Clinical Integration Track

Transcription

1 Clinical Integration Track Tracking Financial Performance of Clinical Decisions Presenters: Michael Louviere, PD, MBA, System VP Supply Chain, Ochsner Health System Mark Growcott, PhD, MBA, Finance & Strategy Manager, Ochsner Health System Sandra Achee, RN, CNOR, CVAHP, Product Analysis Manager, Ochsner Health System

2 Continued Excellence In Quality National Rankings: #2 for Organ Transplant #1 for Liver Transplant #9 for Heart Transplant 7 other Specialties in the top 25 Overall State Rankings: OMC BR #2 Overall Medical Care OMC BR #2 Overall Hospital Care 17 Different Specialties: #1 or #2 in State #1 Hospital in Louisiana Nationally Ranked in 6 Specialties: #24 in Ear, Nose and Throat #31 in Gastroenterology & GI Surgery #40 in Nephrology #23 in Neurology & Neurosurgery #45 in Orthopedics #40 in Pulmonology

3 Ochsner Health System Annual Patient Activity More than 56,000 discharges More than 1.4. Million clinic visits More than 250,000 ED visits More than 72,000 surgeries Footprint 9 hospitals 38 Health Centers 900 Group practice physicians in over 80 subspecialties 1,600 Community Physicians 13,000 employees Fitness centers with 20,000 members 142 room Brent House Hotel In 2012, Ochsner had 11 specialties ranked in the top 50 of US News and World Report Best Hospitals 3

4 Ochsner Core Values Who We Are: At Ochsner, just like any other organization, who we are is all about what we do. And what we do is determined by what we believe in. Our values guide our decisions, inspire our actions, and influence our relationships with patients, co-workers and community members.

5 What is Value Analysis Goal? Provide a process to engage clinicians in a method to initiate and review products to determine their value for use, standardize to improve patient quality, safety, and provide affordable care.

6 Cost Reduction Efforts Traditionally in Silos Supply Chain 6

7 Create a Beyond Value Analysis Committees Evidence Based Healthcare Proactive Holistic Approach

8 Cost Reduction Efforts Traditionally in Silos Traditional View Our View Supply Chain Physicians Pursuit of Value Project Mgmt. Supply Chain 8

9 Pursuit of Value (POV) Our Mission: Highest Quality Care at an Affordable Cost Our Approach Our Structure Physician Led 2Our Approach 1 3 Cost Engineering Variation Reduction Process Improvement Project Mgmt. Clinicians Supply Analytics 9

10 Pursuit of Value (POV) Our Mission: Highest Quality Care at an Affordable Cost Our Approach Our Structure Senior RN lead 2Our Approach 1 3 Cost Engineering Variation Reduction Process Improvement Project Mgmt. Clinicians Supply / Value Analysis Committee Analytics 10

11 Evidence/Data Comes From Many Sources Financial Cost of Product Cost Avoidance Contracts CTI Margins Reimbursements

12 Evidence/Data Comes From Many Sources Clinical LOS Hospital Acquired Infections (HAI) Infection Rates Occurrence Reports FDA, Regulatory Literature Review

13 Evidence/Data Comes From Many Sources Payors Aetna Total Hip Replacement Policy Aetna considers an Food and Drug Administration-approved metal-on-metal, metal-on-plastic, ceramic-on-plastic, or ceramic-on-ceramic total hip arthroplasty (THA) prosthesis medically necessary for adult members when the following criteria are met:

14 Evidence/Data Comes From Many Sources Specialty Cardiology GYN Other specialties All other specialties

15 Evidence/Data Comes From Many Sources Independent Hayes Procured Health GPO Clinical Database Milliman

16 Grading Not All Evidence is Created Equal: Source: American Academy of Family Physicians

17 Balancing Cost and Quality Ever-Changing Economy Declining Reimbursements Affordable Care Act Ochsner Health System: Louisiana Population CJR Bundle Louisiana Sales Tax

18 Financial Analysis Three Main Scenarios: 1. Request 2. Reports Reveal Variation 3. Tracking Every scenario requires ACCURATE data that is DISPLAYED in a meaningful way

19 Pursuit of Value - Orthopedics Costs 1. Supply Cost 2. Length of Stay Management 3. Operating Room Time Evidence 1. Pre-Operative Procedures 2. Intra-Operative Processes 3. Post-Operative Processes

20 Tracking Performance Displaying the Data Physician One Physician Two Physician Three Physician Four Physician Five

21 Tracking Performance Displaying the Data Hospital One Hospital Two Hospital Three Hospital Four Hospital Five Hospital Six Hospital Seven Hospital Eight Physician One Physician Two Physician Three Physician Four Physician Five Physician Six Physician Seven Physician Eight Physician Nine Physician Ten Physician Eleven Physician Twelve Physician Thirteen Physician Fourteen Physician Fifteen

22 Tracking Performance Displaying the Data Patients Hospital One Hospital Two Hospital Three Hospital Four Hospital Five Hospital Six Patients Physician One Physician Two Physician Three Physician Four Physician Five Physician Eighty One Physician Eighty Two Physician Eighty Three Physician Eighty Four Physician Eighty Five

23 Aligning Supply Chain to Hospitals JULY YTD Med Supply Expense Product Line Discharges Med Supply Expense Per Discharge CMI CTS ,358,724 15,185 Neurosurgery 615 6,473,468 10,526 Surg-Vasc 356 1,501,672 4,218 Cardiology 4,048 8,258,001 2,040 Orthopedics 2,097 11,301,495 5,389 Surg-Gen 2,650 9,472,028 3,574 Sur-Colon 696 2,966,399 4,262 Total 11,210 $ 51,331,786 $ 4, Supply Expense / Discharge 4,579 CMI Adj. Supply Expense / Discharge 1, LEM: 2 5 1, , , ,827 Total 18,529 $ 86,815,753 $ 4, Supply Expense / Discharge 4,685 CMI Adj. Supply Expense / Discharge 1,856 Total 17,277 $ 81,105,856 $ 4, Supply Expense / Discharge 4,694 CMI Adj. Supply Expense / Discharge 1,873 Developed based on discussions with system executives/c-suites Seven inpatient service lines account for 70% of inpatient medical supply expense $1,900 $1,875 $1,850 $1,825 $1,800 $1,775 $1,750 CMI Adj. Supply Expense / Discharge 2014A 2015A 2016 YTD

24 Our Next Steps Excellence = Ongoing Journey Software Development Software Investments

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26 Submitting Presentation Once complete, please your presentation to Lisa Ponssa All Presentations due to Lisa by September 11th, 2015

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