The Baby Bridge program: A sustainable program that can improve therapy service delivery for preterm infants following NICU discharge

The aim of this project was to determine revenues and costs over time to assess the sustainability of the Baby Bridge program. 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 (NIC...

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Bibliographic Details
Published in:PloS one 2020-05, Vol.15 (5), p.e0233411-e0233411
Main Authors: Pineda, Roberta, Heiny, Elizabeth, Nellis, Patricia, Smith, Joan, McGrath, Jaqueline M, Collins, Margaux, Barker, Abigail
Format: Article
Language:English
Subjects:
Babies
Biology and Life Sciences
Care and treatment
Cost assessments
Costs
Disability
Discharge
Early intervention
Economic aspects
Engineering and Technology
Equipment costs
Forecasts and trends
Health care costs
Hospitals
Income
Infants
Intensive care
Maternal health services
Medicine
Medicine and Health Sciences
Neonatal care
Neonates
Newborn babies
Occupational therapy
Operating costs
Pediatrics
People and Places
Physical therapy
Premature babies
Premature birth
Premature infants
Programming
Revenue
Risk groups
Social Sciences
Speech therapy
Sustainability
Therapists
Therapy
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Summary:The aim of this project was to determine revenues and costs over time to assess the sustainability of the Baby Bridge program. 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. 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. 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
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0233411