On average, claim denials cost each healthcare provider $5 million every year. This loss of revenue resulting from claim denials is a concern for healthcare providers. Billings Clinic sought to determine the cause of claim denials and realized that it needed an analytics solution that could integrate data from multiple sources. The health system leveraged its data platform and analytics applications to pinpoint the sources of the denials, allowing the organization to implement prevention plans and procedures for recovering the denials. Billings Clinic achieved significant results, including:
Acuitas Health was challenged to identify opportunities for shared savings, reducing cost while also improving quality outcomes. Using Acuitas Health’s advanced analytics, providers and payers can now connect, communicate, and share insights that enable the organizations to identify opportunities to decrease costs for all partners, and increase outcomes that yield benefits in several areas, including quality improvement, claims optimization, and risk adjustment.
UC San Diego Health sought to transform its organization, expanding beyond fee-for-service, transitioning to value-based care, and improving the health of its patient population—forming its Medicare Shared Savings Program (MSSP) ACO. It realized it needed a better understanding of its organizational strengths, opportunities for improvement, and needed actionable, timely data that would enable it to improve outcomes, reduce waste, and succeed in value-based care. The organization leveraged an analytics platform to give insight into performance and improvement opportunities, educating and engaging ACO providers.
Banner Health identified considerable variation in surgical supply use across its facilities. The health system desired a collaborative, data-driven strategy that would allow it to maintain high-quality outcomes while simultaneously decreasing costs across all procedures systemwide. To standardize supply use, Banner Health implemented an analytics application to help identify high-volume, high-cost surgical procedures that varied across the system. It then built standardized surgical preference cards for the high-volume procedures.
Thibodaux Regional Health System sought to transform its blood transfusion practices. Aware that blood transfusions were often over-used, Thibodaux Regional’s leadership prioritized engaging providers to decrease unnecessary transfusions, reduce potential risks to patients, and improve costs of care. The organization leveraged data and analytics to better understand opportunities for improvement.
Caregiver satisfaction and voluntary turnover at Community Health Network (CHNw) were negatively impacted by a lack of standard processes, which resulted in rework and communication gaps regarding procedures and increased labor costs, reducing CHNw’s environmental services (EVS) team’s ability to deliver core services. In an effort to reduce voluntary turnover rates, CHNw convened an improvement team to improve processes, training, and communication related to cleaning requests, which has led to reduced voluntary turnover and labor costs.
Community Health Network identified that inconsistent oversight of durable medical equipment (DME), and process variation, were a likely source of waste and lost revenue. The health network sought a systemwide, data-driven process for the purchasing, dispensing, and billing of DME. A data platform and analytics applications were utilized to understand organizational performance, identify opportunities for improvement, and evaluate the impact of these changes on patient, financial, and organizational outcomes.
Community Health Network, a hospital system in Indiana, discovered that its hospital-acquired C. diff infection (HA-CDI) rate was higher than the national benchmark. The organization knew it needed to decrease infection rates, but without timely, meaningful data, leaders couldn’t identify the right areas to focus improvement efforts. With the use of a high-level, robust analytics system that allowed better access to data, team members were able to determine where to focus their efforts.
MultiCare Health System’s Pulse Heart Institute (Pulse Heart) recognized that better care coordination was required for patients receiving cardiac, thoracic, and vascular care. The organization wanted to further improve quality outcomes, provider engagement and recruitment, and its own economic health. To meet these objectives, Pulse Heart focuses on clinician engagement and organizational alignment, ensuring widespread access to meaningful, actionable data and analytics to inform decisions and drive improvement.
Community Health Network (CHNw) observed higher than national rates of maternal substance use disorder, with a higher number of pregnant women having positive drug screens for opioids, cocaine, amphetamines, barbiturates, and benzodiazepines. It developed a care coordination and substance use program to help reduce the incidence of substance use disorders among pregnant women. Using its data platform and analytics applications, CHNw was able to evaluate the impact of various process measures on patient outcomes.
Thibodaux Regional Health System had implemented evidence-based stroke care interventions in its emergency department. However, the organization was not meeting its established goals for early identification and treatment. With strong leadership support and the help of analytics, the organization’s stroke care transformation team was able to identify opportunities for improvement, culminating in improved care delivery through facility-wide automated alerts and a reduction in the need to transfer patients to other facilities for treatment.
OneCare Vermont, an accountable care organization (ACO), is focused on reducing costs by reforming payment models. As the organization methodically and rapidly moves toward value-based payments, it is challenging current delivery methods and seeking to engage providers and patients in new care models. To be successful, OneCare needed to implement strategies to effectively drive change. With robust data analytics, it was able to prioritize opportunities for improvement and ultimately change the way care is coordinated and delivered throughout its network. Results include nearly $20M in positive, value-based financial results in just one year.
