KHP and six KentuckyOne hospitals have successfully managed 90-day orthopedic episodes for nearly two years. CMS had planned mandatory cardiac 90-day episodes for the Lexington area, and Louisville hospitals were going to also adopt the new care pathways. But just this week, Medicare announced a postponement of the program until later this year.
“Given the infrastructure in place and our experience with orthopedic episodes, we were prepared to go live in July,” explained Dorothy Lockhart, KHP’s Regional Director for Care Management for the Central/East Market. “However, the added time will allow hospital service line teams and KHP to fine-tune the clinical protocols for CABG and AMI.”
The 90-day episode programs require the entity to manage all cause and cost (i.e. if the patient develops an unrelated clinical problem, it is included in the original fix-cost episode). Using KHP’s population management platform and care management team has helped KentuckyOne to excel in the 90-day episode program. KHP is now active in knowledge transfer to other CHI MBOs and CINs.