Combining effective treatment with cost containment
We set the standard before it was set
At Rehab Without Walls® NeuroSolutions, our number one goal is to deliver durable clinical outcomes for our patients by connecting the NeuroCare continuum. But financial outcomes matter as well.
How we achieve savings
Our program is designed to deliver the same or better outcomes compared with other programs at a lower cost to the payer and patient. Some of the reasons behind the savings:
- Shorter length of stay – We provide high-intensity rehabilitation in the setting most appropriate for each patient’s recovery, whether that’s a residential facility or the patient’s own home. As a result, patients can have significantly shorter hospital stays and move efficiently through the continuum of care.
- Clinical coordination and collaboration – Our team members have channels of communication that ensure smooth implementation of the treatment plan, while also helping to avoid gaps and overlaps that could be costly in terms of recovery time and dollars spent.
- Family member involvement – Compared with other diagnoses, brain and spine injuries require a high level of caregiver involvement. Involving family members in our therapy plans helps patients recognize gains more easily, which can increase motivation and reduce the risk of depression. It also lessens the risk of settling into dysfunctional accommodations.
We set the standard before the standard was set
Rehab Without Walls NeuroSolutions started delivering neurorehab in a home and community setting in the 1980s. More than 10 years later, a panel convened at an National Institutes of Health (NIH) conference presented its recommendations on how to provide the most effective treatment for traumatic brain injury (TBI) while still keeping costs under control. The panel’s recommendations remarkably mirrored the principles of our approach:
- Services should be matched to the needs, strengths and capacities of each person and modified as those needs change over time
- Programs for moderate or severe TBI should be interdisciplinary and comprehensive
- Rehabilitation should include cognitive and behavioral assessment and intervention
- Persons with TBI and their families should play an integral role in the planning and design of their individualized rehabilitation programs
- Community-based, nonmedical services should be components of the extended care and rehabilitation available to persons with TBI
and their families
- Specialized, interdisciplinary and comprehensive treatment programs are necessary to address the particular needs of young and school-age children with TBI
When you choose Rehab Without Walls NeuroSolutions, you’re not just selecting a program that follows best practices for financial outcomes. You’re selecting the program that established these best practices in the first place.
Liberty Mutual case study: estimated lifetime savings of $12 million dollars
For payers, the Rehab Without Walls NeuroSolutions care model can translate into hundreds of thousands of dollars saved per patient. To illustrate the savings, consider the case of Ferne P., a woman who was hit by a car in the parking lot of her workplace. She sustained a massive head injury and left side paralysis.
Ferne’s Liberty Mutual workers’ compensation case manager – Rosemary Marnoch, RN, – was concerned about her prognosis. “If she survived, we thought the best case scenario would be anything less than 24-hour attendant care.” Nonetheless, Marnoch recommended Rehab Without Walls NeuroSolutions to maximize whatever functionality was possible.
Ferne first participated in the inpatient residential program in Phoenix for about a month. Then she was discharged into the day treatment program. She also received limited attendant care while her husband was at work. As Ferne continued to gain strength, she no longer needed attendant care. She received the last few months of her treatment in the community, working mostly with a vocational counselor who assisted with transitioning back to the workplace.
As Marnoch is quick to emphasize, it is not just about the money – but the fact is, delivering intensive rehabilitation in the right setting over the appropriate period of time does save the company significantly. In Ferne’s case, attendant care would cost approximately $193,000 a year. If Ferne were to live out her life expectancy according to actuarial tables, attendant care could run as high as $12.5 million over the course of her lifetime.
With results like these, it is not surprising that Rehab Without Walls NeuroSolutions is a preferred provider for Liberty Mutual on catastrophic and traumatic brain injury cases.
“Rehab Without Walls is able to provide savings in several ways. I see a cost savings if I am able to move a patient out of intensive inpatient rehabilitation and into the home as well as when a patient can reach maximum functionality and independence in the home before moving into an outpatient setting.”