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When Henrico Doctor's Hospital in Richmond, VA, launched a hospitalwide initiative to improve patient throughput, the team was able to shave 2.5 hours off the average discharge time and decrease the average length of stay on the medical unit from almost 10 days to five days in the first six months of the project.
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Several months ago, the two EDs of Sacred Heart Medical Center in Eugene, OR, began posting their waiting times on their home page (www.peacehealth.org/shmc).
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After last year's round of budget cuts, Washington Medicaid seemingly exhausted all opportunities to achieve savings through purchasing initiatives.
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Washington's Chronic Care Management Project targets the most medically expensive, high-risk Medicaid clients in its long-term care system. It has lowered mortality and improved the health of clients with chronic conditions such as diabetes, heart disease, and musculoskeletal diseases.
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There is no question that decreasing inappropriate use of the emergency department for Medicaid patients can save significant costs, but getting results is a daunting challenge.
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Medicaid programs may never have had as much reason to redouble their utilization review efforts, in order to be sure funds are not being spent inappropriately, as they do right now.
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In fiscal year 2008, Alabama's Program Integrity Division's Pharmacy Audit unit reviewed 143 medical providers and 629 pharmacies to assure proper claim payment and recovery of identified overpayments.
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On the one hand, expenditures for Medicaid Buy-In participants, who pay monthly premiums, more than doubled from $887 million to $1.9 billion between 2002 and 2005, as did program enrollment. On the other hand, this group was found to be less expensive than other adult disabled Medicaid enrollees, with lower average Medicaid expenditures.
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Often, problems that are a continual thorn in the side for patient access simply cannot be solved without the help of other departments. Likewise, you can spread no small amount of goodwill by helping others with their own troublesome "pain points." Here are some ways to improve cross-departmental relationships:
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Rushing by a registration area on your way to a meeting with a hospital administrator, you think you hear an edgy tone in an access employee's voice while she's answering a patient's question. Do you stop to investigate further, or do you continue on your way?
