How Penn Medicine Reimagined Breast Reconstruction, Shifting the Balance of Postoperative Care from Clinic to Home

Tecce, Michael G.; Hahn, Lauren; Welch, Bethany; Okawa, David; Wendler, Daniel J.; Kalva, Saiesh; Balachandran, Mohan; Delgado, M. Kit; Snider, Christopher K.; Flynn, Danielle; Rosin, Roy; Merchant, Raina M.; Serletti, Joseph M.; Lee, Kathleen C.

doi:10.1056/cat.20.0528.2021.1.test

Cited by 1 publication

(1 citation statement)

References 5 publications

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“…For example, Penn Medicine’s Connected Approach to Recovery program leveraged digital tools to augment home-based postoperative care for breast reconstruction. 10 As Hospital at Home models expand to cover more surgical conditions, the accessibility of home discharges may create a more patient-centered care paradigm and reduce costs.…”

Section: Mapping Costs Across the Surgical Care Continuummentioning

confidence: 99%

Applying Lessons from COVID-19 to Cost Centers across the Phases of Surgical Care

Pathak

Kadakia

Orgill

2022

Plastic and Reconstructive Surgery - Global Open

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OVID-19 has renewed calls for reforming health care organization and financing in the United States after pandemic-induced cancelations of health services resulted in substantial economic losses for providers. This impact was particularly severe for surgical specialties, with over $22 billion in-hospital revenue lost under procedure deferrals or cancelations. 1 Emerging evidence suggests that providers operating under alternative payment models such as global budgets, as opposed to fee-for-service models, were insulated from the financial shock of COVID-19 due to the ability to adjust the unit price of inpatient and outpatient services to offset projected volume losses. This trend has significant implications for surgeons, as risk-based payment models shift the onus for cost-minimization and accountability for a given episode of care onto providers themselves. Although attempts to curtail costs in surgery using alternative payment models have been piloted, common procedures within plastic surgery have not yet been incorporated into alternative payment models. However, procedures that are both expensive and performed frequently, such as breast reconstruction, may become candidates for alternative payment models in the future. 2 Consequently, plastic surgeons may benefit from understanding optimal strategies for managing different costs within a surgical episode of care and incorporating lessons learned during the COVID-19 pandemic to help further control costs.To help guide the adoption of cost-control measures in plastic surgery, this article presents a conceptual framework for mapping costs in surgical care using the five phases model of the American College of Surgeons. 3 By examining cost drivers and delivery innovations at each step of the care continuum, surgeons can be better equipped to contribute to the design of more cost-effective models of surgical care.

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Section: Mapping Costs Across the Surgical Care Continuummentioning

confidence: 99%