Tria Orthopaedic Center in Bloomington offers surgery recovery at Hilton

  • Article by: CHEN MAY YEE , Star Tribune
  • Updated: April 27, 2010 - 5:20 AM

An orthopedic group says forgoing a hospital stay shaves up to 20 percent off surgery costs.

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Matt Broin met with his doctor, Joel Boyd, before his hamstring repair surgery this month at the Tria Orthopaedic Center. A few hours later, Broin would be recuperating at the Bloomington Hilton across the street, seen through the window. The post-op hotel stay is part of a pilot program.

Photo: Glen Stubbe, Star Tribune

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Douglas Odell had a partial knee replacement a few weeks ago. Previous hospital stays had left him cold -- the food was terrible and "you always got the beepy thing next to you."

So when his doctor offered the option of recuperating at the Hilton instead, the Burnsville resident gladly said yes.

When Odell, 63, emerged from surgery at the Tria Orthopaedic Center in Bloomington, his wife drove him across the street to the hotel, where a nurse was waiting with a wheelchair. Up in his room, Odell sank into a recliner, watched "American Idol" and dined on chicken noodle soup and a BLT sandwich. The nurse stayed in an adjoining room, checking on him through the night.

Odell got up the next morning and had an omelet and hash browns before checking out. "I felt like I was on vacation," he said.

His insurer, Blue Cross and Blue Shield of Minnesota, covered the combined cost.

The Hilton deal is part of a pilot program quietly rolled out at Tria in 2008 in an effort to lower costs and raise patient satisfaction. About 70 patients have used it so far, a sliver of the 6,000 surgeries performed at the Bloomington center annually.

Tria says the surgery plus hotel stay works out 15 to 20 percent cheaper than surgery at a hospital, significant savings in these days of rising medical costs. Hospitals tend to have high overhead costs.

Insurers have paid the hotel tab bundled into the overall cost on a case-by-case basis, and Tria is now negotiating contracts with local insurers.

"The goal is to lower the cost of care," said Mary Johnson, president and chief operating officer of Tria.

Day surgery expands

In the last few years, many types of surgeries have moved out of hospital settings and into ambulatory centers. Tria is further expanding the concept of day surgery, taking patients who would normally be monitored overnight in a hospital, and putting them in a hotel instead.

A spokeswoman for the Ambulatory Surgery Center Association in Alexandria, Va., said she had heard of one or two centers around the country sending patients to recuperate at a hotel, but "it's rare."

Tria is a partnership among Park Nicollet Health Services, University of Minnesota Physicians and the Orthopaedic Center, a sports medicine practice. Park Nicollet also owns Methodist Hospital, where many of the Tria surgeons operate. "It's a win for everybody," said Park Nicollet's chief executive Dr. David Abelson.

Not every Tria patient is a candidate for a post-surgery stay at the Hilton. Patients need to be otherwise healthy without co-morbidities such as heart disease. They also need to have a family member or friend stay with them overnight.

So far, the majority of patients recuperating at the Hilton have had partial knee replacements, a procedure that's typically done on an inpatient basis in hospitals. Some patients had multiple ligament reconstruction, hamstring repair or fracture repair. These are patients who don't require much more than monitoring and pain medication through the night. "We wanted to make sure we didn't put anybody at risk," Johnson said.

Tria surgeons would like to start doing total knee replacements outside the hospital too. Tria's executives hope eventually to have one nurse tend to multiple patients on any given night. So far, patients appear to like the arrangement: 98 percent of patients rated it 5 out of 5, Johnson said.

But for numbers to pick up, they'll need to get some insurance contracts in place. A Blue Cross spokesman said its representatives are meeting with Tria later this month to discuss the results of the pilot.

"As with every pilot program, we evaluate many factors, with patient safety being of paramount importance," spokesman Jim McManus said. "They will also look at costs, health outcomes, and if this approach possibly represents a more family friendly environment, which can have a significant impact on a patient's recovery."

Animal crackers

Staff at the Bloomington Hilton have taken the unexpected business in stride, adapting as needed. Initially, they sent the hotel shuttle to pick up patients, but the vehicle's steps were too difficult for knee patients to negotiate. Now relatives drive the patients over in their cars. The hotel also learned to stop stocking its rooms with candy bars, which can upset the stomachs of post-surgery patients. Now they put out animal crackers instead.

On a recent day, Mark Broin drove his son, Matt, from Tria to the Hilton. The younger Broin, 25, tore his left hamstring in a waterskiing accident last summer. After a two-hour surgery, he was feeling weak but still able to crack a few jokes. A nurse and a front-desk manager got Broin into a wheelchair, past business travelers checking in at the lobby, and up the elevator to his room.

Broin sank into bed, eyeing a basket of fruit, crackers, instant popcorn, water and Sierra Mist. He looked around, saw an inviting recliner by the window, and deadpanned: "Think they'll notice if I take it with me?"

A nurse, Kathleen Enger, took his temperature and blood pressure. "I look at it as private duty nursing," she said. "But in a very luxurious setting."

Enger put an ice pack on Broin's leg and left a urinal in the bathroom. She told him to keep the door cracked so she could check on him. A couple of times during the night, she gave Broin morphine shots when Vicodin wasn't strong enough to numb his pain.

Broin is now home, resting. Tria gave him an estimate of his bill: $5,170, of which he will pay about $1,000 in deductibles and co-insurance. Insurance will cover the rest.

Chen May Yee • 612-673-7434

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