green Valley. Additionally, senior physicians Drs. David Jacofsky, Bryan Wall and Jason Scalise from Phoenix will be seeing patients, bringing best-in-class orthopedic care to Southern Arizona.  

“The CORE Institute is thrilled to expand our Excellence through Evidence® platform in Southern Arizona to significantly enhance the orthopedic care available in the greater Tucson area,” said Vice Chairman, Dr. Jason Scalise. “We’re excited to bring our standardized care approach, proprietary quality IT platform, and proven outcomes to Green Valley Hospital, and to help build an orthopedic program in Southern Arizona.”

The CORE Institute plans to continue to expand in Southern Arizona, including additional locations in Tucson. Their investment in the community will ultimately shape the entire orthopedic service line and distinguish Green Valley Hospital as a leader in orthopedics delivery in Southern Arizona.

To schedule an appointment with Dr. Verhoogen, or any of The CORE Institute providers, please call 1.866.974.2673.
For more information, please visit www.thecoreinstitute.com/greenvalley.

About The CORE Institute
The CORE Institute delivers integrated, comprehensive musculoskeletal and neurological care. The CORE Institute is built upon a foundation of pioneering research, academics, community service, and a passion for excellence in patient care. The CORE Institute has locations in Arizona and Michigan, with clinics planned to open in other states, as well as overseas, in the near future. The organization continues to be a leader in payor-reform initiatives, and it is at the forefront of systems-based quality programs which drive value and improve the quality of patient care.

The CORE Institute's fellowship-trained physicians provide specialized care in the areas of surgical, non-surgical and rehabilitative hip, knee, shoulder, elbow and ankle procedures, joint replacement, sports medicine, arthroscopy, fracture management, orthopedic traumatology, hand and wrist procedures, complex articular cartilage restoration, musculoskeletal oncology, foot and ankle reconstruction, physical medicine and rehabilitation, comprehensive spine care, pain management, clinical neurophysiology, epilepsy, headache and facial pain, neuromuscular medicine, spine and peripheral nerve disease, clinical neuroimmunology, multiple sclerosis, and general neurology care.

Connect with The CORE Institute at www.thecoreinstitute.com or on Facebook, Twitter, and YouTube.

About Green Valley Hospital
This new 50-bed, full-service general acute care hospital is being constructed on a 21.5-acre campus (12.5 acres for the hospital and 9 acres for medical office buildings and future expansion) in Green Valley near Interstate 19, south of Continental Ranch Road and northeast of Canoa Ranch Road. The 147,000 sq. ft, three story hospital will house a full cardiac catheterization laboratory, complete imaging and laboratory/blood bank, a four room surgical suite, Intensive Care Unit, full gastroenterology procedure rooms, emergency room, helipad and restaurant and coffee shop.  Green Valley Hospital will provide services and amenities commonly found in larger, more metropolitan hospitals. Physician specialties including Orthopedics, Cardiology, Pulmonology, General and Vascular surgery, Gastroenterology, ENT, Emergency Medicine, Urology, Oncology, Pathology, Radiology, Internal Medicine/Hospitalists, Ophthalmology as well as a battery of other specialties will be located within the hospital.  Green Valley Hospital is scheduled to open in the Spring of 2015. For additional information visit www.greenvalleyhospital.com.

How The CORE Institute grew 40% last quarter — IT leads the way

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The CORE Institute made several key moves recently to expand the practice and position itself for success in the future.

Based in Phoenix, the practice also has locations in Michigan and will be expanding into additional states this year. In March, the practice signed a partnership with Surgical Care Affiliates and six physicians to open The CORE Institute Specialty Hospital in Phoenix.

"We continue to grow," says David Jacofsky, MD, CEO of The CORE Institute. "The excitement and adoption of our proprietary quality programs and IT platforms for managing risk and predicting the quality and cost of care has been far greater than we ever expected. Now that we have five years worth of data showing outcomes related to the platform deployment for hospitals and physician groups, we're getting calls almost daily from hospitals or groups interested in working with us."

