From the April 2021 issue of HealthCare Business News magazine
Raymond W. Liu, M.D., FSIR
A prime example of this successful model is Mount Sinai Hospital in New York, where the IR department moved from having 65% of IR treatments conducted as inpatient procedures to 65% of them conducted as outpatient procedures, which led to substantial growth. Mount Sinai Interventional Radiology started with one hospital with five IR rooms and five staff members and grew to six hospitals with 13 IR rooms and 10 IR staff within 10 years. As a result, they increased their revenue tenfold.
When patients are treated by an IR, the benefits extend well beyond the patient experience to the overall quality and cost of care. IR treatments can lower the costs for hospitals and insurers — without sacrificing high-quality outcomes. This also aligns with risk-based payment models, making IR services well positioned for the shift to value-based care.
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IR treatments often result in fewer interventions and complications, along with shorter length of stay, particularly as part of a broader patient care team. For example, Brigham Health in Boston embraced the technical skills of IRs, assigning them a leadership role in efforts to prevent central line-associated bloodstream infections (CLASBI). As key members of the Vascular Access Team, IRs were empowered to object to inappropriate central lines often being left inside patients “just in case.” This innovation, which leveraged IRs’ skill sets and abilities to assess optimal quality-care standards, led to a decrease in CLASBI from 106 to 80 per year, saving potentially $1.2 million in direct Agency for Healthcare Research and Quality (AHRQ) costs and approximately $500,000 in new admissions.
These positive impacts are strongly felt in rural settings. Here, homebound patients and those in assisted-living facilities often face daunting logistical and financial challenges in finding specialty hospital care. But IRs have the skill set and technology that allows them to reach this patient population outside the hospital. In Highland, Indiana, for example, a group of primary care physicians saw many patients struggling to reliably access care because they lacked transportation, faced care-coordination challenges, and did not receive adequate case management. The team engaged an interventional radiologist to provide critical treatments outside the hospital, such as ultrasound-guided needle biopsy, gastrostomy tube management, paracentesis and thoracentesis, wound care, and drug infusions. Within 12 months, the practice treated more than 1,000 patients, reduced emergency department usage by 77%, and cut hospital readmissions by 50%. Patient satisfaction scores increased from 17% to 84%.