Revenue Enhancement


Retooling hospitals, one data point at a time

 Kaiser Health News staff writer Julie Appleby, working in collaboration with USA Today, reports: "When a car rolls off an assembly line, the automaker knows exactly what parts, labor and facilities cost. Not so in health care, and now some health executives are trying to change that. Although U.S. hospitals account for the single largest chunk of the nation's $2.7 trillion in health spending, few of them can say how much it actually costs them to care for every patient they admit. ... Today, the [University of] Utah health system is one of a handful in the nation with a data system that can track cost and quality for every one of its 26,000 patients. That data is shared with doctors and nurses for further input about ways to streamline cost and improve care."  

Ensuring competition begins with transparency

"In theory, {healthcare} it's an environment ripe for collusion and imposition of market power-driven price increases on consumers, insurers and employers, who can be taken for a ride by dominant insurers blithely passing along price increases. In theory, excessive market power also squelches innovation and makes it difficult for new entrants to enter the market. Yet there's no evidence any of that is taking place. In fact, healthcare delivery appears to be at the dawn of new era of innovation that's helping drive down both volume and prices."

Hospital consolidations raise costs, reduce care quality

According to The Synthesis Project, an ongoing national study by the Robert Wood Johnson Foundation, hospital consolidation generally results in higher prices and a decline in care quality. A second study in the project concludes that for-profit hospitals are more likely to focus on highly profitable services than nonprofit hospitals.

What's the difference between "cost" and "cost?"

Virtually everybody, from CMS to veteran muckraker Steven Brill, argues that healthcare costs are too high- but which costs are they really talking about? It's often hard to tell. After cracking his dusty business school textbooks and making the rounds of his finance experts, Michael Koppenheffer can tell you for certain what the problem is: People are talking about no fewer than six different types of "costs." Michael Koppenheffer outlines these six types of costs in an infographic.

Operating Room staffing and allocation

Dr. Dexter provides an innovative and practical approach to staffing and allocation of operating room (OR) time to reduce overall OR expense and reduce variability in late staffing. The presentation has links to an intensive course in OR management offered through the University of Iowa.

Top-Five list to improve emergency medicine and reduce costs

The Daily Rx summarizes on a study led by Jeremiah D. Schuur, M.D., an emergency medicine specialist at Brigham and Women's Hospital in Boston, to reduce excess utilization and costs in the Emergency Department.

Interventional radiology throughput optimization

This paper is a case study of work done at Parkland Memorial Hospital in Dallas, Texas, to improve interventional radiology throughput with the main objective of reducing patient wait times and avoiding costly capital investment.

Reducing patient charges by eliminating amylase from lab panels - HBR Blog Network

One hospital was able to reduce patient charges by over $300,000 annually by reducing the frequency of amylase and lipase testing for ED patients with abdominal pain and other conditions.

Organizing for systemwide improvement - Cutting costs without cutting corners: Lessons from Banner Health

There are two keys to successful cost-cutting in healthcare: the first - necessary but not sufficient - is to apply proven tools and tactics from industrial engineering, lean, Six Sigma, and business process re-engineering; the second is to align the initiative with the organization's mission and culture and engage clinical and administrative staff across the organization to collaborate in the process.

This post from the HBR Blog Network describes how Banner Health, one of the nation's largest health systems, did it.

Value-based purchasing of health benefits: strategies and outcomes

Neil Goldfarb, the executive director of the Greater Philadelphia Business Coalition on Health, was a guest lecturer at the Temple University Fox School of Business Seminar Series. His presentation addressed the impact of value-based purchasing on healthcare providers and consumers.

Sustaining financial performance through a large scale system wide performance improvement initiative

In this presentation at the 2011 SHS Conference, Lynn Alters describes how a system-wide performance improvement initiative improved margins by 40 percent at WellStar Health System using internal resources and fostering an environment of trust and respect. In addition to the financial benefits, the initiative created stronger leaders and will soon exceed its initial goals by three-fold.

Indiana hospital pharmacy saves $1 million annually with lean improvements

Pharmacy leaders at Elkhart General Hospital, in Elkhart, Ind., applied a number of lean concepts resulting in lower operational costs and improved patient care. Examples of improvements cited in the Modern Medicine e-zine article were to redeploy two pharmacists to clinical roles, consolidate unit medications, and reduce batching of IV medications.

Study finds high quality hospitals deliver trauma care at lower cost

A recent study in the Annals of Surgery found that high quality hospitals deliver lower cost care to trauma patients, according to a news release by the University of Rochester Medical Center.

Significance of case management 

Discusses the increasing importance of case management in reducing costs and improving reimbursement in the current environment.

