Study assesses ways to optimize care following IPP implantation

Commentary
Video

"The viability and survivability of practices is in jeopardy," says Bradley Gill, MD.

In this video, Bradley Gill, MD, highlights the rationale for the study, “Optimizing Care - Economic Impact of Reduced Teaching Visits After IPP Implantation,” which he presented at the 24th Annual Fall Scientific Meeting of the Sexual Medicine Society of North America in San Diego, California. Gill is an associate professor of urology at the Cleveland Clinic Lerner College of Medicine in Cleveland, Ohio.

Video Transcript:

Looking at what we're facing in urology right now, we know there's 2 big problems. One is a shortage of urologists, and the other is decreasing reimbursement for the work that's done. The viability and survivability of practices is in jeopardy. Looking at the 90-day global period for inflatable prostheses, there's an assumed 2.5 teaching visits incorporated into that bundled payment. Thinking about how a practice flows and what can be done with a surgeon schedule in the office, the question came to mind, if you're able to decrease that expected 2.5 teaching visits, even by 1 visit, what can that mean for your practice in terms of improving access and opening new appointments for new patients? And also, what it can mean for your practice in terms of reimbursement and viability?

What we did is we took a model of an implanter's practice, and essentially looked at practices doing 25, 50, or 100 implants a year, so varying degrees of surgical load, and said, "if we can drop 1 teaching visit from the outpatient clinic schedule in each one of these practices, what does that translate to in terms of other care that we're able to offer patients?" We know that many of us face long wait times to get patients into the office and that patients also face delays in care because of this. If we start with the practice doing 100 implants annually–a nice round number, easy to look at and model–what we found is that looking at outpatient encounters, whether they be a low, moderate, or high complexity visit, you can create an additional up to $8000 or $9000 of annual reimbursement based upon Medicare rates. Using Medicare rates was one way that we modeled in our study, because we wanted to provide a very conservative estimate. We all know that Medicare reimbursement tends to be substantially lower than that private insurers pay for the care that patients receive. Looking at these numbers is a very conservative estimate of what can be done to help a practice sustain.

This transcription has been edited for clarity.

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