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    ICJR Interviews: A Different Model of Postop Rehab

    Healthcare providers – particularly those involved with joint replacement –had plenty of warning that value-based care was on the way. How they prepared for that eventuality may end up meaning the difference between profit and loss.

    Knowing that change was on the way, the physical therapists at Fox Rehabilitation in New Jersey began looking at an innovative model for delivering rehabilitation services to Medicare joint replacement patients in the home.

    Medicare Part A home health services are generally prescribed for patients being discharged home, which can cost up to 30% of the entire episode of care, with patients typically managed by a nurse and a physical therapist.

    What would happen to costs and resource utilization if Medicare Part B services were prescribed instead, with only a physical therapist managing the patient?

    And just as important, would that have any deleterious effects on outcomes and patient safety?

    William Dieter, DPT, from Fox Rehabilitation, said that physical therapists have a broader scope of practice than many people realize, and they generally can monitor medications, perform wound assessments, auscultate lungs, and in some states even remove staples.

    For a higher-functioning patient, he said, physical therapists can take over management the overall health of the patient. That would allow nurses to focus on sicker joint replacement patients who need care beyond the scope of the physical therapist (such as medication administration).

    The study from Fox Rehabilitation showed a trend toward cost savings and decreased resource utilization with no negative effects on outcomes or patient safety. This is a pilot study, and Dr. Dieter said larger studies are needed to confirm the results.

    Click the image above to hear Dr. Dieter discuss the results of the study, “An Innovative Model for Postoperative Rehabilitation in Total Joint Arthroplasty” (Paper 345), which was presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando.

    Producer: Henrik B. Pedersen, MD; Director: Michael Bugera; Post Production: Charles J. Maynard