In a 2017 study conducted by EY and published by Becker’s, four factors were identified as the key barriers for healthcare executives to the value-based shift. The four factors were:
- Inefficiency, which drives up cost due to lack of integration among healthcare sites of care.
- Staff retention and engagement in making this cultural shift amidst ongoing regulatory pressures and requirements.
- No ability to measure outcomes consistently with no standard definition of “quality.”
- Poor working relationships between providers and payers.
The ability to measure, monitor, report and act upon solid data has become a critical need for providers to maneuver the path from volume to value-based. Data related to clinical outcomes, clinical variation, financial performance, operational efficiencies and market comparatives should be measured frequently (daily updates are preferable), shared transparently among the providers and acted upon expeditiously.
In an 85-bed facility in the northwest with decreasing financial performance, a decision was made to engage the orthopedic providers to reduce variation, improve efficiencies and place a higher quality service within the 51,000-member community.
Initially, the process began by identifying the improvement focus for each year of a multi-year Dynafios C2i (Combination to Integration) agreement. Dynafios C2i is a comprehensive physician alignment methodology, backed by Dynafios 4CAST healthcare analytics tool, to identify opportunities for improvement. With Dynafios 4CAST, organizations receive valuable real-time provider and program effectiveness, presented in a powerful visual and interactive format. Users can immediately identify variations, trends, behaviors and other performance metrics against best practices and benchmarking indicators for a complete 360° view. By deploying the C2i methodology and 4CAST analytics, it was discovered that the most significant opportunity existed within lumbar fusions. To add another layer of complexity, the hospital’s spine program was staffed with both neurosurgery and orthopedic spine surgeons bringing a new level of complexity to the process.
The first step was to identify the comparative group. It was determined that with the amount of clinical variation within the program, a natural first step would be to use internal comparatives. It was agreed to use the internal best quartile performers as the “best practice” and compare those cases to all others.
In order to begin to develop actionable items, an analysis of the difference in utilization and cost among the clinical care was identified showing a $10K difference in this single level lumbar fusion population between best practice cases and all others.
Providers were then given the specific clinical details of the differences to make decisions about changes in clinical standards such as the blood example below. Best practice cases used less blood products—1.0 compared to 4.0. Surgeons were then able to standardize the transfusion guidelines.
Similar actions were taken with supply usage with surgeons discussing not only vendors but usage patterns as well.
Through the work of the teams within the C2i process, they were able to use these analytics to eliminate over $700,000 in costs and improve the performance of the program by over 35%.
To learn how the C2i methodology and Dynafios 4CAST can improve clinical outcomes and financial performance, give us a call at 877.858.3282 or email us today.