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.
Despite being common, healthcare-associated infections are potentially deadly and carry a significant financial cost. Of healthcare associated infections, catheter-associated urinary tract infections (CAUTI) are one of the most common, despite most instances of CAUTI being preventable.
As CAUTI was determined to be one of the top five influential factors in the publicly report quality scores, Piedmont Healthcare looked to data for more visibility into factors that were contributing to CAUTI rate in an effort to permanently reduce the number of infections. By engaging staff for compliance with CAUTI prevention best practices, Piedmont has seen sustainable improvements.
50.2 percent relative reduction in CAUTI standardized infection ratio (SIR). This translates to 37 fewer patients with infections than expected.
6.7 percent relative improvement in insertion bundle compliance.
Maintenance bundle compliance improved dramatically, with nearly a three-fold increase in the percentage of patients receiving the maintenance bundle.
One in three women delivers via cesarean in the U.S., and more than 90 percent of them have repeat operations in subsequent deliveries. Despite numerous evidence-based guidelines and established best practices for labor and delivery, clinical care varies widely for many practices. Labor and delivery care varied at Thibodaux Regional Medical Center, causing the organization to look for ways to standardize care.
To better understand variations in care, and opportunities to reduce its cost, the labor and delivery care transformation team at Thibodaux Regional used the Health Catalyst Labor and Delivery Advanced Application as well as the Financial Management Explorer application, which integrates data from billing and costing, and creates snapshots of current financial metrics.
Informing and educating providers with provider-specific data in conjunction with redesigned workflow, standardized supplies, and new, standardized protocols enabled the labor and delivery care transformation team at Thibodaux Regional to experience cost savings and improved outcomes, including:
24.4 percent relative reduction in the cost of care for uncomplicated vaginal delivery. Projected annual cost savings of $266,067.
22 percent relative reduction in the cost of care for cesarean deliveries. Projected annual cost savings of $346,856.
Increasingly, high-functioning healthcare organizations are recognizing the challenge of sustaining results following successful clinical improvement initiatives. Sepsis is a major driver of mortality in the U.S. In fact, it is estimated that up to half of all hospital deaths are linked to sepsis. After executing a successful strategy to improve outcomes for patients with sepsis, Piedmont Healthcare was determined to sustain those critical reductions in mortality, length of stay, and cost.
The health system “hardwired” process changes into the EHR, monitored performance compliance via a well-developed analytics application, and fostered strong leadership on the frontlines to champion a culture of continuous improvement. In the second year of its latest sepsis improvement effort, Piedmont was able to not only sustain, but also to further improve upon its first-year improvement results.
14.2 percent reduction in mortality for severe sepsis and septic shock translating to 68 lives saved in one year.
30.7 percent improvement in number of patients receiving calculated fluid target.
$1.2 million saved in one year from decreased variable cost.
Nationally, approximately 700,000 hospitalizations occur each year with the principle diagnosis of Chronic Obstructive Pulmonary Disease (COPD), with one in five patients being readmitted within 30 days. Even with a national cost for each COPD readmission costing between $9,000 and $12,000, evidence-based measures that improve patient outcomes and decrease COPD readmissions are largely lacking.
When reviewing organizational performance for 30-day all cause readmission, MultiCare Health System identified COPD as one of the top two readmission diagnoses, along with a rate higher than expected. This prompted the organization to take action. MultiCare implemented a NOREADMITS bundle, using the Health Catalyst Analytics Platform and integrating performance measures for each element of the bundle, resulting in:
16.5 percent reduction in readmission rate.
Approximately 34 fewer patients with COPD readmitted each year, saving an estimated $360,000 annually based on national benchmarks.
95 percent of COPD patients were assessed for readmission risk.
Two-fold increase in COPD order set utilization.
One hundred thirty-three million Americans, 45 percent of the population, have at least one chronic disease. Chronic diseases are responsible for 7 of 10 deaths each year, killing more than 1.7 million Americans annually. Moreover, chronic disease accounts for 86 percent of our nation’s healthcare costs.
An integrated delivery system and an accountable care organization with two large academic medical centers and six community hospitals, Partners HealthCare is increasingly compensated for outcomes of care. Recognizing the need to more effectively manage its chronically ill patients, Partners implemented an integrated care management program (iCMP) to improve the outcomes of rising-risk patients and better manage treatment costs. The iCMP is a primary-care embedded, longitudinal care management program led by a nurse care manager working collaboratively with the primary care provider and care team.
The iCMP is contributing to Partners effective management of patients and financial success in at-risk contracts. In its Pilot Phase as a Medicare Demonstration Project, the program achieved the following results:
20 percent lower hospitalization rate per 1,000 patients.
13 percent lower rates of emergency department (ED) utilization.
25 percent relative difference in mortality.
Unprecedented changes in the healthcare payment system have resulted in health organizations across the country investing in the pursuit of the Institute for Healthcare Improvement’s (IHI’s) Triple Aim to improve population health, improve patient experience and outcomes, and reduce costs per capita. Health organizations must develop effective population health management strategies, and they need the right data and analytics to inform their initiatives.
Once armed with the information to make data-driven decisions, leading healthcare providers are implementing care management programs, which have proven to be helpful mechanisms for achieving the Triple Aim. Many healthcare organizations have identified specific patient cohorts to monitor the impact of care management interventions on individual and population health outcomes.
Data-driven care management programs that target high-risk and rising-risk patients can achieve impressive results, including:
Up to 20 percent lower rates of hospitalization in mature care management programs.
Lower rates of emergency department utilization.