2018 Dynafios C2i Management Consulting/C2i/2018... · Hospital X structured the Year II C2I...

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2018 Dynafios C2i ManagementHospital X – Neuro/Spine

Year II Results

Helping healthcare organizations adapt to new payment and care delivery models by improving quality patient care and

enhancing physician satisfaction.

Dynafios, LLCwww.dynafios.com 1© 2004-2018 Dynafios, LLC All Rights Reserved

1. Introduction – What we do?

2. Executive Summary

3. Year II Results • Quality Indicators• Operational Indicators• Strategic Indicators• Financial Indicators• Financial Results

Table of Contents


Dynafios helps hospitals engage and align providers using healthcare analytics and clinical expertise to enhance patient outcomes and financial performance.

Experience and approach:• 500 Co-Management Agreements• 600 Medical Directorships• 350 On-Call Agreements

Design, valuations, adjudications and expert testimony…

Introduction – What we do?

Celebrating our 14th anniversary!


Executive Summary

Hospital X structured the Year II C2I management agreement to better align and engage the neuroscience physicians to drive results around both quality and program improvements.

An executive summary of achievements included:

1. Positive financial ROI of $305,000 • Reduced Inpatient LOS by .3 Days for all IP Procedures by implementing clinical best practices and pain management

protocols.• Reduced IP LOS while simultaneously shift cases to OP setting.• Standardized clinical supply items for both lumbar and cervical fusions.

2. Increased Median Variable Contribution Margin Per Care from $12,757 to $13,318• Cervical Fusion CM Increase of 23% Per Case• Lumbar Fusion CM Increase of $2000 per case

3. Increased operating room efficiency including First Case on Time Starts and Turn Over Times• Improved FCOTS by 45% (80% of time cases start on time!) • Turnover time reduction of 10% or 3 Minutes per case

4. Eliminated unnecessary Neuroscience transfers from the Emergency Department• Implemented standards for appropriate transfers• Simultaneously increased elective procedure volumes


NET IMPACT:

1. Pre-Operative Education and Pain Management are aimed at reducing LOS by managing patient expectations and elimination delays in discharge due to pain. Hospital X has reduce LOS while also shifting cases to OP.

This is worth noting because typically shift of IP to OP typically causes an artificial rise in LOS because healthier single day patients are removed from the measurement group.

Quality IndicatorsIndicators

1. Pre-op Education2. Pain Management

Results


Operational Indicators

Dynafios Benchmark

Indicator Baseline Current Improvement Median90th

Percentile95th

Percentile

First Case On Time Start 35% 80% 45% 64% 88% 91%Turn Over Times 37.5 34 10% 35 32 30

Results

NET IMPACT:

1. Efficient utilization of OR Services are critical to the health of all procedure based service line. Hospital X Surgeons made significant improvement first case on time start and turn-over times.

While operational improvement is hard to measure at a case bases, over all studies suggest these improvements results in the following:

• Decreased OR Staffing Cost• Decreased Surgical Case Delay (All Service Lines)• Reduced PACU and Floor Bottlenecks• Increased OR Availability

Indicators

1. First Case On Time Starts2. Turnover Times


Strategic IndicatorsIndicators

1. Community Education2. Improved Patient Access3. Development of Back Institute4. TX Guidelines for Neuroscience Patients

NET IMPACT:

1. A critical item for Hospital X leadership was to discontinue the practice of unnecessarily transferring ER Neuro patients to non-partner facilities. Since the guidelines were established, the team eliminated such practices. Equally important that X has identified Health System resources that have the ability to accept and provide care for patients who are ineligible to receive case at Hospital X

2. Despite reports of market leakage to Location A and the Location B markets, the co-management team has been able to improve elective surgical access by implementing both the primary care and payor community initiatives.

3. The trend of OP cases as a percent of total surgical cases has grown considerably. This is driven by both patient access initiatives as well as changes is surgical care.

OP SHIFT Elective Volume Growth


Financial IndicatorsIndicators

1. Reduction of Variation – Lumbar Spine Fusions2. Reduction of Variation – Cervical Spine Fusions

NET IMPACT: 1. Hospital X’s Neurosciences Team achieved a 23%

increase in VCM by reducing clinical and supply variation, increasing access, and reducing LOS.

2. Hospital X’s Neurosciences Team increased VCM by almost $2,000 by reducing clinical and supply variation, increasing access, and reducing LOS. Results


Financial Results1. Primary growth of VCM driven by OP Surgeries and

improved elective procedure access • Cervical Spine Fusion – 20% Increase in Cases and

contribution margin increase of $4,500 per case

Where it matters…

Strong momentum for the start of year III…

2018 Dynafios C2i Management Consulting/C2i/2018... · Hospital X structured the Year II C2I...

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