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Opportunity Analysis Permits Successful Execution of At-Risk Contracts

Growth in the government payer mix and an increased cost burden to the commercial population, decreases in the private payer population, and programs like the Medicare Shared Services Program, have caused joint ventures, partnerships, and co-branding efforts, better known as at-risk contracts, between payers and providers to increase.

Allina Health has three Integrated Health Partnership (IHP) contracts, an accountable care model that incentivizes healthcare providers to take on more financial accountability for the cost of care for Medicaid patients, which cover approximately 90,000 members. To achieve success in its IHP contracts, and avoid losses, Allina Health needed to reduce healthcare costs while improving patient outcomes and experience.

Allina Health has integrated several data sources, including claims and developed the infrastructure required to perform opportunity analysis. Using data and analytics for opportunity analysis has given Allina Health insight into its IHP patient population, supporting the development of interventions to decrease the total cost of care and improve outcomes.

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Using Data to Spotlight Variation and Transform Total Joint Care

Total Hip (THA) and Total Knee (TKA) Arthroplasty are the most prevalent surgeries for Medicare patients, numbering over 400,000 cases in 2014, costing more than seven billion dollars annually for the hospitalization alone. Today, more than seven million Americans have hip or knee implants, and the number is rising. Furthermore, substantial variation in the cost per case has raised questions about the quality of care. At Thibodaux Regional Medical Center, total joint replacement for hips and knees emerged as one of the top two cost-driving clinical areas with variation in care processes.

To address this, Thibodaux Regional maintained its focus on the IHI Triple Aim while developing organizational and clinical strategies to transform the care of patients undergoing THA and TKA. It commissioned a Care Transformation Orthopedic Team that set multiple outcome goals. Among its many efforts, the team established standard care processes, created an educational program, redesigned order sets and workflows, and deployed a joint replacement analytics application.

Thibodaux Regional reduced variability and decreased costs significantly while maintaining high levels of patient satisfaction:

  • 76.5 percent relative reduction in complication rate for total hip and total knee replacement.
  • 38.5 percent relative reduction in LOS for patients with total hip replacements.
  • 23.3 percent relative reduction in LOS for patients with total knee replacement.
  • $815,103 cost savings, achieved in less than two years.

 

 

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Clinical and Financial Partnership Reduces Denials and Write-Offs by More than $3 Million

CMS denies nearly 26 percent of all claims, of which up to 40 percent are never resubmitted. The bane of many healthcare systems is the inability to identify and correct the root causes of these denials, which can end up costing a single system tens of millions of dollars. Yet almost two-thirds of denials are recoverable and 90 percent are preventable.1 Despite previous initiatives, The University of Kansas Health System’s denial rate (25 percent) was higher than best practice (five percent), and leadership realized that, to provide its patients with world-class financial and clinical outcomes, it would need to engage differently with its clinical partners.

To effectively reduce revenue cycle and implement effective change, The University of Kansas Health System needed to proactively identify issues that occurred early in the revenue cycle process. To rethink its denials process, it simultaneously increased organizational commitment, refined its improvement task force structure, developed new data capabilities to inform the work, and built collaborative partnerships between clinicians and the finance team.

As a result of its renewed efforts, process re-design, stakeholder engagement, and improved analytics, The University of Kansas Health System achieved impressive savings in just eight months.

  • $3 million in recurring benefit, the direct result of denials reduction.
  • $4 million annualized recurring benefit.
  • Successfully partnered with clinical leadership to transition ongoing denial reduction efforts to operational leaders.
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Unleashing the Data to Sustain Spine Service Line Improvements

Research shows that despite an increase in the number of improvements in clinical, cost, and operational outcomes, there is a lack of sustained improvements. Some of the key challenges can be access to the data and analytics, and adherence to data-driven clinical standards, things the Allina Health Spine Clinical Service Line (CSL) clinical leadership team experienced.

By providing widespread access to the data and analytics, the Spine CSL at Allina Health has been able to continue its reduction in LOS and further improve its reduction in complications, all while increasing cost savings and achieving pay-for-performance incentives.

Results:

  • $1 million in pay-for-performance incentives received.
  • More than $2 million in supply chain savings, a result of data-driven clinical standardization.
  • 31 percent of expected complications avoided.
  • 22 percent relative reduction in surgical site infections.
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Driving Strategic Advantage Through Widespread Analytics Adoption

With the current state of uncertainty facing healthcare organizations, survival requires unprecedented agility when it comes to acquiring and responding to meaningful, strategic information. After adopting the Health Catalyst Analytics Platform, including the Late-Binding™ Data Warehouse and broad suite of analytics applications, Partners HealthCare promoted a philosophy of expanded access to the enterprise data warehouse (EDW) to increase adoption and self-service analytics to improve patient care and outcomes.

Partners needed widespread adoption of the EDW so that information could be meaningfully incorporated into strategic, clinical and operational decision making to support patient care. This meant that users who had a legitimate need to access data to support their job function were encouraged to seek access to the EDW. The organization continues to focus on further increasing the effectiveness of this strategy by ensuring that users have the means to acquire the skills, knowledge, and support they need to effectively use data stored in the EDW.

