An Industry Expert Shares Insights on the Challenges and Opportunities around Bundled Payments | Healthcare Informatics Magazine | Health IT | Information Technology Skip to content Skip to navigation

An Industry Expert Shares Insights on the Challenges and Opportunities around Bundled Payments

January 24, 2018
by Mark Hagland
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Charlene Frizzera, a former senior CMS official, has been on the front lines in helping providers succeed in bundled-payment models

Certainly. I’ve been advising a start-up company called PeerWell, which has developed a patient-facing app. The thing is that, while physicians automatically factor post-acute care into how successful their patients might be post-surgery, many don’t realize how pre-habilitation activities can help patients’ processes. By participating in a pre-hab program, such as that offered by PeerWell, hip and knee replacement candidates can optimize their health before surgery, offering a way for hospitals to contain the cost of care per patient by focusing on improving patient health pre-procedure, therefore reducing the amount of time needed in a costly skilled nursing facility for post-op rehab. By doing so, more patients are in a better condition to be discharged directly home after surgery, cutting after-care costs dramatically—which has shown to be a large cost to providers.

Do you have any metrics to share around that?

Yes. A one-percent improvement in terms of the percentage of patients discharged to their homes, will result in $100,000 in cost savings. Meanwhile, if clinicians can reduce the cost of an episode by $1,215 through one to two hours of pre-hab care, that would represent a cost savings of $1.2 million in cost, for a hospital that performs 1,000 joint replacement cases a year.

What are the critical success factors involved in this pre-hab care management?

There are several. First, they connect very directly to patients. Patients connect pretty easily with the presentation. It’s simple. Patients can review with them what the plan is. It really does create the continuity between the beneficiary and the surgeon, and they guide them through the pre-hab process. So having a care manager do the pre-hab process. It needs that little bit of a personal touch. So that they pay attention to the pre-hab procedures, and patients stick with the program and prepare for the surgery; it’s really pretty impressive.

The reality is that bundles aren’t going away. So people who think bundles aren’t going to be a form of payment in the future, are kidding themselves.




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