FOTO Rehab Outcomes

Cost and Outcome

Written by Selena Horner | Mar 3, 2016 10:30:00 AM

When I was a little girl, I didn't dream of my future wedding... nor my future husband... nor my future house. My dreams were of a horse and a really cool barn. I didn't envision any old red barn for myself. I wanted a special barn. I wanted simple landscaping around it so there would be color and no weeds. I wanted a place that had a stall door with my horse's name on it. And of course, I wanted a cool horse.

15 years ago I got that really cool horse as an anniversary gift. My husband knew that he'd have to leave the choice of the barn AND barn builder in my hands. Because I am horrible at taking an image out of my head and putting it on paper, I went online and found the almost perfect barn. It had a little porch overhang at the front door... it had a cupola... it had windows... it had a loft... and it had a dang post in the middle of the barn! Almost perfect - just get rid of the post, right?

I sat down with 3 different builders. I provided the drawing. I shared a bit of my vision and my dream. AND... I made it very, very clear: no post in the middle of the barn. Obviously, I was very engaged in this project. I took every step possible to ensure my dream would become reality.

Interestingly, I had 3 very different quotes for the very same outcome: the barn of my dreams. Okay... wait... all 3 quotes did not lead to the barn of my dreams. I had 3 very different quotes, I had 2 barns that were not my dream and 1 that would be my dream. 

We could have saved over $5,000 on that barn project if we went with the cheapest quote. That builder though, he was dumber than a box of rocks. I'm not sure he ever saw a blueprint in his life! We could have paid $10,000 more on the barn project. That builder though wasn't really going to provide anything more than what I wanted and I really wasn't sure if he would eliminate the post in the middle of the barn. My builder came through with a middle of the road quote. He was an older guy and chuckled that I had a blueprint. He connected with me and realized I was going for the look, not the actual blueprint. He immediately described how he'd solve the post problem. He also gave me a sideways look as he tapped my blueprint: the outside stall doors would not work as drawn. He also described a solution. He quickly mentioned the dimensions of the barn and described what they would mean from a functional position: standing tall in the loft at the side walls would result in banging one's head. I knew, as he and I were sitting there in the middle of my flower garden, that this builder got it. He totally understood my vision... he wasn't going to blindly follow a blueprint that was riddled with problems. He could think on his feet. He was going to be my builder.

My brain can't wrap itself around health care. There is an extreme difference in cost focused on the same outcome. A person who would like to alleviate knee pain has all sorts of options with a wide variety in the amount of cost. The options are siloed and not interconnected. The likelihood of a person with knee pain being aware of various options may be slim. The most costly option (surgery) also has the highest amount of risk, which leads to more cost. The most costly option also has all sorts of potential financial add ons: oops, we need to add the post-surgical infection package; oops, your body really wasn't a surgical candidate, we'll call the coroner; oops, those medications we prescribed are seriously affecting you. The most costly option requires more dedication, commitment and time for the patient than any other option. The most costly option requires at least 1 year before the desired outcome may be acquired.

Total Knee Arthroplasty Estimated Cost:

Pre-surgical: $1,200

Average Pre-surgical WOMAC: 35

Hospital Stay and Surgery: $57,000

Outpatient Services: $2,100

WOMAC within 3 years after total  knee arthroplasty: 12

Septic Joint Revision: $110,000

When I had the barn built, the key for me was having the right builder. In health care, patients need the right provider at the right time. If the right patient calls you on the phone, do you have the right tools within your practice to sit down and talk about what you can deliver? Can you easily tell someone how much time and money it will cost to achieve a defined outcome? Can you use the information you have to bring the right patients to you?

If you don't think you have the information I'm mentioning, you need to talk to Judy Holder. She can assist you with how you can have discussions to help be the right provider at the right time.

 Until next time,

~Selena