Non-payment for non-performance

St. Luke’s Hospital & Health Network is offering a surgical guarantee – both financial and clinical – as part of a partnership with urogynecologists at The Institute for Female Pelvic Medicine & Reconstructive Surgery in Allentown, Pa.

“We are proud to be able to offer this kind of clinical guarantee,” said Joseph Merola, MD, St. Luke’s chief of obstetrics and gynecology. “Creating this sort of partnership and offering a clinical guarantee ultimately benefits every woman who undergoes this surgery. Knowing that our patients have guaranteed care plans should provide women with every confidence in her surgeon, surgical team, this surgery and her outcome.”

According to Merola, St. Luke’s has implemented a care plan to direct the pre-operative and inpatient process for patients who undergo pelvic reconstructive surgery utilizing mesh at the 480-bed main campus in Bethlehem, Pa.

If St. Luke’s and its surgeons do not follow the care plan, or if a patient develops specific complications directly related to the mesh pelvic reconstructive surgery within thirty days of surgery, the patient and her insurance company will not be billed for services rendered by St. Luke’s or the participating gynecologic surgeons.

“The partnership between the hospital system and our practice is a trailblazing relationship enabling us to realize the concept of ‘pay of performance’ or ‘non-payment for non performance’,” said Vincent Lucente, MD, chief of urogynecology at St. Luke’s Hospital.

The surgical procedure that St. Luke’s and IFPM are guaranteeing is a minimally-invasive surgery using synthetic mesh to support pelvic organs. “The procedure offers promising long-term results for women with pelvic organ prolapse,” said Lucente.

This is not the first surgical guarantee offered by a U.S. health system. Geisinger Health System in Danville, Pa., offers a 90-day guarantee on elective heart surgery. If complications arise following cardiac surgery, Geisinger pays the additional cost of treatment.

Lucente explained that his surgical colleagues and hospital administrators developed a step-by-step plan based on research and clinical data that has demonstrated favorable outcomes for patients.

The team approached those steps as a standard protocol for all four of the surgeons at IFPM, so that the same process is followed for each patient, every time, regardless of which surgeon performs the surgery.

“This guarantee exemplifies how a hospital and private physician practice work together to create protocols that adhere to a higher standard of quality care,” said Donna Sabol, St. Luke’s chief quality officer.

“This is the hospital’s second surgical guarantee - the first was developed for robotic prostate surgery last September. We anticipate developing others based on the favorable response and outcomes we have received.”

St. Luke’s Hospital & Health Network is an integrated network of four non-profit hospitals, encompassing 734 beds, affiliated entities and 1,200 physicians.

Show All Comments