30 cos savings initiatives - vmgma.memberclicks.net cost...idea program & strategic committees...
TRANSCRIPT
3/4/2016
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Virginia MGMA State Conference, Richmond, VA
Monday, March 21, 2016
10:45 AM – 12 Noon
1:15 – 2:30 pm
Michael O’Connell, MHA, FACMPE
Vice President, Clinical & Support Services
Cleveland Clinic, Marymount Hospital
30 Ideas on How to Save Money in
Your Medical Practice
Objectives
Explore 30 cost-saving ideas to consider for your medical practice
Describe how these ideas were investigated and vetted
Determine whether one of these ideas could benefit your practice in 2016
Our Current Reality
Care Affordability Consumerism
Cost, Quality, Value Transparency
Value Based Purchasing Increased Access
Quality & Efficiency Metrics
Accountable Care Organization
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Remain True to Our Cleveland Clinic Mission
Reaffirming our strategy to invent the future of healthcare, Dr.
Cosgrove said,
“We will act with courage in the face of this new reality.
I know that you have the courage to make the change to
assure quality and ready access at an affordable cost.
I believe in you and the future of Cleveland Clinic.”
CEO Toby Cosgrove, MD, 2015 State of the Clinic Address
Idea Program & Strategic Committees
Cleveland Clinic developed a “MyTwoCents Program” which invites employees (caregivers) to submit their ideas for consideration. Ideas can be to improve quality, safety, and/or access or ways to save money. Program resulted in 1,000 ideas and $7 million in savings.
Improving care affordability resulted in $498 million in cost savings for Cleveland Clinic in 2014-2015.
$53 M Hospitals
$169M Indirect/Administration
$268M Clinical
$8M Other
Cost Repositioning and Care Affordability Eight Teams with a Long-term, Enterprise-Wide Effort in which Every Clinical and Administrative Area Assesses Everything They Do to Provide Services More Effectively and Efficiently:
1. Clinical Program and Asset Optimization (Clinical programs, assets, and services to optimize locations and capacity)
2. Indirect Program and Asset Management (non-billable operational support, corporate shared services, administrative overhead)
3. Non-Staff Workforce and Productivity (Non-Physician Employees including hiring patterns, productivity, span of control, pay/benefit policies)
4. Staff Workforce and Productivity (Physician Recruitment, Practice, and Retention)
5. Stewardship (Managing System Resources, Discretionary Spend, Sustainability, Waste)
6. Education (Educational Services including GME, CME, and Health Sciences)
7. Research (Performance of basic, translational, and clinical research)
8. Value Based Care (Care Paths, Care Coordination, Contracting)
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30 Ideas
Energy Usage Sustainability Conduct RFPs to
Consolidate Services/Supplies
World Health Organization
Protocol Marking Computers
Medication Drug Costs
Recycling Surgery Cost Per
Case Work Week Printing
Employee Health Plan Incentives
Paper, Paper, Paper
Courier Services Cell Phone Use Computer Training
Desk Top Printers Clinical Service
Integration Inventory Control
Reprocessing Surgical Items
Pharmacy Expired Items
And Many More ….
Provide More
Electronic Options
Reduce Paper and Mailings No More Paper Checks
Purpose: Reduce unnecessary use of paper and mailings.
Initiatives: Stopped mailing W-2s to employees and employee open enrollment packets. All available on-line. Offer e-billing statements online. No employee paper checks.
Savings: $640,00 for one year of one type of mailing!
Wound Cleanser
Initiative: Standardized to
single wound cleanser product
from five products with extensive
cost variances for same outcome.
Cost Savings: $10,000
A Clinical Committee can
evaluate options.
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Double-Sided
Printing
Initiative: Default
printers to double-sided
printing
Cost Savings: 50%
reduction on paper costs
Comments: Buy-in from
Senior Leadership
Replace Sharpies
with Alternative
Initiative: Purchase alternative
marker for pre-operative
markings
Cost $3 per marker, alternative
product $1
$2 cost savings per surgery
Cost Savings: $20,000 annually
10,000 surgeries per year
Eliminate Exam
Room Phones
Initiative: Eliminated
phones from exam rooms
Shut off six phone lines in
one department
Cost Savings: $1,500
annually for one
department only.
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Decrease Overtime
Creation of Multiple Options OVERTIME REDUCTION
• Purpose: Create options
that prevent inappropriate
use of overtime.
• Initiatives: 36 Hour Work
Week, Creation of Float
Pool, Hiring PRNs, 15
Minute Creep Reduction
Drug Information
Resources
Initiative: Consolidate
online drug information
resources
Went from two sources to one
Cost Savings: $1 million
enterprise wide
In-house
Computer Training
Initiative: Provide in-house
computer training for desktop
applications
Eliminates outside vendor fees
Cost Savings: $200,000
annually.
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PACU Bedside Carts
Initiative: Reduce par levels
of supplies kept on clinical
carts.
700 items to 330 items
Cost Savings: $69,000
annually.
Or eliminate carts and
centralize supply inventory.
Alcohol Pads
Initiative: Change
vendors for alcohol pads by
leveraging vendor
proposals.
