Some factors commonly used to explain poor operating performance do not prevent many hospitals from being highly profitable. For example, Truven Health AnalyticsTM has found that rates of uncompensated care, drug expense, and other factors do not seem to differ between unprofitable and very profitable hospitals. But factors such as Medicaid utilization rates and poor reimbursement rates do appear to impact the least profitable hospitals. One controllable factor that appears to be significant is labor productivity, with the most profitable hospitals posting the lowest labor expense per patient.
The annual Truven Health 100 Top Hospitals® identifies U.S. hospitals with the best overall performance across multiple organizational metrics, including clinical, operational, and financial. The ability of some hospitals to adapt as the industry is changing demonstrates leadership as the winners set the standards their peers seek to achieve. Study projections indicate that if the new national benchmarks of high performance were achieved by all hospitals in the United States, nearly 126,500 additional lives could be saved, almost 109,000 additional patients could be complication-free, and $1.8 billion in inpatient costs could be saved.
Healthcare organizations with strong bond ratings are regarded favorably from a financial perspective, of course. In addition, research by the Truven Health AnalyticsTM ActionOI® program shows that such organizations tend to excel in other categories, such as average length of stay and results of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys.
The median fiscal and operational performance of U.S. hospitals over the past year remained relatively flat, despite expectations to the contrary. The data spans a four-year period from 2009Q4 to 2013Q4. Overall, hospitals saw flat or no growth in utilization, but major teaching hospitals saw steady utilization growth.
The Truven Health 15 Top Health Systems study annually identifies those health system leadership teams that have most effectively aligned outstanding performance across their organizations, and achieved more reliable outcomes in every member hospital. Truven Health Analytics measures U.S. health systems based on a balanced scorecard across a range of performance factors: care quality, patient safety, use of evidence-based medicine, operational efficiency, and customer perception of care.
Spending on supplies and pharmaceutical services varies among U.S. hospitals. It is not uncommon for hospitals with similar types of patients, including case mix and severity, to have significant differences in purchasing intensity for certain clinical services. Even small changes in efficiency can make a difference for hospitals and health systems, because supply-chain spending typically accounts for hospitals’ biggest spend after labor costs. Costs totaled about $74 billion in 2012, according to the Healthcare Supply Chain Association.
Medicare spend per beneficiary (MSPB) information is a Centers for Medicare & Medicaid Services metric that reflects the average cost of an episode of care for Medicare patients. This measure is important to consider as part of a hospital’s national balanced scorecard, as it reflects executives’ efforts to transform the healthcare delivery system and manage the full continuum of care, including the prominent shift from inpatient to outpatient utilization.
The Agency for Healthcare Research and Quality’s Patient Safety Indicators (PSI) are a set of metrics that provide information on the potential for inpatient hospital complications and adverse events following surgeries, procedures, and childbirth. PSIs can be used to help hospitals identify potential adverse events that might need further evaluation, provide the opportunity to assess the incidence of adverse events and complications, and understand patient safety events on a broader level.
The Truven Health Analytics 50 Top Cardiovascular Hospitals study identifies hospitals that achieve the best performance on a scorecard of performance measures. This year, based on comparisons between the winners and a peer group of similar high-volume hospitals that were not winners, the study found that if all cardiovascular providers performed at the level of this year’s winners, approximately 9,500 additional patients could survive, more than $1 billion could be saved, and almost 3,000 additional bypass and angioplasty patients could be complication-free. This is based on an analysis of Medicare patients; if the same standards were applied to all inpatients, the impact would be even greater.
The Truven Health Analytics 50 Top Cardiovascular Hospitals study identifies U.S. hospitals that have achieved the best performance on a balanced scorecard of performance measures. Based on comparisons between study winners and a peer group of similar hospitals that were not winners, winners are achieving better outcomes while operating more efficiently and at a lower cost. If all cardiovascular providers performed at the same level of this year’s winners, almost 8,000 additional lives could be saved; nearly 3,500 heart patients could be complication free; and more than $1.3 billion could be saved.
Truven Health Analytics™ evaluated the extent to which community need— a measure of the underlying economic and social factors that affect the overall health of a community, including income, cultural/language barriers, education, insurance and housing—is associated with elevated rates of preventable hospitalizations or an increased risk of hospitalization believed to be preventable with quality ambulatory care. The results of this investigation reveal a modest but statistically significant association between community need and an increased risk of hospitalizations that are believed to be preventable with good-quality ambulatory care.
