A Network initiative has proposed alternate pricing for hospital-based outpatient rehab for the MOHLTC hip and knee bundled care pilot.

The Network used its outpatient rehabilitation model for total joint replacements (which provides an optimal level of care) and an average pricing for hospital-based outpatient physiotherapy in Toronto Central LHIN to estimate a cost per hip replacement and knee replacement. To validate the pricing, the Network used 2017/18 quarterly outpatient data from Network member hospitals to confirm the average number of outpatient attendances for these patients.

The calculations showed that the outpatient rehab pricing for hip replacement in the bundled care pilot was close to actual cost, but that the pricing for knee replacements was significantly less than the cost of providing best practice care.

This information was shared with Toronto Central LHIN (the bundle holder at that time), who shared the information with the Ministry of Health and Long-Term Care.

The Network also continues to facilitate discussions with participating hospitals regarding next steps.

For more information, please contact project manager Sharon Ocampo-Chan.