General Medical Staff Meeting Volume Statistics & Clinic Update January 2016

Transcription

1 General Medical Staff Meeting Volume Statistics & Clinic Update January 2016

2 Statistics Comparison % Q4 Q4 Variance 1. Discharges 2,676 2,846 6% 2. Patient Days 16,203 16,710 3% 3. Average Daily Census % 4. Bed Utilization 72% 78% 8% 5. Average Length of Stay % 6. Case Mix Index (CMI) % Outpatient Visits: 7. Outpatient Ancillary 14,688 16,321 11% 8. Observation % 9. Clinic Visits (Same Store) 35,617 37,069 4% 10. Outpatient Surgery Cases (OR only) 1, % 11. Other OP Surgery Cases 1,060 1,081 2% 12. ED (DOS) 16,499 20,153 22% 13. Inpatient Surgery Cases (OR only) 1,121 1,093-2% 14. Other IP Surgery Cases % Hospital Payer Mix (% of Revenue): 15. Medicare 14% 20% Medicaid 35% 30% (5) 17. Managed Care / Commercial 11% 14% Self Pay and Other 40% 36% (4) ED Metrics: 19. ED Admissions 2,119 2,478 17% 20. ED Conversion Rate 11% 11% % of Admissions through ED 80% 88% 9 Clinic Visits (Same Store) EXCLUDE: Landry closed 2015; APC no longer exists; Education visits no longer performed on separate day CMI=Discharges Coded, Updates Monthly Available Beds 246, Excluding CAU 234 Favorable Within 2% of Favorable Unfavorable

3 FINANCIAL CLEARANCE WORKFLOW Provider determines patient is in need of procedure/surgery Provider places Order/ Case Request in EPIC must allow 10 days minimum for Clearance Emergent/Urgent cases will be expedited based on medical necessity by calling the admission nurse at Provider Patient Access Order is routed to Patient Access to begin Financial Clearance Surgery Order resides in EPIC OpTime Depot until Financial Clearance occurs Non-Surgery Order (excluding Nuclear Medicine) resides in Patient Access until Financial Clearance occurs Within 48 hours M-F Patient Access begins Financial Clearance Financial Clearance Includes: Using Provider Order, Verification of Medical Necessity Insurance Verification/Authorization: In Network, Covered Service, Patient Status (IP/OBS), Length of Stay If Out of Network, Informing Patient of Financial Liability If Non-Covered service, Informing Patient of Financial Liability If No Insurance, screening for Medicaid If Patient Does Not Qualify for Medicaid, Completing Charity Care Application If Patient Does not qualify for Charity Care, offers Discounted Self Pay Rates and Payment Arrangements Patient accepts financial responsibility Patient Access calls and s Scheduling and Attending Provider to inform status of Financial Clearance Provider Cancels or Reschedules 7 Days prior to requested procedure date, Patient is NOT Financially Cleared or 7 Days prior to requested procedure date, Patient IS Financially Cleared Patient Access places Green check mark in EPIC Surgery moves case from Depot to the Surgery Schedule Non-Surgery, service remains on schedule Patient receives services Patient Does NOT receive services Provider Cancels or Provider Reschedules or Patient Access calls the patient to inform status of services Patient Access calls Surgery to Cancel the Case Patient Access calls Surgery to Provide reschedule date from Provider Patient Access calls the patient to inform status of services Order with revised date is routed to Patient Access to begin Financial Clearance Surgery Removes Case Request, inputs Cancel Reason Surgery Revises Case Date in EPIC Surgeries = Procedures coded as surgeries including operating room procedures, endoscopy, invasive lab, invasive radiology Non Surgeries = Other services provided not coded as surgeries including Imaging, EKG, Echo, Stress Tests, Infusion, etc.

4 Financial Clearance Surgery Cancellations Dec-15 Date Patient's Name Canceled Specialty Physician No Payor Auth/Non Covered Pt Unresponsive Pt Not LA resident Pt did not complete Charity App 12/1/ RW X UROLOGY WANG, JULIA X out of network 12/2/ X GENERAL SURGERY STUKE, LANCE X not covered by ins 12/2/ X OMFS KING, BRETT X 12/2/ X ORTHOPEDICS RODRIGUEZ, RAMON X 12/7/2015 JI X CARDIOLOGY VIRAL, LATHIA X 12/7/2015 SL X INTERNAL MEDICINE JEX, KELLEN X 12/7/ PM X OPTHALMOLOGY WORLEY, MICHAEL X 12/8/ X ENT MEHTA, RAHUL X out of network 12/8/ X ORTHOPEDICS MARRERO, CHRISTOPHER X 12/11/ TT X ORTHOPEDICS LEE, OLIVIA X 12/17/ RI X ORTHOPEDICS KRAUSE, PETER X 12/18/ X UROLOGY HELLSTROM, WAYNE X 12/18/ X GENERAL SURGERY MORRISON JR., JOHN X 12/23/ TP X NEURO SURGERY TENDER, GABRIEL X 12/23/ AM X GENERAL SURGERY MORRISON JR., JOHN X 12/30/ DK X OMFS WELCH, MARK X 12/30/ SA X ORTHOPEDICS PARKER, CHEVELLE X Other By Specialty: Cardiology 1 ENT 1 General Surgery 3 GI 0 Gynecology 0 Internal Medicine 1 Neuro Surgery 1 Oncology 0 OMFS 2 Ophthalmology 1 Orthopedics 5 Plastics 0 Pulmonary 0 Urology 2 17

5 Clinic Leadership Council One Physician Representative Per Service Line: 22 physicians & hospital leadership 2 nd meeting held in December with 45% MD participation Faculty Coverage-Subgroup developing proposal for policy on when providers can request to close clinic Responsible Patient Agreement-To be implemented for all clinic patients Scheduling and Clinic throughput metrics reviewed- Need consistent usage of dot s from all providers in order to measure effectively Meet monthly for the first quarter: (January 26, February 23, March pm)

6 Scheduling Metrics

7 Scheduling Metrics Notes: Calls will continue to decline over time due to appointments being made upon discharge from Inpatient/ED/Clinic

8 Scheduling Metrics

9 Clinic Metrics Metric PY Avg Aug 2015 Dec 2015 Goal 1. Appointments Completed 39% 51% 53% > 79% 2. No Show Rate 44% 25% 22% < 10% 3. LWBS 2% 1% 1% < 1% 4. Cancellation Rate NA 23% 24% < 10% 5. MD % Cancellations NA 50% 42% < 10% 6. Patient % Cancellations NA 50% 58% < 90% 7. MD Cancellations % Appts NA 2,772/11.5% 2,570/10% < 1% 8. MD Open Encounters 10,340 1,684/14% 956/8% < 5% Appointments completed are not visits. Visit = unique patient per day per specialty.