Cost Insights

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Product Overview

The Cost Insights application integrates detailed clinical and financial data from multiple sources to help organizations understand, and actively manage, the cost of the services they deliver to patients. The application’s infrastructure facilitates flexible ad-hoc analysis and can serve as a single source of truth for understanding your true cost of care and your areas of greatest variation and potential improvement.

Cost Insights Datasheet

Features

  • Combined clinical, operational, and financial performance measures—from the service line all the way down to the patient, procedure or activity—reduce time required to generate performance information and give visibility into profitability and variation by provider, procedure, DRG, etc.
  • Embedded logic provides for quick and easy identification of clinical and/or operational process variation by provider and department type, offering insights that help drive strategy
  • Highlighting of rate vs volume issues at the activity level identifies process issues leading to cost variation, allowing teams to quickly identify cost reduction opportunities
  • Access to the most granular level of activity and costing data for all patients engages users and helps drive adoption of best practices

Measures

Key Measures Include:

  • Outcome measures: Cost per case, LOS, margin
  • Process measures: OR utilization rate, variation in productivity, use of preferred supplies or medications, OR turnaround time, adherence to best practice indications for imaging

See Sample Screenshots of Cost Insights

Data Sources

  • EMR Clinical
  • Billing (if separate from EMR)
  • Costing (CORUS: Activity-Based Costing application optional)

Cost Insights: A Deeper View

Background

Today U.S. health systems are struggling to navigate a host of challenges: lower inpatient volumes, increasing risk for bad debt, value-based payment models, lower reimbursements, and shifting payer mix. To stay profitable in this landscape, systems need to be able to understand the true cost of the services they provide. Cost Insights delivers this understanding, aggregating data from multiple source systems to reveal costs—and improvement opportunities—across the continuum and  by procedure, provider, and patient. Via dashboards that are customizable to the user’s role, Cost Insights serves up the timely, actionable knowledge critical to improving outcomes today and sustaining the organization over the long term.

Users

  • Chief Financial Officers (CFOs)
  • Directors of Decision Support
  • Cost Accountants
  • Financial and Data Analysts
  • Providers
  • Service-Line Leaders

Use Cases

  • A financial service-line lead identifies significant variability between surgeons as it relates to their patient readmission and complication rates. The physician with the lowest readmission and complication rates also has the lowest cost per case. The physician service-line lead uses Cost Insights to assess patient detail for the high-performing physician’s patients and determines that it is not a severity of illness issue, but rather a difference in surgical approach, room staffing, and instrumentation. The high-performing physician is asked to present her process at medical staff, and other physicians voluntarily change their practices, leading to an overall reduction in cost per case.
  • CFO is reviewing the cost trends for the clinical/service lines in the Cost Insights and notices an increase in costs in the orthopedic service line. She asks her costing team to analyze what is driving the increased costs; the team determines that pharmaceutical and operating room (OR) costs—including OR procedure times and supplies—have increased. The CFO reviews the information with the physicians and financial service line and asks them to present a plan back to her within the next 30 days to reduce costs and physician variation.
  • The CFO is considering a bundled payment contract. He knows there is a lot of variation in the cardiovascular service line, particularly related to acute myocardial infarction (AMI).  He needs to know the total cost of an AMI bundle so that he can negotiate a price.  After a first phase review of the costs using CORUS™ Suite, he sees significant variation in hospital costs correlated with readmissions and complications. The CFO teams with physician and finance leads in the service line to review several strategies to decrease variation and reduce readmission rates and complications.

Opportunity Insights

  • Identify causes of clinical variation
  • Quantify the potential opportunity for cost reduction

Potential Improvements

Outcomes Improvements:

  • Reduce length of stay
  • Reduce cost per case
  • Improve margin
  • Increase user satisfaction related to data access, usefulness

Process Improvements:

  • Reduce the variation in OR utilization rate.
  • Reduce variation in provider productivity.
  • Increase percentage of surgeries completed using preferred supplies.
  • Increase percentage of imaging orders that meet best practice indications.
  • Reduce the time required to generate and disseminate performance information.