Bundled Care Funding

Total Joint Replacement and Post-Op Physiotherapy

What is bundled care?

Bundled care is the provision of health care services for an episode of care across multiple settings and providers which is funded by the Ministry of Health under a single payment. As of April 2019, total elective joint replacements (hip and/or knee) fall under Bundled Care.

Perth and Smiths Falls District Hospital is a bundle holder and is responsible for making sure payment is provided to qualifying partner organizations that offer care related to surgical recovery, including inpatient, outpatient, and homecare.

What is my role in bundled care?

Perth and Smiths Falls District Hospital must track the name of the clinic/organization where patients receive post-op physiotherapy. After surgery, a member of the physiotherapy team will ask you “where you will be going for post-op physiotherapy/rehabilitation?” It is important that you provide the name of the clinic to the staff member so that arrangements and information can be shared.

Are there limits to where I receive post-op physiotherapy?

For patients within the catchment area of Perth and Smiths Falls, your post-op physiotherapy will be provided by the outpatient physiotherapy department at the hospital. For those patients that are not within the Perth and Smiths Falls District Hospital catchment area, a list of qualifying partner organizations is listed below.

Can I go to a private clinic?

Every patient has a choice as to where they would like to receive care. Under this funding model, payments cannot be made to private clinics unless identified as an Ontario government-funded community outpatient rehabilitation provider.

Patients may choose to supplement their bundled-care with private pay recognizing that the patient is responsible for any costs associated with the private clinic.

How do I arrange my post-op therapy?

Prior to discharge from hospital, a member of the physiotherapy team will fax a referral to the clinic/organization. Every effort is made to secure an appointment time and provide this information to you.

What should I expect?

For patients who have had a total knee replacement, outpatient rehabilitation should begin 7 days after discharge from hospital. You will be expected to attend therapy sessions 2 to 3 times per week. The duration of therapy is dependent upon achieving pre-set goals, achieving independence, or once a plateau is reached.

For patients who have had a total hip replacement, outpatient rehabilitation should begin 2 to 6 weeks post-discharge from the hospital. The frequency of treatment is usually once per week. The duration of therapy is dependent upon achieving pre-set goals; achieving independence, or once a plateau in progression is reached.

Please contact us if you would like to complete your post-op therapy at a clinic/organization not on the list.

Funding Eligibility

Bundled care partners and non-partners may request funding from Perth and Smiths Falls District Hospital when their patients meet the following criteria”

The patient had an elective unilateral/bilateral hip or knee replacement surgery at Perth and Smiths Falls District Hospital on or after April 1, 2019 and
The patient meets OHIP eligibility criteria and
The patient’s primary diagnosis meets the MOH Quality Based Procedures criteria for elective unilateral/bilateral hip or knee replacement surgery and
All post-acute ambulatory rehabilitative care must be reported to NACRS Clinic Lite. Providers must obtain a master number from the MOH to report into NACRS Clinic Lite.

Pricing

Perth and Smiths Falls District Hospital will reimburse a pre-set amount for post-op rehabilitation therapy. This amount applies to the full scope of services provided for the episode of care (not per visit) and are:

Non-negotiable
Applicable for qualifying Quality Based Procedures (unilateral/bilateral hip and knee replacement surgeries) completed after April 1, 2019
Subject to change
Payment Requests and Contact Information

Requests can be directed to:

Chantal Menard, Manager, Obstetrics and Rehabilitation Services

chantal.menard@psfdh.on.ca

613-283-2330 ext. 4208