Rehab hospital develops global pricing program
Rehab hospital develops global pricing program
Moss offers package billing for foreign payers
Talk about a market niche. Moss Rehab in Philadelphia has found an interesting one: providing packaged pricing for services provided to amputees, brain injury patients, and those with neuromuscular disorders. The payers in these cases are foreign governments.
In 1999, the hospital expects to see 25 to 50 patients whose care is financed under global billing arrangements with foreign governments, says Bob Meighan, program manager at Moss Rehab. The hospital has provided these services for the past five years based on word-of-mouth referrals and the reputations of three well-known Moss Rehab physicians: Mary Ann Keenan, MD, director of neuromuscular surgery; Nathaniel Mayer, MD, director of the brain injury center; and Alberto Esquenazi, MD, director of the Moss Rehab Regional Amputee Center. "These three got together and realized that the sum of their expertise was greater than what they had individually, and they began publishing," Meighan says. "We started small with a couple of patients by accident. The physicians and administrators said, Let’s learn while we go.’ And we built this into something more than we thought it would be."
The three physicians developed their own program, known as the Institute for Mobility Examination and Treatment, Meighan says. Then they calculated costs for the typical patient for specific types of cases and came up with a set price that includes fees for surgery, operating room costs, anesthesia, X-rays, durable medical equipment, and rehabilitation.
"The original idea was to limit this to areas where we could get a handle on our costs. We wanted to make sure we accounted for outliers, so we set a price range in which 90% of patients fall," he says. Contracts with the governments include language protecting the hospital "against extraordinary events," he says. For example, a patient might suffer from another illness, such as a heart attack, while in the hospital. Providing services for that illness obviously would create more costs.
Developing cultural sensitivity among hospital staff has been key, he adds. "Any time you’re working with foreign patients, you have to go to another level. Our staff has really jumped on that in an exciting way. For example, when we first began getting United Arab patients, we had a Muslim member of our staff teach cultural sensitivity for this patient population. If you go into one of our rooms for these patients now, you’ll see arrows on the wall that point to Mecca. We even leave a compass in the room so they can find which way to pray toward Mecca in case they want to check whether we’ve done it correctly."
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