The Difficult Journey to Value: A Roadmap for Success (Ari Robicsek)
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Speaker presentation from U.S. News Healthcare of Tomorrow leadership summit, Nov. 17-19, 2019 in Washington, DC. Find out more about this forum at www.usnewshot.com.
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The Difficult Journey to Value: A Roadmap for Success (Ari Robicsek)
- 1. The Difficult Journey to Value: an inpatient ‘Value Oriented Architecture’ Ari Robicsek 11.19.2019
- 2. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 % of encounters Physician# Antibiotics for febrile respiratory illness during flu season (PCPs with at least 250 FRI encounters)
- 3. % of shift spent at the bedside RNs, single orthopedic surgery unit, day shift Feb-May 2019
- 4. Option 1 Elective, Unilateral, Primary Total Knee Replacement Direct Variable Cost/Case Option 2
- 5. Elective, Unilateral, Primary Total Knee Replacement Ratio of Cost/Case to system average
- 6. 6 Better Better Value Plot Cost vs Outcome OR timeTranexamic acid Liposomal bupivacaine Fibrin sealant Antibiotic bone cement
- 7. Value Oriented Architecture Schematic 3rd party Patient Exp. PROs EMR Registries w/Risk Models Cost Normalization Intuitive Hierarchies Statistical Engine Outcomes we really care about
- 12. 0 5 10 15 20 25 30 35 $0 $100 $200 $300 $400 $500 $600 $700 $800 #ofsurgeons Surgeon's average bone cement purchase cost / case Avg cost/case: $163 Infections: 0.11% Avg cost/case: $395 Infections: 0.17% Avg cost/case: $603 Infections: 0.31% Average bone cement cost/case Elective, Unilateral, Primary Total Knee Replacement, high volume surgeons n = 20,000 cases
- 14. 14 Average total cost/case Elective, Unilateral, Primary Total Knee Replacement $9,625 $9,384 $9,625 $9,384 $9,625 $8,519
- 16. Average bone cement cost/case Elective, Unilateral, Primary Total Knee Replacement $265 $189
- 18. Jan-Dec 2018, Swedish Hospital Med/IM, General Med DRGs, Docs with at least 640 patient days
- 19. Dr A Dr B
- 20. Dr A Dr B
- 21. Dr A Dr B
- 22. Dr B Dr A Dr B
- 23. Jan-Dec 2018, Swedish Hospital Med/IM, General Med DRGs, Docs with at least 640 patient days
- 24. Dr A Dr B
- 25. Dr A Dr B Dr A
- 26. Dr A Dr B Dr B
- 28. 28 Normalized cost – an example
- 29. 29 Blue – Non Normalized Orange – Normalized Each circle represents one case Normalized cost – an example