Cost Savings: $17,000
Bacitracin Waste
Initiative: Convert to unit dose
bacitracin packets
Originally using 28g tubes
Cost Savings: $8,000 annually
Decreases amount of wasted
product
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Courier Services
Initiative: Audit and
consolidate courier pick-up
locations and times.
Cost Savings: $35,000 in
courier charges.
Default E-Prescribing
in EMR
Reduce Paper Use Adapt to Technology Benefits
Purpose: Providers have the option to either e-prescribe or write their outpatient prescriptions for patients.
Initiative: Making e-prescribing the default option instead of paper printing as option, decreased paper accost associated with written prescriptions.
Savings: 1 Cent per Page
Create Multi-
Functional Devices
Initiative: Eliminate
individual desktop printers;
utilize a central printing
unit for departments for
printing, copying, and
faxing, and scanning.
Cost Savings: $5,000
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Lotion
Initiative: Reduce size of lotion
bottles given to patients, 20 oz. to
10oz.
Cost Savings: Dollars per unit.
Decreases amount of wasted product
Save Our Supplies
Initiative: Restock and
reuse supplies that are still
sealed instead of throwing
them away.
Cost Savings: $5,000 in
one month.
Drug Concentration
Standardization
Initiative: Standardize
bivalirudin concentration
5mg/ml to 1mg/ml
Reduces amount of
medication wasted.
Cost Savings: $200 per
drug dispensed
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Replace Foam
Cradle at ASC
Change Supply Use Comparable Product
Purpose: At Ambulatory Surgery
Center, anesthesia uses a foam
cradle for the patient’s arm at
$6.19 each.
Initiative: Work with vendor for
comparable product at $2.57 each.
Cost Savings: $1,042 annually at
one ASC based on surgery volume.
Employee
Health Costs
Initiative: Implement programs and incentives for healthy lifestyle choices
Tiered health plan
No smoking policy
Chronic care programs
Cost Savings: Reduced rate of employee health costs by 50%. 7.5% to 3.6%
Changed Use
of Sterile Gloves
Work with Vendors Sterile Gloves
Purpose: Use of one type of sterile glove in one department was $78 per box. Other options weren’t considered.
Initiative: Found comparable product at $20 per box.
Cost Savings: $5,000.
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Single Use Device
Reprocessing
Program Throughout
Cleveland Clinic
Scorecard for Results
Initiative: FDA Approved Process where we track monthly and look for at least 60% compliance with eligible products and use scorecard to track results
Cost Savings: $3,286,837 savings in 12 months and 95,101 pounds of waste diverted.
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Computer
Monitors
Initiative: Power off
computer monitors at night.
Cost Savings: $6,100
annually.
Audit
Telecommunication Lines
Initiative: Deactivate
telephone and fax lines no
longer in use
Cost Savings: Thousands
of dollars after first audit
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Develop a
Green Team
Reduce, Reuse, Recycle Cleveland Clinic Green Team
Initiative: Create a Green Team
to identify ways to reduce, reuse,
and recycle waste.
Cost Savings: One site has saved
over $15,000 annually by
eliminating use of one dumpster
weekly.
Pharmacy
Initiatives Avoidance
Initiative: Evaluate
formulary approvals based
on evidence based
medicine.
Cost Avoidance:
$750,000 from oncology
formulary decisions.
Medical Executive Committee
Pharmacy & Therapeutics Committee
Clinical Sub-Specialty Panels
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Evaluate On-call
Services & Technology
Initiative: Evaluate use of
pagers and on-call schedules
One department consolidated
to one on-call pager from
three.
Cost Savings: $8,500 annual
for one department (On-call pay
+ monthly pager fee).
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Eliminate
Desktop Printers
Purpose: Integrate
technology to central
Multi-Functional Devices.
Initiative: Removed desk
top printers in one location
and eliminated toner user
and maintenance costs.
Cost Savings: $12,000
Energy Savings
Energy Committee
Replace light bulbs
Decrease temperature settings
Turn off lights
•
Initiative: Reduce energy use by 20% by 2010
• Creation of an Energy Committee to identify opportunities
• Savings: $100,000 in projects for the 1st year in one location.
Rapid Sequence
Intubation Kits
Initiative: Remove RSI
kits and incorporate
needed medications into
code carts
Removed two medications
Cost Savings: $1,200
annually
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Purple Bags
Initiative: Evaluate alternative
waste operations
Utilize purple waste bags for
recyclable surgical items.
Cost Savings: $230,000
annually.
Reduce garbage bin fees.
Key Take Aways
Get Ready for the 2017 Budget!
Engage Your Caregivers and Professional Staff to Submit Ideas
Encourage a Culture of Innovation and Creativity
Encourage Everyone to Submit Ideas – the More the Better!
Explain to Idea Submitter the Reason Why Idea Was Not
Considered and Thank Person for Submitting Idea
Let Staff Know When A Cost Saving Idea Has Been
Implemented
Celebrate Ideas that Are Implemented!
Questions?
Michael O’Connell, MHA, FACMPE
Cleveland Clinic, Marymount Hospital
Telephone: 216-587-8087
Email: [email protected]