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Investing In Patient Care and Savings

Successful investment bankers have a nose for profitable innovation. In the case of Penn Nursing Board of Advisors member and Wharton alum John J. Rydzewski, he knew as soon as he heard Mary D. Naylor, PhD RN FAAN present early research findings for the Transitional Care Model (TCM) that it was potentially transformational. That led him to recently make a generous gift to Dr. Naylor’s work at Penn Nursing’s NewCourtland Center for Transitions and Health.

Rydzewski says, “The way to be successful in health care services is to figure out a way to deliver superior care at a lower cost. TCM is evidence-based health research demonstrating how to deliver better patient care while saving the system money.”

The NewCourtland Center—of which Dr. Naylor is Director (she also serves as the Marian S. Ware Professor in Gerontology)—focuses on the growing population of chronically ill adults living with complex health and social needs and their family caregivers. Among the Center’s many accomplishments and pursuits, Dr. Naylor and a multidisciplinary team of colleagues at Penn designed the TCM to address the negative effects associated with common breakdowns in care when at-risk older adults transition from acute care settings to their homes, and it prepares patients and family caregivers to more effectively manage changes in health associated with multiple chronic illness. Notably, this innovative care model also has been tested in primary care settings, preventing the use of costly health services by at-risk older adults.

“The TCM is delivered by advanced practice nurses, supported by each patient’s care team, who manage the transition of chronically ill older adults from hospital stays to post-acute skilled nursing facilities, if referred, and then to home,” says Dr. Naylor. “Multiple NIH-funded clinical trials have demonstrated the health and economic benefits of TCM, including enhanced quality of life, reduced hospitalizations and decreased total health care costs. The TCM is a pioneer in the world of evidence-based care management, and it’s been gratifying to see more and more health systems implementing this evidence-based solution.”

Indeed, health systems, communities, payers, and funders have partnered with her not just to test the model but to spread an approach to care that is critically needed by at-risk older adults and their caregivers. Dr. Naylor was recently granted a multi-million dollar investment from Arnold Ventures and co-sponsored by Missouri Foundation for Health and the Health Services Research and Development Service, U.S. Department of Veteran Affairs, to evaluate the TCM as a potential country-wide system for replication.

John J. Rydzewski, W75, WG77John J. Rydzewski, W75, WG77Even though the TCM centers on patient care and experience, its financial impact on health care delivery remains the component that Rydzewski feels should be more widely studied. He says, “When I was a Wharton student, there was no health curriculum. At least now there’s a Penn Nursing-Wharton dual degree program where students are exposed to the TCM. However, rising health care costs affect all industries. Tomorrow’s business leaders being trained in technologies that improve operating efficiency across industry should learn how health services innovations such as TCM can also produce a better bottom line. This will make them more demanding consumers of health care payer and provider services and contribute to bending the cost curve.”

To make a gift in support of the NewCourtland Center, please contact Josh Nay, Penn Nursing’s Senior Director of Development and Alumni Engagement, at 215-898-1942 or