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.
Read how Memorial Hospital at Gulfport embraced the challenge of reducing LOS to lower costs and improve outcomes for its patients. Its commitment to a data-driven, multi-pronged approach to reducing LOS has produced impressive results in one year.
It is estimated that $25 to $45 billion is spent annually on avoidable complications and unnecessary hospital readmissions—the result of inadequate care coordination and insufficient management of care transitions. By implementing care coordination programs and leveraging its analytics platform, the University of Texas Medical Branch reduced its readmission rate and achieved significant cost avoidance.
Unwarranted variation in clinical care is costly, representing as much as $30 million of actionable savings opportunity for a typical organization. Allina Health launched its Clinical Value Program—a systemwide effort to measure and improve clinical value. The program quantifies the value of clinical change work to improve outcomes while reducing costs and increasing revenue for reinvestment in care.
Activity-Based Costing and Clinical Service Lines Team up to Improve Financial and Clinical Outcomes
Cost challenges in healthcare are threatening the future of many healthcare organizations and their ability to effectively care for patients. Read how UPMC took on these challenges by partnering activity-based costing and service line operations to gain insight into cost and clinical variation.
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.
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.
Every three seconds, someone in the United States will need a blood transfusion, which adds up to nearly 17 million blood components transfused annually. Yet, evidence shows that up to 60 percent of red cell transfusions may not be necessary. In 2011, Allina Health, a healthcare delivery system that serves Minnesota and western Wisconsin, had a wide variation in transfusion practices throughout the system and a transfusion rate that was 25 percent above national benchmarks. In an effort to improve outcomes of high-risk transfusions, Allina Health turned to its data to develop an evidence-based blood conservation program aimed at reducing costs and saving valuable blood resources.
$3.2M decrease in annual blood product acquisition costs since 2011
30,283 units saved annually
111 units of red cells saved per 1000 inpatient admissions
Today’s healthcare industry, in which a lack of insight into clinical variation has contributed to increased expenses, has significant opportunities to use data and analytics to improve outcomes and reduce costs. As part of its ongoing commitment to improve clinical value, Allina Health has employed a systemwide process to identify, measure, and improve clinical value. The health system has been able to quantify the value of clinical change work to improve outcomes, while reducing costs and increasing revenue for reinvestment in care.
Allina Health achieved the following meaningful results with this collaborative, data-driven opportunity analysis process:
Identified nearly $33 million in potential cost savings for the first three quarters of 2017.
Achieved over $10 million of confirmed savings during the first three quarters of the year.
Elevated discussions of cost concerns, leading to the development of standard processes, and significantly reducing unwarranted clinical variation.