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Perioperative Surgical Homes: Can PSH Reduce Healthcare Costs?

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Over the past several decades, when you are admitted to the hospital and then require surgery, your insurer has a code known as a DRG (diagnosis-related group) that determines how many days you will spend in the hospital. But additional factors such as requirements for preoperative blood work, x-rays, CT scans as well as need for pain management and clinical stabilization are important considerations in how long you may need to stay.

But now with a shift to value-based care and the creation of MACRA-MIPS, the evolution of bundled payments is changing the landscape for how reimbursement for surgery and preoperative and postoperative care is determined.  Streamlined care that capitalizes on evidence-based medicine requires creativity and shifting of previous roles of medical providers to incorporate new roles.

One new model to further reduce length of stay while improving care is known as the perioperative surgical home (PSH) , a care plan that makes your anesthesiologist the quarterback for delivery of inpatient care before, during and immediately after surgery. In this model, an anesthesiologist works closely with your primary care physician, orthopedic surgeon, and other specialists to pinpoint areas where quality of care can be improved to reduce costs, length of stay, and to better manage pain, or need for blood transfusions.

And with MACRA-MIPS now center stage for determining physician reimbursement in the era of value-based care, creating ways to streamline care and reduce waste will be necessary to survive in this era of cost containment. In short, the creation of the PSH may be one way to help achieve such cost savings while also improving delivery of care.

And, according to a study presented this week at the annual 2016 American Society of Anesthesiologists (ASA) meeting in Chicago, the PSH did just that—improving care by decreasing the number of tests, blood transfusions and length of stay in the hospital, while also improving patients’ pain management and communication with physicians, as part of TEAMHealth Anesthesia at Tampa General Hospital in Tampa, Florida.

“Implementation of the core PSH evidenced-based practice principles through physician leadership and redesign of the perioperative process has become ‘job one’ across all of our practices nationwide,” said Sonya Pease, M.D., Chief Medical Officer at TEAMHealth Anesthesia. “Being able to take better care of patients and be successful in new payment models can go hand-in-hand, this model of care does exactly this.”

For more on TeamHealth’s research and the perioperative surgical home, click here to read the full article from Forbes.