by Jill Clendening
Employees covered by Vanderbilt University Medical Center health plans and employees covered by the Metro Nashville Public Schools health plan can now enroll in two new MyHealth Bundles: MyUrologyHealth for the treatment of kidney stones and MyRecoveryHealth for the treatment of substance use disorder.
Bundled payments are a value-based approach to managing some common and often costly health conditions and are designed to improve health outcomes and lower costs. Services related to the diagnosis, management and treatment of a specific condition during a defined episode of care are included in a bundle. The grouping of payment for episode-related services is called a bundled payment. MyHealth Bundles are designed so that patients have little or no out-of-pocket expenses.
“We’re really trying to make the goals of the provider and the health care system and our patients all line up to make the entire experience better,” said Sabrina Poon, MD, MPH, medical director of Episodes of Care in the Office of Population Health. “We’ve set these bundles up to be comprehensive. We’ve covered a broad period of time for both of these bundles to ensure we’re able to provide all the services that contribute to recovery and a successful patient journey.”
The bundled payment model encourages care coordination and adds incentives for clinical providers to better manage a patient’s entire experience, reducing employers’ overall costs and building a concierge service experience for the individual receiving care.
Statistics show that individuals who have kidney stones are 60% more likely to develop another, so the MyUrologyHealth bundle includes services to analyze the kidney stone to determine its composition and dietary counseling to help reduce the risk and frequency of future kidney stones.
“Dr. Ryan Hsi, a urologist who co-leads the Complex Kidney Stone Clinic here at VUMC, helped us design our kidney stone bundle,” Poon explained. “The bundle really has two arms. If you have a stone, you might need an intervention to address that such as an operation. Then we cover a generous postoperative period. There’s also the situation where you have a kidney stone, but you pass it without any intervention. We cover a period of time after that as well. This is because we offer unique services to help reduce the individual’s risk of getting a kidney stone again.”
The MyRecoveryHealth bundle includes support for opioid use disorder as well as other substance use disorders, which could involve alcohol, cannabis, cocaine, methamphetamine and other stimulants, sedatives, hallucinogens, inhalants and other psychoactive substances. Services include inpatient treatment as well as multiple levels of outpatient treatment.
“We’re especially excited about our bundle to assist those dealing with substance use disorder,” Poon said. “I don’t think you really realize how difficult and frustrating it can be to get help until you’re trying to get connected to the services you need during what is often a crisis. And many people give up because it’s just too hard. With the MyRecoveryHealth bundle, we want them to know we’re on their side.”
Patient navigators, who simplify a patient’s access to providers, streamline appointments, provide guidance and answer questions are “the backbone of the bundles program,” Poon said.
A recent addition to the MyHealth Bundles program is an online patient navigator chat feature to walk individuals through eligibility, enrollment and any questions about the program.
Vanderbilt Health launched the first MyHealth Bundle, MyMaternityHealth, in 2020. Designed to cover services an expectant mother and baby need for the entire length of a pregnancy, MyMaternityHealth has received high patient satisfaction scores and provided large cost reductions for both employers and patients.
There have been 5,210 enrollments to date for all MyHealth Bundles. More than 23,000 pounds have been lost by enrollees in the MyWeightLossHealth bundle.
All bundles, with exception of the most recently added, are available to approximately 80,000 individuals through four employer contracts: VUMC, Metro Nashville Public Schools, Ryman Hospitality Properties and Lee Company. The eligibility for MyUrologyHealth and MyRecoveryHealth will expand as employer contracts are added.
Additional MyHealth Bundles include the MyHearingHealth bundle for cochlear implant surgery; the MySpineHealth bundle for select spine surgery; MyOrthoHealth bundles for hip and knee joint replacement, hip and knee osteoarthritis, and shoulder pain; and the MyWeightLossHealth bundle for medical and surgical weight loss.