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The Journey to Episodic Care
Chris Vannello
Director of Quality Improvement
Rothman Institute
Current Payment Structure
• Hip fracture-NO
• Oncology- NO
Navigation
Must have….
• Patient navigation
• Automation
• Technology
• Care coordination
– PCP
– Hospital
– Specialists
– Post-Acute Facilities
Risk Assessment
Goals
Episode of Care
Cost Drivers(1):
(1) Source: Data Gen – “Evaluating Opportunities in Medicare Bundled Payment Program” Gloria Kupferman; January 2014
Metrics
30 day mortality Nerve palsy
30 day re-operation Non-ortho surgical procedure
AFIB unrelated index surgery
CVA Paralysis
Deep Infx PE
Dislocations Peri-prosthetic fx
Dural tears Respiratory failure with intubation
DVT Return to OR
GI Bleed Superficial infx
Hemorrhage Unexpected ICU stay
Inpatient mortality Vascular injury
Wound dehiscence
Intra-op peri-prosthetic fracture
MI Wrong level surgery
Wrong site surgery
Metrics
• Average LOS
• Discharge Disposition
• Quality of Life Scores
• Functional Outcomes
• Practice Patient Satisfaction
• HCAHPS
• Online Reputation Scores
What to do with your data??
✓ QI Committees ✓ Monitor
Guidelines Data/Performance
& Protocols Improvement
✓ Active w/Hospital
I Q
Committees
✓ Research ✓ Transparency
Thank You!