By Stephen Lair
In the health care vocabulary of seniors, the phrases “knee replacement” and “hip replacement” are heard all too often. Joints can give out for a variety of reasons: unrepaired injuries as a youth; pain and deterioration caused by osteoarthritis; overextending yourself physically as an older person. Whatever the reason, there are hundreds of thousands of joint replacement surgeries performed each year, and the number continues to grow as the baby boomer population ages.
Joint replacements are costly surgeries that require hospital stays, rehabilitation, and can sometimes be accompanied by complications during recovery. Some insurance companies and health care providers have partnered to create a program called Bundled Payments that aims to increase the quality of care while reducing costs. The program is essentially a flat rate for a given procedure—most often, a hip or knee replacement. The hospital, physician group, and health insurer (or Medicare) agree on a price for a “bundle” of services involving the procedure. The one payment covers everything from pre-operative care to the procedure itself to follow-up and physical therapy. Even if the patient develops a complication and has to go back into the hospital, the hospital absorbs that cost.
Our friends at EmergeOrtho (formerly Triangle Orthopaedic Associates) partnered with Blue Cross and Blue Shield of North Carolina in 2012 to offer the first bundled payment program on the east coast. A registered nurse with EmergeOrtho follows each patient’s case closely and guides them through the process. “The goal of the program is to help patients become better more quickly and get them back into their normal routines,” said Chris Zito, bundled payments department manager for EmergeOrtho. “Patients love knowing they have an angel on their shoulder and can call their RN case manager if they have a question.”
EmergeOrtho is now working with Home Instead Senior Care franchises across North Carolina to help prepare patients who may be in need of a joint replacement but aren’t quite ready for surgery. “If a patient’s BMI or A1C is too high for safe surgery, or they aren’t prepared for the recovery process, Home Instead CAREGivers can help them with that,” said Stephen Lair, owner of Home Instead Senior Care of Chapel Hill. “We want to see our clients live healthy, active lives, so any chance we have to help them reach that goal is a win-win for everyone.”
Home Instead’s CAREGivers help orthopedic patients become more active, work with them on nutrition, and educate them about the surgery and recovery. This “pre-hab” program can be included in the bundled payment, further streamlining and simplifying the process for patients. “We want to make sure patients have the best experience possible before, during, and after surgery,” said Zito. “Home Instead is a great partner for us because they think outside the box and go above and beyond offering basic care.”
For more information on EmergeOrtho’s bundled payment program, please visit www.triangleortho.com or contact Home Instead Senior Care of Chapel Hill.
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