 Here are five key notes on the group's growth:

  • Last year, The CORE Institute hired 41 providers and 137 staff members
  • The group doubled the Michigan practice in the last 12 months.
  • The institute had a 40 percent growth for the first quarter of 2015.
  • The group plans to expand to Tucson, and has signed a term sheet with a state in the Southeast.
  • The CORE Institute signed a co-management agreement with Green Valley Hospital's orthopedics department.

So what's the key to the practice's success?

"The reason we are able to grow so rapidly is we are scalable," says Dr. Jacofsky. "We are standardized both operationally and clinically, which makes it easier to scale and oversee based on best practices and evidence-based consensus. We have a robust leadership program that includes leadership training for physicians."

The CORE Institute University provides training and education for different staff categories to prevent a leadership vacuum. The most challenging part of expansion is the initial move into a new market, but once there, it's easy for the practice to implement existing platforms and increase in size.

"The visibility of our outcomes and quality metrics, and in many cases the costs for consumers and patients, is very attractive," says Dr. Jacofsky. "We are seeing increasing numbers of patients coming from outside Arizona to our facilities, and we are seeing insurance companies that have the ability to directly compare cost, quality and patient experience between different physician groups willing to create narrow networks and steer patients to the facilities they believe will provide the best value."

The group has a proprietary IT platform that includes phone apps, customized electronic medical records, specialized pagers providers use to communicate with each other, and a data warehouse to collect and analyze data in real time. The group invested between $12 million and $15 million on their IT platforms, and has employed six to seven software engineers or programmers in-house for the past half-decade. The IT specialists are responsible for building programs and interfaces to improve value.

"This concept of a virtual care network is an important one," says Dr. Jacofsky. "If you are going to be at risk with payers, you need to be able to take care of the right patient with the right procedure in the right facility at the right time. If every total knee replacement patient were to go to the high acuity hospital or ICU, every episode of care would be expensive. One needs to triage patients between such a hospital and a specialty hospital where we treat relatively healthy patients who need inpatient care or the outpatient surgery center for young total knee patients in the best health. Directed care to the highest quality, lowest cost setting that provides the appropriate safety factor for that particular patient."

The wealth of data allows the practice to participate in bundled payment models based on the surgical episodes and 90 days after the procedure. The practice takes full capitation and full risk capitation per member per month in a manner consistent with population health. They have shared savings models through partnerships with hospitals and insurance companies.

"We have programs where we receive bonus payments if we reach certain rates for patient report cards," says Dr. Jacofsky. "Our biggest challenge has been managing growth and finding the right physician and hospital partners; our growth opportunities have been so extensive that growing and executing efficiently has always been the biggest challenge. This is why the right partner is key."

In addition to the data gathering, the proprietary software programs have had an impact on outcomes, cost and patient satisfaction. In some cases, episodes of care were 30 percent less expensive than their competitors with a lower complication rate based on objective CMS data.

Dr. Jacofsky recently started to publish articles on the use of standardized protocols to improve outcomes for arthroplasty, as well as two or three different papers related to standardization and the use of IT platforms and integrated systems to improve outcomes and lower costs overall," says Dr. Jacofsky.

Dr. Jacofsky continues to look for progressive groups looking to lead consolidation in their state and region.

Source: Becker's Healthcare


Phoenix Woman Suffers Multiple Back Fractures Due to Osteoporosis

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By the way Geraldine “Jerry” Rutledge moves around, you’d never know this sprightly 83-year-old has suffered several fractures in her back, an all too common occurrence for those like Jerry whose bones have become brittle because of osteoporosis. In one instance, she lost her balance and fell, another time she was moving boxes, and most recently, she was simply riding a stationary bike at the gym. 

“These fractures caused me to feel the worst physical pain I have ever felt in my life. On a scale of 1 to 10, they were a 10 every time,” said Jerry, who has suffered seven fractures in the last seven years since retirement, the last two this past October. “You never get used to the pain and you never know what’s going to set it off.”

For people with osteoporosis, small movements, or even a sneeze or a laugh, can cause vertebrae, small bones in the back, to collapse on themselves resulting in vertebral compression fractures, which can lead to severe pain, limited mobility, deformity, trouble breathing, a hunched upper back, and loss of height.  

