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The Baby Bridge program: A sustainable program that can improve therapy service delivery for preterm infants
Roberta Pineda1,2,3, Elizabeth Heiny3, Patricia Nellis3
1Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, United States of America.
Insights
The Baby Bridge program, offering early therapy services for high-risk infants, achieved financial sustainability within 16 months. Initial losses were overcome, projecting future net income and demonstrating the program's viability.
Area of Science:
- Healthcare Management
- Pediatric Therapy Services
- Infant Health Outcomes
Background:
- High-risk infants require timely, consistent, high-quality early therapy services post-Neonatal Intensive Care Unit (NICU) discharge.
- The Baby Bridge program was designed to bridge the gap in care continuity for these vulnerable infants.
- Key program features include early therapist engagement in the NICU, rapid post-discharge home visits, and a consistent provider model.
Purpose of the Study:
- To determine the revenues and costs associated with the Baby Bridge program over time.
- To assess the financial sustainability and potential for scalability of the early intervention program.
- To evaluate the program's financial performance in relation to its operational capacity.
Main Methods:
- Tracked costs including therapist salaries, travel, and equipment for the Baby Bridge program.
- Compared program expenses with participant claim records and reimbursement data.
- Estimated operational costs at full capacity based on projected claims and reimbursements.
Main Results:
- The program incurred a loss of $26,460 in its first year (2016) but achieved a net positive income of $2,969 in 2017.
- Program revenue exceeded costs by Spring 2017, 16 months after implementation.
- Projected cumulative revenue to exceed cumulative costs by January 2019, with an estimated net annual income of $16,308 at capacity.
Conclusions:
- Despite initial operating below capacity leading to early losses, the Baby Bridge program demonstrated financial sustainability within 16 months.
- The program's financial viability was achieved through effective service delivery and reimbursement models.
- Further research is warranted to explore potential cost reductions associated with mitigated health burdens due to early therapy.
Objective:
The aim of this project was to determine revenues and costs over time to assess the sustainability of the Baby Bridge program.
Methods:
The Baby Bridge program was developed to promote timely, consistent and high quality early therapy services for high-risk infants following neonatal intensive care unit (NICU) discharge. Key features of the Baby Bridge program were defined as: 1) having the therapist establish rapport with the family while in the NICU, 2) scheduling the first home visit within one week of discharge and continuing weekly visits until other services commence, 3) conducting comprehensive assessments to inform targeted interventions by a skilled, single provider, and 4) using a comprehensive therapeutic approach while collaborating with the NICU medical team and community therapy providers. The Baby Bridge program was implemented with infants hospitalized in an urban Level IV NICU from January 2016 to January 2018. The number of infants enrolled increased gradually over the first several months to reach the case-load capacity associated with one full-time therapist by mid-2017. Costs of the therapists delivering Baby Bridge services, travel, and equipment were tracked and compared with claim records of participants. The operational cost of Baby Bridge programming at capacity was estimated based on the completed and anticipated claims and reimbursement of therapy services as a means to inform possible scale-ups of the program.
Results:
In 2016, the first year of programming, the Baby Bridge program experienced a loss of $26,460, with revenue to the program totaling $11,138 and expenses totaling $37,598. In 2017, the Baby Bridge program experienced a net positive income of $2,969, with revenues to the program totaling $53,989 and expenses totaling $51,020. By Spring 2017, 16 months after initiating Baby Bridge programming, program revenue began to exceed cost. It is projected that cumulative revenue would have exceeded cumulative costs by January 2019, 3 years following implementation. Net annual program income, once scaled up to capacity, would be approximately $16,308.
Discussion:
There were initial losses during phase-in of Baby Bridge programming associated with operating far below capacity, yet the program achieved sustainability within 16 months of implementation. These costs related to implementation do not consider the potential cost reduction due to mitigated health burden for the community and families, particularly due to earlier receipt of therapy services, which is an important area for further inquiry.
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