Lancaster Rehabilitation Hospital is indicative of how IRFs can operate profitably while meeting the Triple Aim goals of reducing costs, improving the patient experience and producing better outcomes.Before 2007, Lancaster General operated a rehab unit within its own 600-bed hospital in Lancaster, Pa. But it was not performing to standards.“It was not a good patient experience: We had low-acuity patients, and the setting was on multiple floors causing patients to go up and down elevators,” says Geoffrey Eddowes, senior vice president for post-acute service at Lancaster General, now a part of Penn Medicine. Eddowes knew it needed to do a better job, so he began a search for improvement opportunities. Lancaster General opened a 50-bed rehab hospital in 2007 as a joint venture partnership with Kindred Healthcare. Lancaster General provides the clinical services, and Kindred handles the administration and management. Prior to opening the rehab facility, Lancaster General Hospital’s rehab unit was on 100 percent medical review. But clinical quality and patient outcomes began to improve in the first year the new rehab hospital was open. “Since opening the IRF, the Lancaster Rehabilitation Hospital has outperformed the national average on nearly every major clinical quality and outcome metric,” Eddowes says.The Lancaster IRF, which expanded to 59 beds in 2010, includes designated brain injury and stroke units, and advanced programming capabilities. Financial benefits and superior clinical outcomes have come in tandem, says Eddowes:
• Almost 80 percent of patients are going home. • The IRF produces more than 30% EBIDTA margins• Patient satisfaction scores have increased from 90% to 98% since offering IRF services
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