Dartmouth Institute for Health Policy and Clinical Practice takes lead on data and analysis for national collaboration for reducing healthcare costs 

The Dartmouth Institute for Health Policy and Clinical Practice, TDI, has been selected to support a national collaboration aimed at reducing costs for high-volume, high-cost chronic and acute medical conditions that have high cost variation. Dartmouth-Hitchcock Medical Center, Cleveland Clinic, Denver Health, Geisinger Health System, Intermountain Healthcare and the Mayo Clinic have teamed together to take on such things as knee-replacement surgery where there is up to 50 percent cost variation.

A stratified sampling plan for billing accuracy in healthcare systems

Many U.S. healthcare organizations are already being exposed to Recovery Audit Contractor (RAC) reviews of Medicare and Medicaid billing as well as other third-party payor audits to assure accurate and non-fraudulent billing. In response, the authors propose an analytical approach to efficiently evaluate the accuracy of billing.

Patient tracker

A case study of a centralized patient tracking system at Sentara Careplex Hospital in Hampton, Va. The case study shows how Sentara was able to reduce patient registration labor by over 50 percent and save over $300,000 per year. 

Revenue Cycle Improvement: A Six Sigma Approach to Denials Management 

Provides a case study presentation using Six Sigma to improve denials management. The first three months of the project produced 1.6 million dollars in annualized savings at the 97-bed Stanly Regional Medical Center.

Adding Value to the Surgical PAT Process

Using Lean Six Sigma tools, a hospital redesigns its PAT department process so that all charting is completed 72 hours prior to the day of surgery.

Management Engineers

Management Engineering: What is it?

An Introduction to External Funding for Health Care Improvement

Management engineers may need money to implement healthcare improvement. This article outlines several potential funding sources.

Using Material Pull to Improve a Pharmacy Process

Replenishment of IV fluids and medications can be more methodical than repeated visual inspections.

Beginning the Lean Improvement Journey in the Clinical Laboratory

Using examples from several clinical lab redesigns, the sequence of steps utilized during a lean improvement effort are described.

Utilizing Industrial Engineering Student Teams to Benefit Management Engineering Efforts

An ED lean project is discussed, highlighting some advantages that undergraduates can bring when partnered with professionals in the field.

Productivity and Quality Indicator Monitoring

A productivity monitoring system is installed and used to manage budget

Finding the Right Improvement Opportunities - BEST Bang for the Buck

A productivity monitoring system is installed and used for each department in the system to measure budget compliance, production efficiency, and patient satisfaction. Decisions must be made regarding the weighting factors of each input to determine each department's relative score.

Using the Theory of Constraints to Supercharge Inpatient Throughput

A consulting group presented their throughput ideas, including reasons why some department-specific projects fail to realize proposed improvements.

Enhancing Performance Excellence: Total Emergency Services Redesign

All processes in an ED are redesigned, with multiple outcomes showing improvement.

The Journey Toward a Lean ED

A 100,000 annual visit hospital ED is redesigned using lean principles. Wait times decrease and pt satisfaction and revenue increases.  Simulation shows further viability of new processes.  This presentation is made by a MD who became a lean coach.

Applying Redesign Principles to Design ED and Hospital Patient Flow Processes

This is an overview of several lean redesign projects in the ED with overall solutions discussed and analyzed.

Going Beyond - Finding New Ways to Analyze Revenue Cycle Performance Improvement

Issues with billing denials can be addressed by creating and addressing a Pareto chart of top reasons for lack of payment.  This is analyzed through implementation.

Using Six Sigma Principles to Reduce Billing Errors

Billing error reduction as a Lean Six Sigma project

Lean Concepts for the Service Industry: Healthcare Pharmacy Example

A lean project is done with a general physician clinic and an outpatient pharmacy; results are discussed.

Optimization of Overtime Costs and Operating Room Utilization

A program is proposed that effectively confronts a majority of the issues with scheduling patient surgeries.

Design the Greatest Emergency Department - Applying Basic & Advanced Lean Healthcare Tools!

The author facilitates a lean educational journey through an ED.

A Better Way to Manage Supplies

Two supply cost projects are described, analyzed, and discussed.

Lean System for Managing© (LSFM), the Missing Change Management Tool Lean

The authors present a tool for introducing lean across a system. Results from selected projects are discussed.

"Never Events" and HACs - You Break It, You Buy It

Medicare's changes to payment require a higher degree of awareness from hospitals nationwide. This presentation addresses some of the concerns and discusses mitigation efforts currently underway.

Measuring the Success of Hospital Acquired Pressure Ulcer Prevention

Pressure Ulcers are a known issue with long hospitalizations. This presentation deals with several issues surrounding eliminating their occurrence.

Capturing Supply Charges in the Emergency Department: How and Why?

ED charge capture is a constant problem for hospitals. This presentation covers one system-wide approach to increasing the capture rate.

Reducing Inventory Waste Through Material Pull

A pull system is implemented within a surgical suite, saving on inventory cost. Other accomplishments and lessons learned are discussed.

A Six Sigma Approach to Denials Management

Payment denials were decreased, resulting in a cost savings of $1.6 million annually. This project steps through the list of improvements made.