Reducing costs while increasing or maintaining quality is a primary goal of US healthcare organizations seeking to achieve the “triple aim” and succeed in value-based payment models. By the beginning of 2014, it had become apparent that our own health system had substantial opportunity to improve value.
In April 2014, NYU Langone Health instituted a comprehensive, institution-wide value-based management program to systematically identify and act upon opportunities to increase the value of care. Key features of the program included joint clinical and operational leadership of the overall program ("Value-Based Management (VBM) Task Force" chaired by the CMO) and of individual projects; granular and transparent cost accounting based on actual costs; dedicated project management staff with specific tracking of project metrics and cost savings; and a departmental shared savings program to encourage additional projects.
The VBM Task Force focused on six main areas of potential opportunity: operational efficiency (as measured by labor efficiency and patient throughput metrics); resource utilization (as measured by variable direct cost/case); supply chain management (as measured by wasted materials, price and utilization); revenue cycle (as measured by appropriate coding and documentation); outliers (as identified by highest cost patients); and corporate services (measured by administrative and overhead costs). Over time, the Task Force identified areas of opportunity within each of these categories through cost analytics, in-person feedback from clinicians, and a web-based idea submission form (Table 1). Each opportunity was assessed by both the finance group, clinical leads and project management staff that provided recommendations for final approval by senior leadership. The Task Force also created a custom set of seven comparator hospitals that were categorized by Vizient as being high quality and low cost to benchmark performance and identify additional opportunities.
The program chartered 62 projects (see attached image for a sample listing), of which 36 were completed and 26 remain in progress. Departments independently chartered an additional 12 projects. After reviewing 160,434 hospitalizations, net costs were reduced by 7.7%. Costs relative to peers improved from 13% above median to 2% above median for teaching hospitals without a significant change in observed/expected length of stay, 30-day same-hospital readmission or in-hospital mortality. Estimated total savings to the institution was approximately $59.3 million.
While our health system's leadership team fostered an environment that allowed us to succeed, our systematic program to increase healthcare value by lowering the cost of care without compromising quality that is achievable and sustainable over several years could certainly be adopted and adapted at other medical centers.
Easy one-click social registrationIs this safe?
We only receive the minimum information necessary to verify your account. We never get access to your friends/contacts or your profile, and we never post on your behalf. Your social account is used for logging in only.ORRegister via email
Send me updates on this Contest
In order to ensure a fair voting process and to make sure that no one votes more than once, we ask that you register either with a social networking account (easiest, only requires one click) or by registering with your email address (this will require you to click on a verification email that we will send you).
You only need to register once.