Total joint replacement surgery is one of the most prevalent and expensive surgeries in the U.S., and a study published in the Annals of Translational Medicine indicates that costs and outcomes for such surgeries can be improved by using artificial intelligence platforms.
Specifically, the research examined the efficacy of PreHab AI technology from mobile technology company PeerWell. Offering pre-operative education, PreHab was associated with a reduction in surgery costs of $1,215 — with one big catch: It had to be delivered in person by a physical therapist.
Many insurance plans only allow for a small number of paid physical therapy sessions per year, making surgeons reluctant to use them before surgery.
The platform was able to deliver effective preoperative optimization without the need for clinicians, findings showed.
A patient’s use of PeerWell led to significant cost reductions including a 25 percent drop in hospital length of stay, an 80 percent increase in going home without the need for home care, and a 91 percent reduction in discharges to skilled nursing facilities.
The platform uses patient data to create personalized daily plans to get patients ready for surgery. Plans include video physical therapy, nutrition counseling, comprehensive anxiety management and pain resilience training, home preparation guidance and medical risk management.
By using machine learning, PeerWell can also glean clinically relevant data from ordinary smartphones. For example, using the accelerometer and gyroscope, it can track the range of motion. Or, by using the smartphone camera, it can identify trip and fall hazards in the home.
The largest insurers in the world, including Medicare, have changed regulations to put the onus on care providers to reduce costs while maintaining high quality. This dynamic has left many surgeons and hospitals in a bind, shouldering more administrative work for less reimbursement.
Medicare’s randomized trial of a new bundled payment model for hip and knee replacement surgeries led to $812 in savings per procedure, or a 3.1 percent reduction in costs when compared with traditional means of paying for care, the research found.
The bundled payment model was also associated with a reduction in the use of skilled nursing care after hospitalization but had no effects on complication rates among patients.
Bundled payments are an alternative payment strategy that health plans, Medicare and Medicaid are experimenting with to reduce expenses. Unlike traditional fee-for-service payments, bundled payments provide a single, fixed payment for a procedure and follow-up care rather than individually paying all parties separately.