Challenge

This major healthcare center in the western United States operates hospitals, clinics and a highly respected medical school. Financial pressures stemming from commitments to the school, along with capital pressures and health-reform initiatives, amplified the need for efficiency. Members of the executive team requested swift implementation of an improved model for care management across the organization’s portfolio of facilities.

What Accenture did

Opportunity

While earlier efforts to reduce cost through improved care coordination had fallen short, streamlined care management remained a strategic priority. Previously, the client had lacked the right mix of resources to work through an objective redesign across hospitals, clinics and departments. In 2016, the client wanted to implement a superior operating model before opening a new facility. Having helped the client with prior strategic, operational and financial improvement initiatives, Accenture agreed to assist in designing, and beginning to implement, a strategic model for care management.

Solution

The project team focused on ways to improve outcomes in five areas:

  1. Emergency services
  2. Trauma care
  3. Unit huddles (i.e., daily collaboration among providers on patient-care floors)
  4. Outliers (i.e., management of people with clinical complications and longer stays)
  5. Denials of coverage for treatment by insurance companies

Along with the design of an overarching model for care management, Accenture organized quick wins for each area. Additional benefits included:

Establishment of a new management structure.

Project Management Office (PMO) work that included the establishment of communications, performance management and monitoring tools.

Transitioning the project to internal leaders, along with solutions for ongoing management and benefits tracking.

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Value delivered

The value of successfully implementing the new model across facilities over two years is expected to exceed $25 million. Quick-win projects have already yielded cash-flow relief of up to $2.1 million.

Progress is tracked with key performance indicators on management dashboards:

  • The Daily Unit Huddles Dashboard shows increasing success in forecasting the accuracy of hospital stays and documentation of expected discharge dates.
  • The Outlier Management Dashboard focuses on trends among patients with lengths of stay greater than five days, and a reduction in “difficult to discharge” cases.
  • The Clinical Denials Dashboard shows a reduction in denied accounts due to poor clinical documentation, and realization of cash-collection benefits ahead of schedule.

A new strategic operating model for care management—including improved processes and automated tools—is helping this medical center control rising costs while delivering high-quality treatment for patients.

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