BPCI Initiative Cuts Readmissions, Costs for Patients Having Cardiac Valve Surgery.

Vanderbilt University Medical Center's first bundled payment program for cardiac valve replacement and valve repair surgery patients was so successful that the medical center added total joint replacement and stroke to its bundles. A multidisciplinary team, led by nursing, physician, and business leadership, looked for areas of opportunity and set up work groups for each component of the program. The team designed a care coordination program and the hospital hired two care coordinators who follow the patients from the pre-surgical educational session through post-acute care. To meet the goal of reducing overutilization of post-acute facilities, the team created "prehab," a pre-surgical physical therapy program for patients who need it, and everyone who comes in contact with the patients educates them to expect a discharge to home.