Results:

  • 243 percent increase in user base—achieved over a two-year period (700+ unique users).
  • More data available to a broader audience than ever before.
  • Physician time to access data reduced from weeks to clicks.
  • 87 percent of user community satisfied with the effectiveness of communication provided to support their use of the EDW.
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Faster Data Acquisition Delivers Speedy Time to Value

Effective data integration enables high value through more strategic, data-driven decision-making, while faster data acquisition feeds and speeds up the process. Orlando Health, one of Florida’s most comprehensive private, not-for-profit healthcare networks, recognized the need for effective data integration to successfully manage to the organization’s changing business needs. The health system needed the ability to rapidly acquire and link disparate healthcare data sources in various ways in order to answer clinical and business questions.

Leaders at Orlando Health needed a data warehouse that better met their needs. They determined that switching from an early binding data process to a late-binding process would provide greater flexibility and expand their access to critical data, with shorter data acquisition times.

With the new EDW, Orlando Health achieved the following efficiencies:

  • 245 fewer days and 1.0 less full time employee (FTE) needed to integrate encounter billing summary system data.
  • 56 fewer days and 0.4 less FTE needed to integrate Infection control system data.
  • 99 percent reduction (90 days saved) in the amount of time needed to implement system enhancements.
  • 98 percent reduction in the work hours needed to incorporate system enhancements.
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Collaborative Partnerships and a Three-System Approach to Driving Healthcare Transformation

Healthcare organizations are among the most complex forms of human organization ever attempted to be managed, making transformation a daunting task. Despite the challenges associated with change, Texas Children’s Hospital identified that it needed to evolve into a data-driven outcomes improvement organization.

Texas Children’s embarked on a journey to transform care, building a three-systems approach—analytics, best practice, and adoption—designed to develop a data-driven quality improvement organization that could achieve outcomes improvement expediently and at scale across the entire organization. Texas Children’s leadership knew that the foundation for clinical systems integration would be meaningful, actionable data. That realization prompted the organization to implement the Health Catalyst Analytics Platform including a Late-Binding™ Data Warehouse (EDW) and a broad suite of analytics applications.

After deploying the analytics platform supported by multidisciplinary quality improvement teams, Texas Children’s was able to improve patient outcomes related to the following:

  • 35 percent relative decrease in hospital-acquired conditions (HACs).
  • 44 percent relative decrease in LOS for patients with Diabetic ketoacidosis (DKA).
  • 30.9 percent relative reduction in recurrent DKA admissions per fiscal year.

 

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Turning Data from Five Different EHR Vendors into Actionable Insights

When healthcare information systems don’t talk to each other, countless inefficiencies and patient safety issues may arise.

Community Health Network (CHNw) believes in delivering outstanding care to every patient. In order to minimize patient safety risks and inefficiencies resulting from using different EHRs, CHNw embarked on a journey to integrate its healthcare information technologies. After implementing a Late-Binding™ Data Warehouse from Health Catalyst that integrates all key data sources, CHNw now has a consistent and comprehensive perspective for multiple patient encounters across the enterprise. It has achieved the following results:

  • Data from multiple EHR vendors, including four inpatient EHRs and two ambulatory EHRs, plus five transactional systems—HR, patient experience, patient safety, finance, and supply chain— were integrated within 12 months.
  • More than 55,000 data elements and over 18 billion rows of data were incorporated.
  • Patient-to-patient matching was implemented for over one million patients across the four inpatient EHRs. This is vital for managing patient populations.
  • Operational efficiency was improved by 70 percent, with data architects spending an estimated 15 percent of time supporting interfaces compared to an estimated 40-50 percent before the integration. In one example, CHNw linked its ERP/costing system to the EDW’s EHR source marts with just a single interface; previously, this would have required building separate interfaces for all six EHRs.
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Effective Healthcare Data Governance: How One Hospital System is Managing its Data Assets to Improve Outcomes

As healthcare invests in analytics to meet the IHI Triple Aim, data has become its most valuable asset—and one of the most challenging to manage. Healthcare organizations must integrate data from a complex array of internal and external sources. To establish a single source of truth, The University of Kansas Hospital deployed an enterprise data warehouse (EDW). However, they quickly realized that without an effective data governance program clinicians and operational leaders would not trust the data. Led by senior leadership commitment, The University of Kansas Hospital established processes to define data, assign data ownership and identify and resolve data quality issues. They also have 70+ standardized enterprise data definition approvals planned for completion in the first year and have created a multi-year data governance roadmap to ensure a sustained focus on data quality and accessibility.

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Improving Healthcare Data Quality to Drive Lower C-Section Rates

Cesarean deliveries have become one of the most common surgical procedures performed in the United States each year.  Between 1998 and 2008, the rate of cesarean delivery in the United States rose by 50 percent — from 22-33 percent of all births. Many healthcare stakeholders have turned their attention to reducing this rate for clinical, financial and regulatory reasons. Read how this healthcare system developed a Women and Newborn’s population health registry and discovered they had to start first with addressing their healthcare data quality issues.

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