“Many people think back pain is a normal part of aging so they never seek treatment and just live with it without ever seeing a doctor about it,” said Joshua Abrams, DO, an orthopedic spine surgeon at The CORE Institute.

According to the International Osteoporosis Foundation, about 750,000 people suffer at least one vertebral compression fracture each year,i but only one-third of patients present to a physician for a diagnosis.ii 

Even after falling in a department store and hurting her back nearly seven years ago, Jerry had to be convinced to go see a doctor about the pain. “I just thought it (the pain) would eventually subside,” she said. It didn’t, and she found herself in the emergency room with two vertebral compression fractures, for which she wore a back brace and received steroid injections for a period of six months. She said the pain never really went away, but did become more manageable. 

“Most of these fragility fractures can be treated with simple bed rest, physical therapy, or pain medication. However, for others, particularly those with osteoporosis, the pain and limited mobility may never go away unless a procedure is performed,” said Dr. Abrams. “The good news is these procedures are minimally invasive and can potentially help patients achieve significant pain relief and get back to an active retirement and living life to the fullest.”

Jerry had a vertebral body balloon outpatient procedure, or vertebral augmentation, both the second and third time she found herself with vertebral fractures and severe back pain. 

Vertebral body balloon procedures are used to strengthen and restore the shape and height of collapsed or fractured vertebra.  A medical balloon is inserted into the fractured area and inflated to restore lost height and to create a space for the injection of special bone cement, which hardens and stabilizes the vertebra. 

After the procedure, Jerry says she went from barely being able to stand or take a deep breath, to moving normally without pain in five days. A month later, she was back to her routine – going to the gym three times a week, taking care of the house, shopping, going to or hosting weekly supper clubs with friends, and making bi-weekly drives to the public library. She says she’s read more than 1,800 murder mysteries, historical novels and romance books. 

“This procedure really gave me my life back. Pain isn’t my constant companion,” said Jerry, who has two children, two grandchildren, two great grandchildren, and a great granddaughter less than a year old. “I feel great today, no pain or walking bent over. ‘Fit as a fiddle’ as they say,’ and if I find myself with another one of these fractures, it’s good to know this option is out there.” 

The risk of fractures steadily increases as people age and once a person suffers one, he or she is at five times the risk for a subsequent fracture.  According to the National Institutes of Health (NIH), people with osteoporosis can improve their bone health through a combination of a diet rich in calcium and vitamin D, exercise, lifestyle modifications and medication.  Osteoporosis affects about 10 million Americans; 80 percent are women.  

In addition to the vertebral body balloon procedure, vertebral compression fractures can be treated with vertebroplasty, another minimally invasive outpatient procedure that can potentially reduce pain and improve mobility. In this procedure, a type of medical grade spinal cement is injected directly into the fracture, but unlike the balloon procedure, it does not attempt to restore the height of the vertebral body.

“Physicians work with their patients to determine which treatment approach is right for them based on the nature of the injury and the pain and disability level,” said Dr. Abrams, who has performed more than 1,000 vertebral body augmentation procedures. “This is why it is so important for patients to see a doctor to find out if the back pain they are experiencing can be effectively treated.”

DePuy Synthes Spine sponsors patient and physician education on vertebral compression fractures. The company is the manufacturer and developer of both vertebral body balloons and spinal cements for vertebroplasty or vertebral augmentation. Jerry received the DePuy Synthes Spine Vertebral Body Balloon. 

The potential benefits of surgical intervention should be weighed carefully against the risks. Please consult a surgeon to better understand if vertebral augmentation is an appropriate option for you.  

To learn more about osteoporosis or treatment options for vertebral compression fractures, visit www.allaboutbackpain.com. 

About DePuy Synthes Spine

DePuy Synthes Spine has one of the largest and most diverse portfolios of products and services in spinal care and is a global leader in traditional and minimally invasive spine treatment. The company offers procedural solutions for the full spectrum of spinal disorders including adult and adolescent deformity, spinal stenosis, trauma and degenerative disc disease. DePuy Synthes Spine is part of DePuy Synthes Companies of Johnson & Johnson, the largest provider of orthopaedic and neurological solutions in the world.