Here's a twist: A hospital that doesn't want patients coming to its emergency room when they break a bone.
HealthPartners, owner of Regions Hospital in St. Paul, is reporting success with a home-visit program that sends specialists to nursing homes for residents who fall and suffer orthopedic injuries. Regions estimates $6,000 to $8,500 in savings when elderly patients use this option instead of the ER.
It works like this: An X-ray technician is sent out when staff at any of the 110 nursing homes affiliated with the program suspect a resident has suffered a fracture. The technician e-mails X-ray images to a surgeon at Regions, who determines whether the patient needs surgery at the hospital or if a nurse-practitioner can go to the home and treat the patient, often with a simple splint or cast.
The savings go mostly to patients and their insurers, who avoid costly ambulance rides, ER visits and hospital admissions. But the benefits go beyond dollars, said Dr. Julie Switzer, who directs Regions' geriatric orthopedic trauma program.
The elderly patients are often frail and suffer dementia, so transporting them can cause stress and pain.
"It's just a better way to provide care for patients," she said.
For the hospital, it seems like a win-lose proposition: Regions is losing revenue from ER visits, but gaining a stable pipeline of patients to its orthopedic surgery program. Switzer says it's not quite that simple, but the hospital is no doubt positioning itself well for an aging population and the likelihood of more geriatric orthopedic cases.
Patients also receive postoperative visits at their homes — again saving them the cost and trouble of clinic visits.
Patients and relatives appreciate the program, Switzer said, and researchers hope to verify the estimated savings and whether the system results in faster recoveries.
The strategy isn't a cure-all; a quarter of elderly hip fracture patients die within a year, and that isn't likely to change.
But even those patients will gain comfort and convenience from this service, Switzer said. "We have such an opportunity to improve the quality of life for these patients, and this program is built on that concept."