2096 Clinical and Operational Alignment in a Multidisciplinary Brain Tumor Institute: An Integrated Practice Unit (IPU) as a New Model for a Condition-Based Approach to Healthcare. The Cleveland Clinic Experience

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INTRODUCTION: The structure of healthcare in the United States is typically organized based on traditional postgraduate academic training programs but may not reflect what these physicians do. Integrated practice units (IPU) are a team of multidisciplinary healthcare providers with expertise, skill and support to provide efficient care for a particular disease or condition. We report on the reorganization of such an IPU - our Brain Tumor institute (BTI). METHODS: BTI was conceived as an IPU within the Cleveland Clinic Taussig Cancer Institute, composed of neurosurgeons, neurologists, medical oncologists and radiation oncologists, with alignment of clinical, academic, administrative and financial agendas. RESULTS: From January 1, 2002, through December 31, 2024, BTI cared for substantially more patients with an increase in outpatient visits of 702% and new visits of 1934% - (average Annual Compounded Growth Rate [ACGR] of 9.9% and 14.7%, respectively). Surgeries increased by 159% (ACGR 4.4%), and cranial and spinal radiosurgeries by 651% (ACGR 9.6%). A total of 16 service lines are active for patient care. Major philanthropic gifts ($750,000 prior to 2002) totaling more than $25 million resulted in recruitment of senior, internationally recognized clinical investigators and laboratory scientists focused on brain tumors resulting in substantial increase in clinical and laboratory research, with a total of 17 active clinical trials, and 70 patents/innovations. CONCLUSIONS: Reorganization of cooperative centers into multidisciplinary business units or IPUs can significantly enhance programmatic efficiencies establishing a successful model in an era of healthcare reform and accountable care.

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