Top Opportunities to Reduce Wasteful Healthcare Spending
By How can providers change their workflows and technologies to cut wasteful spending and improve the quality of care?
- Reducing the amount of wasteful spending is one of the highest priorities for any financial officer in the healthcare setting, but identifying opportunities for improvement can be a difficult task. Few departments in a hospital or health system will ever say that they are adequately funded for their mission, yet simple process improvements, workflow adjustments, and a higher reliance on health IT can help organizations make better use of what they already have in hand.
Optimizing EHRs, health IT for higher productivity
Most EHR detractors have turned sour on the software due to its reputation for turning highly trained physicians into frustrated typists. One recent study found that physicians lose 48 minutes per day to EHRs with cumbersome interfaces, confusing check boxes, and inadequate record retrieval, which causes clinicians to lose crucial time with patients or even significantly reduce their office hours in order to meet documentation requirements. Lost time is lost revenue, but there are ways to mitigate the negative impact of EHRs before experiencing a cash flow squeeze.
EHRs can be optimized with templates that highlight common documentation requirements or auto-fill information to make data entry quicker. Some providers use dictation software that cuts typing time, while others have found success with medical scribes that do the heavy lifting while physicians focus on their patients. Before writing off EHRs as a money-draining time waster, providers can seek ways to improve their workflows and shave extra minutes off the EHR routine.
Using analytics to predict patient flow, track staff activities
Understanding how people in a hospital do their jobs is about more than ensuring that coffee breaks stay under fifteen minutes. Everything a healthcare worker does in the course of his or her duty can have wide-ranging impact on the overall function of the organization, and especially on downstream costs related to patient safety. Clinicians and staff members who don’t wash their hands, for example, can spread costly and deadly infections, while poor management of patient intake in unpredictable environments like the emergency department can slow down care or reduce access.
Analytics technologies, from emergency room simulators to electronic hand hygiene reporting, can help organizations track and improve the way staff members operate in order to provide more efficient, high quality care.
Investing in ICD-10 ahead of October 1, 2015
A stitch in time saves nine, says the old proverb, but proper training now can help medical coders save ICD-10. Despite widespread fears that productivity will drop up to 60 percent in the billing department, providers can ensure a smooth transition to the new way of processing claims if they provide training and education as soon as possible.
Providers should also take the time to conduct a thorough impact assessment, especially when it comes to their claims processing activities. With ICD-10, it’s anticipated that days in accounts receivable may go up by 20 to 40 percent,” warns Summer Scott Humphreys, Executive Consultant for Beacon Partners. “Denials may increase. I would suggest having a strong revenue cycle team in place that actually starts looking at denials now as problem areas now are just going to become larger with ICD-10. Focusing on those denials by provider, by coder, by payer and figuring out why they’re happening is going to help an organization prepare for ICD-10.”
Building relationships with partners for care coordination
Repeating tests, scans, and procedures is wasteful for the patient and the provider, which is why it is so important for healthcare organizations to develop strong pathways of communication between care settings. Whether an organization decides to invest in a local health information exchange (HIE) or subscribe to a statewide system, the ability to access data from other providers isn’t just a crucial piece of Stage 2 meaningful use participation.
One case study in New York State found that physicians who never or rarely queried the HIE system accounted for 90% of duplicate scans, and cost healthcare providers more than a million dollars in unnecessary imaging tests. In South Carolina, hospitals were able to save about the same amount by using HIE to improve emergency care and avoid repeated services.
“Nearly 90 percent of participants said that quality of patient care was improved, and 82 percent of participants said that valuable time was saved, reporting a mean time savings of 105 minutes per patient,” said Christie Carr, MD, the Medical Director in the Division of Emergency medicine at the Medical University of South Carolina.
Securing patient engagement to reduce unnecessary visits
In addition to ensuring that providers don’t overuse healthcare resources, patients can learn to stay away from the doctor’s office when a time-consuming visit isn’t necessary. Online patient portals can keep patients connected to their providers without having to schedule a consult, keeping calendars clear and allowing physicians to focus on cases that require more immediate attention. Portals can aid with chronic disease management, improve medication list accuracy, and even save administrative staff valuable hours each day by replacing phone calls with emails.
Portals can also produce higher patient satisfaction scores and prompt more thorough conversations with physicians that encourage better self-care. At CareOregon, a targeted patient engagement program helped to raise HEDIS scores, improve communication, and increase the delivery of preventative care services.
“We are really focusing on the Triple Aim as part of our business plan. If we’re struggling around the financial return on investment, let’s look and see if the other two elements of the Triple Aim – the patient experience and health outcomes – have been impacted by this program,” said Dr. Margie Rowland, Chief Medical Officer. By addressing issues of health literacy and encouraging patients to stay connected with their healthcare providers, the program did indeed produce measurable improvements in quality and self-management.
The patient experience is becoming increasingly important for financial reimbursements, especially for organizations exploring accountable care arrangements. Ensuring that patients are engaged, satisfied, and achieving higher levels of well-being is a critical step towards reducing expensive over-utilization of care that has a profound impact on the revenue cycle for individual providers as well as the healthcare system at large.
