Large Health System Identifies 170k in Missed Savings by Reinforcing Dose for One Medication

November 1, 2021

problem

Teams Struggle to Sustain Cost Reduction

Healthcare delivery systems across the U.S. are balancing many strategic initiatives to improve patient experience, drive better quality of care and reduce costs. For most organizations, teams juggling cost reduction efforts with other priorities often struggle to achieve set cost reduction targets through sustained improvement. After completing a program designed to reduce unnecessary waste from a larger dose of an expensive pain management drug, this large, multi-site health system needed to analyze the program’s success.

Previously, physicians could use one of two different charge codes for Exparel, an expensive pain management drug. To curb overutilization and waste of the larger dose, the organization recommended physicians avoid the larger per procedure dose (266MG/ ML) and use only the smaller one (133MG/ML). The problem this organization faced was the inability to track compliance long-term.

play

Establish Tools and Processes to Sustain Cost Reduction Program

Months after their focus had shifted to other projects, the system partnered with Strata’s Continuous Improvement team to assess whether physicians were still compliant in using the recommended lower dose of the drug. Once the pharmacy team saw the drop in the usage of the 266MG/ML charge code sustained for a year, they stopped monitoring the initiative. Eight months after they stopped tracking the program’s outcome, the organization’s Clinical Analytics team used StrataJazz Continuous Improvement to validate that adoption of this change had been sustained. Drilling into the drug’s utilization, they realized that physicians had not complied with the program and instead were ordering two smaller 133MG/ML doses together to avoid flagging the system with the larger 266MG/ML charge code. Having an automated system enabled this organization to track compliance on an ongoing basis.

impact

Extend and Maintain Tracking of Cost Reduction Program Compliance

After automating tracking within the Continuous Improvement tool, the Clinical Analytics team shared their reporting with the Pharmacy team. They were “floored” and impressed with the level of detail in the analysis. Prior to partnering with Strata, the Pharmacy team was only able to see the charge codes for each specific dose, not the frequency being used in each case by each physician. Using the Exparel utilization analysis in StrataJazz Continuous Improvement, the organization discovered noncompliance from 116 physicians. This represented an annualized value of approximately $170,000 in missed cost savings. The accuracy of the data used in their analysis also helped the team build trust with the pharmacy team, which will allow for more cross-organizational collaboration. After realizing the impact of tracking one specific drug, the organization plans to use this tool to discover future quality improvement and cost savings opportunities.