Case Study                                     Community Health Network Decreases                                     Lost...
Case Study”Since I left residency, I haven’t   helps caregivers avoid adverse drug                     each account, those...
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Community Health Network Decreases Lost Drug Charges by 40% with Anesthesia Management Solution


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Discover how a large healthcare provider was able to decrease lost anesthesia drug charges by 40% and improve patient safety through improved Anesthesia management

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Community Health Network Decreases Lost Drug Charges by 40% with Anesthesia Management Solution

  1. 1. Case Study Community Health Network Decreases Lost Drug Charges by 40% with Anesthesia Management SolutionAt a Glance Indiana’s Community Health Manager™, improvements began.Organization Network ranks among the nation’s During patient assessment, a top 20 integrated healthcare preoperative nurse completes aCommunity Health NetworkIndianapolis, Ind. networks. Faced with declining comprehensive checklist with the revenue, Community Health patient, entering physical history– 5 hospitals Network sought to boost finances in the surgery system, which is– 12 surgery centers while building an electronic integrated with the anesthesia– 1,442 beds medical record. management solution.– 43 OR suites After implementation of McKesson McKesson Anesthesia Care populates– 106,336 surgical visits/year Anesthesia Care™, McKesson’s the corresponding ICD-9 codesIndiana Surgery Center comprehensive anesthesia and specifies comorbid conditionsNoblesville, Ind. management system, Indiana requiring a higher level of care. The– 3,100 surgeries/year Surgery Center increased comorbid system also registers ASA modifiers, documentation, reduced claim such as BMI and age extremes. TheSolution Spotlight rejections and decreased lost provider can accept or reject these anesthesia charges by 40%. codes before sending data to the– Horizon Surgical Manager™ billing system.– McKesson Anesthesia Care™ Challenge Indiana Surgery Center’s manual “ICD-9 codes assigned at bedsideCritical Issues allow us to assign a diagnosis-related drug capture process needed– Lost revenue due to manual improvement. As drugs were group (DRG). As the patient’s acuity anesthesia drug capture process dispensed, the anesthesiologist rises, the DRG assignment changes. By– Time-consuming anesthesia noted the dosage on both the accurately capturing ICD-9 codes, we coding process missed comorbid patient’s record and a separate gain the maximum reimbursement,” conditions drug charge sheet for pharmacy. says Dr. Gregory Bray, medical The drug was never charged for if director, chief of anesthesia, Indiana– Returned patient claims required additional documentation for the second step was omitted. Surgery Center. billing Before implementing McKesson Since the anesthesia management– Lack of drug contraindications Anesthesia Care, 4% of the solution is integrated with both alerts and awareness Center’s first claim submittals nursing preoperative and PACU were returned due to incomplete documentation, anesthesiologistsResults arrive well-prepared. “I review the documentation, requiring hours– Improved patient safety through next patient’s record before leaving of record validation. While this ADE prevention and automated the current bedside, decreasing vital sign capture figure was lower than the national average – at 19%, anesthesia time between cases,” explains Dr.– Streamlined pre-anesthesia charges have the highest rejection Bray. “I no longer repeat the nurse’s evaluation process questions, because I’ve already rate – Indiana Surgery Center– Decreased lost anesthesia drug wanted to eliminate rejected reviewed the patient’s history.” charges by 40% claims.– Increased revenue from greater Anesthesiologists now scan all detection of ASA modifiers and Answers medications prior to delivery, comorbid conditions recording the drug type and dosage After implementing McKesson’s amount. McKesson Anesthesia Care– Increased reimbursement through surgical system, Horizon Surgical accurate ICD-9 code capture
  2. 2. Case Study”Since I left residency, I haven’t helps caregivers avoid adverse drug each account, those losses significantly events with a qualified cross-reference affected our bottom line. Now, weseen a device that can help process for dispensed medications, know we’re receiving maximuma provider impact patient including formulary reference for revenue,” says Dr. Bray. allergies and as much as McKesson By establishing an automated record ”We’re very pleased with the for anesthesia, the Center has virtuallyAnesthesia Care.” real-time, stop-check analysis of eliminated claim rejections, leading to meds,” says Dr. Bray. “Before, faster revenue recognition. Previously, we’d only realize medications were 4% of all patient claims were returnedDr. Gregory Bray contraindicated after the patient due to discrepancies. That figure has had problems. McKesson Anesthesia dropped dramatically: in the first year,Medical Director, Chief of Care processes the intricate details only two claims were returned.Anesthesia, Community Health of multiple drugs interacting together — giving us a patient safety “Our billing agents need less timeNetwork, Indiana Surgery feature we didn’t previously have.” to process claims, because they This documentation of medication don’t have to touch them multipleCenter reconciliation helps Indiana Surgery times,” notes Dr. Bray. “The surgeon Center meet regulatory body types the procedure description into requirements. Drug delivery details Horizon Surgical Manager, and that are sent directly to their clinical first-hand account is received by the documentation and billing services billing service. McKesson Anesthesia department. Care captures actual surgery start and stop times – everything we need to With the automatic capture of vital withstand an audit.” signs from physiological monitors, McKesson Anesthesia Care frees With automated coding, anesthesiologists from recording data anesthesiologists can review their by hand — allowing more time for procedure notes and quickly assign patient care. “Since I left residency, I CPT codes. By integrating comorbid haven’t seen a device that can help coding into the assessment phase, a provider impact patient safety as McKesson Anesthesia Care increased much as McKesson Anesthesia Care,” the Center’s comorbid documentation notes Dr. Bray. by 2% over three years. Results “I don’t mess with paperwork any Electronic anesthesia documentation more,” says Dr. Bray. “I can focus and streamlined medication on the patient. All I do now is sign management have greatly improved my standing orders.” With Indiana drug charge capture. Three years Surgery Center experiencing such after implementation, Indiana Surgery success, Community Health Network Center realized a 40% decrease in lost looks forward to rolling out the anesthesia drug charges. “Because complete integrated anesthesia we’re reimbursed a percentage for system across the enterprise.McKesson Provider Technologies Copyright © 2010 McKesson Corporation and/or one of its subsidiaries. All rights reserved. Horizon Surgical5995 Windward Parkway Manager and McKesson Anesthesia Care are trademarks of McKesson Corporation and/or one of itsAlpharetta, GA 30005 subsidiaries. All other product or company names mentioned may be trademarks, service marks or registered trademarks of their respective companies. PRT428-08/10