• J Oncol Pract · May 2017

    Impact of a New Palliative Care Program on Health System Finances: An Analysis of the Palliative Care Program Inpatient Unit and Consultations at Johns Hopkins Medical Institutions.

    • Sarina R Isenberg, Chunhua Lu, John McQuade, Chan Kelvin K W KKW Johns Hopkins Bloomberg School of Public Health; Johns Hopkins Health System; Johns Hopkins Medical Institutions, Baltimore, MD; Sunnybrook Odette Can, Natasha Gill, Michael Cardamone, Deirdre Torto, Terry Langbaum, Rab Razzak, and Thomas J Smith.
    • Johns Hopkins Bloomberg School of Public Health; Johns Hopkins Health System; Johns Hopkins Medical Institutions, Baltimore, MD; Sunnybrook Odette Cancer Centre; University of Toronto; and Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada.
    • J Oncol Pract. 2017 May 1; 13 (5): e421-e430.

    PurposePalliative care inpatient units (PCUs) can improve symptoms, family perception of care, and lower per-diem costs compared with usual care. In March 2013, Johns Hopkins Medical Institutions (JHMI) added a PCU to the palliative care (PC) program. We studied the financial impact of the PC program on JHMI from March 2013 to March 2014.MethodsThis study considered three components of the PC program: PCU, PC consultations, and professional fees. Using 13 months of admissions data, the team calculated the per-day variable cost pre-PCU (ie, in another hospital unit) and after transfer to the PCU. These fees were multiplied by the number of patients transferred to the PCU and by the average length of stay in the PCU. Consultation savings were estimated using established methods. Professional fees assumed a collection rate of 50%.ResultsThe total positive financial impact of the PC program was $3,488,863.17. There were 153 transfers to the PCU, 60% with cancer, and an average length of stay of 5.11 days. The daily loss pretransfer to the PCU of $1,797.67 was reduced to $1,345.34 in the PCU (-25%). The PCU saved JHMI $353,645.17 in variable costs, or $452.33 per transfer. Cost savings for PC consultations in the hospital, 60% with cancer, were estimated at $2,765,218. $370,000 was collected in professional fees savings.ConclusionThe PCU and PC program had a favorable impact on JHMI while providing expert patient-centered care. As JHMI moves to an accountable care organization model, value-based patient-centered care and increased intensive care unit availability are desirable.

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