More often than not, it seems you usually hear people railing against government action as opposed to praising it, but one executive from the University of Rochester Medical Center is giving credit where it’s due. According to HealthcareFinanceNews.com, James Garnham, the school’s director of contract and payment innovation, recently took a trip to Capitol Hill for a hearing to share his perspective.
Garnham has overseen the federal government’s recently enacted bundled payment joint replacement program at the U of R medical center and found it to have a great deal of success. According to Garnham, the University of Rochester Medical Center was able to reduce the percentage of patients receiving rehab care for joint replacement at a skilled nursing facility with the help of this bundled payment program. The rate dropped almost 50% in just one year from 74% to less than 25%.
“You would expect the clinical leaders would all be about hey, let’s apply these great resources to more than just the Medicare bundled payment folks,” Garnham said at the hearing. “What I didn’t expect, I’ve had just as much attention from the administration of the hospital saying, ‘How can we leverage this to other patients? We have a unique opportunity here to really improve the quality of care that we’re delivering, reduce the costs that we’re delivering. How can we figure out a way to afford this to broaden it out to other populations?'”
The panel on which Garnham spoke was hosted by the Kaiser Family Foundation and the Alliance for Health Reform and was titled, “Medicare Payment System Reforms: What Do We Know?” This program is currently only offered through Medicare. Medicare benefit payments totaled $597.2 billion in 2014, according to the Congressional Budget Office. Meanwhile, only two in five Americans have employer-based health care coverage.
Garnham noted that two of the keys to this bundled program are the ability to increase post-surgery treatment in the home (rehabilitation at skilled nursing facilities can be incredibly costly) and the presence of a “care navigator.” The care navigator is a person who is the single point of contact for both patient and provider; this person would help facilitate the process from start to finish.
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