The annual Truven Health AnalyticsTM 100 Top Hospitals® identifies U.S. hospitals with the best overall performance across multiple organizational metrics, including clinical, operational, and financial. The ability of some hospitals to adapt as the industry is changing demonstrates leadership as the winners set the standards their peers seek to achieve. The study revealed that the nation’s best hospitals had a lower mortality index, considering patient severity; had fewer patient complications; followed accepted care protocols; had lower 30-day mortality and 30-day readmission rates; sent patients home sooner; provided more timely emergency care; kept expenses low, both in-hospital and through the aftercare process; and scored better on patient surveys of hospital experience
The shift from inpatient to outpatient care is increasing as hospitals transition from volume to value. A specific shift is seen in interventional cardiology treatment (cardiac catheterization, intracoronary stents, and percutaneous transluminal coronary angioplasties [PTCA]), which is moving from an inpatient hospital to outpatient hospital setting. Preliminary data show that most interventional cardiology procedures will soon be performed in the hospital outpatient setting. It will be important for hospitals to consider future demand and volume for interventional cardiology services; capacity for an increase in hospital outpatient volume; and staffing and operational implications.
The changing healthcare environment has put pressure on healthcare organizations to deliver top-quality care while keeping costs under control. Superior operational and financial performance can be measured by high margins and low costs. But there are significant operational indicators that differ between high- and low-performing hospitals, depending on whether performance is defined by expense or by margin. Often, hospitals with the lowest costs are considered the most successful. But low-cost hospitals do not necessarily behave the same way as hospitals with healthy margins. Low-cost hospitals can include both efficient hospitals and hospitals that are in dire financial circumstances that have forced them to even eliminate expenses necessary for their long-term fiscal health.
What do standard best practices for radiology look like? Without them, it is impossible for a hospital to identify the strengths and weaknesses of its current radiology services and strive for improvements.
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Published By: Parallon
Published Date: Dec 18, 2015
Download the free, on-demand version of this webcast that took place on December 16, 2015.
Change is commonplace within the healthcare industry. Executives are faced with many of the traditional challenges of operating hospitals. Now emerging external factors like the HITECH Act (meaningful use), the Affordable Care Act and an aging U.S. population are pushing providers to change the frameworks in how they view and solve these traditional problems.
Discover how St. John’s Children's Hospital is improving pain management, patient satisfaction and nursing efficiencies through Interactive Patient Care (IPC). By integrating their IPC solution with the hospital's EMR and nursing notification badge, they’re managing patient expectations for pain control and streamlining assessments and documentation.
Even as the move to electronic health records (EHR) progresses in earnest, there are a myriad of challenges involving legacy data systems. Chief among these challenges is the cost of maintaining obsolete systems solely for the patient information they contain. When up to 70% of a typical IT budget is spent on maintaining the current IT infrastructure and application portfolio, organizations have little left to invest in much-needed innovation. According to a recent HealthLeaders Media Survey, many organizations are still adjusting after their migration to a new EHR system. Hospitals need to get a better grasp on all forms and sources of data that they have—and the data they don’t yet have—so that the right information can be delivered to the right individual, and in the right context, at the point of care.
Creating a state-of-the-art clinical documentation improvement (CDI) program isn’t just about boosting coding accuracy. It’s a key strategy in managing the transition from volume-based to value-based care, say healthcare leaders. That transition is a risky endeavor that is putting hospital and physician financial performance to the test. As hospitals participate in new care and business models aimed at improving value, leaders must ensure that their organizations are able to maintain reimbursement levels, effectively treat the chronically ill—especially in outpatient settings—and gather accurate data that will allow them to assess performance and segment their varying populations. While some organizations often believe they are leaving revenue on the table because of documentation and coding issues, CDI offers numerous opportunities for improving financial performance, finds a recent HealthLeaders Media survey of 149 healthcare executives at provider organizations.
In the coming era of accountable care, providers will finally have something to gain by actively engaging patients in taking care of their health—and a lot to lose by not doing so. The best way to do that is to manage every aspect of their care. But the patients themselves will remain free to defect to another provider whenever they choose, either temporarily or permanently. Persuading them to centralize their care will rapidly become job 1. This report explores survey results about the primary forces enabling patient engagement and features a case study about the active care management program in development at Beaufort Memorial Hospital in South Carolina.
Download the free, on-demand version of this webcast that took place on December 8, 2015.
Leaders from Beaufort Memorial Hospital and Influence Health discuss the challenges providers face and the skills they must acquire to increase patient engagement. In the coming era of accountable care, providers will finally have something to gain by actively engaging patients in taking care of their health—and a lot to lose by not doing so. Increasingly, providers will receive a fixed sum to care for each patient attributed to them by payers, and they will be able to make an overall profit only by keeping those patients as healthy as possible.
Driving financial performance in the outpatient setting is a top-of-mind priority among senior health system leaders. But managing the differing clinical documentation methodologies and risk assessment strategies present the greatest challenges to optimizing this important source of revenue, according to a recent HealthLeaders Intelligence survey. Provider organizations are finding the ambulatory setting is still a ‘Wild, Wild West’ in terms of assessing risk, clinical documentation, coding billing and medical record keeping practices. Download this report to discover key targets to improve ambulatory revenue.
A recent Health Leaders survey sheds light on the top 5 workforce initiatives healthcare executives across the country are using for successful quality of care and labor cost improvements. Learn how these leading strategies can help your hospital.