UnityPoint Health evaluated its percutaneous coronary intervention (PCI) performance and identified the opportunity to further improve. The health system decided to identify ways to improve its PCI outcomes. With its data operating system and a robust suite of analytics tools, UnityPoint Health took a data-driven approach to improving its PCI outcomes.
Colorectal cancer (CRC) accounts for $16 billion in healthcare costs, and with 142,250 new cases annually, it’s the second leading cause of cancer deaths in the U.S. Thibodaux Regional Health System had implemented evidence-based screening and oncology treatment guidelines for colon cancer, yet it still needed to meet organizational goals for early diagnosis and colon cancer survival. With support from the CEO and senior executive leadership, a collaborative approach to tackling CRC diagnosis rates, and a robust suite of analytics applications to deliver accurate data, Thibodaux Regional improved CRC outcomes and patient satisfaction.
UnityPoint Health created a task force to develop and implement a plan for maximizing blood management. The task force incorporated decision support to improve transfusion ordering in alignment with the transfusion standards. An analytics platform has also been leveraged, which monitors the utilization of blood products, including predictive modeling to risk-adjust blood utilization specific to patient case-mix, and data down to the ordering provider level.
Managing and retaining a talented workforce represents approximately 60 percent of hospital costs. In an effort to improve staffing efficiency, Hawai‘i Pacific Health (HPH) sought to realign its staffing practices to better manage and predict its labor needs. Utilizing its data platform and analytics, HPH was able to forecast its workforce needs and effectively manage staff schedules—two changes that led to significant cost savings.
Mission Health trauma services provide evidence-based care. Despite its efforts to measure the impact of this care on outcomes, the overwhelming burden of manual data review limited its ability to effectively monitor key process measures in a timely manner. This prompted Mission to use data and analytics for timely insights into injury-specific process measure performance and concurrent chart review to improve trauma care.
Actionable Analytics Enables Improved Care, Reduced LOS, and Costs in Patients with Traumatic Brain Injury
To provide high-quality, cost-effective care to patients with traumatic brain injury (TBI), Mission Health needed insight into individual patient and provider performance data. Without access to accurate data, Mission couldn’t accurately pinpoint patient outliers, understand causes of TBI, and identify opportunities to improve TBI patient care. By utilizing its data platform and analytics accelerators, Mission was able to utilize patient data to identify patients suffering from TBI.
Emergency departments (ED) provide care for a staggering 145 million patients a year. Improving throughput times remains a top priority for hospitals as overcrowding and long wait times can lead to potential safety events and dissatisfaction with care. To improve ED throughput, Orlando Regional Medical Center (ORMC) assembled an improvement team to analyze the problem, utilizing data analytics and staff feedback to help identify a series of workflow changes designed to improve ED throughput and improve care delivery.
Annually, U.S. hospital supply chain overspend costs an estimated $25.4 billion, which represents 30 percent of all hospital spending. Utilizing data and analytics, Hawai’i Pacific Health gained a deep understanding of its supply chain processes and data, allowing it to improve and maintain the reliability of this information, leading to meaningful and sustained improvements across the system.
Community Health Network (CHNw) was keenly aware of the needs of the elderly population in its communities of impact. However, despite the development and implementation of a successful geriatric program, the organization lacked access to, and visibility of, meaningful data to quantify program outcomes. The CHNw Geriatric Evaluation and Management (GEM) team used an analytics application to demonstrate the sizeable, positive impact of the GEM team care and interventions on both patient and financial outcomes:
With patients responsible for an increasing amount of their healthcare costs, self-pay accounts are now the top contributor to bad debt for hospitals and health systems—accounting for more than $55 billion annually. Allina Health partnered with Health Catalyst, using catalyst.ai™, to create a predictive model that could successfully support a propensity to pay strategy.
Learn how Allina Health leveraged its analytics platform and Health Catalyst professional services to perform an analysis demonstrating the impact of pharmacist-led medication therapy management (MTM).
Offering a competitive healthcare plan for employees is a business essential, and a differentiator for organizations to attract top talent, but as healthcare costs continue to rise, employers are increasingly challenged to offer affordable employee healthcare with extensive benefits. Learn how Health Catalyst embraced self-insurance to take the management of its healthcare costs and benefit design into its own hands.
The positive impacts of community health workers (CHWs) have been well documented, yet in general, CHWs remain underutilized and have not been fully integrated into care teams. Read how Partners HealthCare successfully integrated CHWs into its integrated care management program (iCMP) care team to improve patient outcomes and reduce cost.