Care Transformation Center Blog

Your top avoidable cost opportunity


Bonnie Jin

In our ongoing research on avoidable costs, we’ve found that inpatient medical admissions, outpatient surgery, and prescription drugs consistently rank among the top avoidable cost opportunities for health systems with populations under risk.

While many of our members have already taken steps to curb prescription drug spending, they've voiced challenges with getting a handle on inpatient medical admissions and outpatient surgery spending due to their nearly all-encompassing definition.

We recently dove deeper into the data to identify specific conditions that are driving costs in these areas—and found some surprising results within inpatient medical admissions.

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Septicemia: Your top avoidable cost opportunity


Septicemia is the largest driver of inpatient medical cost, which may be surprising because this cohort of health systems predominantly serves a self-insured population. However, a closer inspection suggests that undetected infections are escalating to higher cost events like septicemia.

Given the high mortality rate associated with this condition, hospitals are now using data to surface failure points in care delivery and designing tactics to get ahead of the issue.

One example is Eastern Alabama Medical Center, a 373-bed hospital that has taken steps to implement an early sepsis bundle to target patients presenting in the ED. As a result, they’ve saved lives and cut costs from preventing expensive ICU stays.

More on Avoidable Costs

Every provider needs to focus on reducing avoidable costs—even if risk-based reimbursement contracts are not on the horizon. Learn what you need to know in our research briefing, Primer on Avoidable Costs, and watch our experts present the practices members are raving about.

READ THE BRIEFING

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  • 1 PMPM opportunities aggregated into MS-DRG families (e.g., collapsing of severity tiers).
    2 Acute myocardial infarction.
    3 Among patients with and without comorbidities/complications.

Primer on Avoidable Costs

Every provider needs to focus on reducing avoidable costs—even if risk-based reimbursement contracts are not on the horizon. Here's what you need to know »


 

Improving Sepsis Outcomes with Crimson

Explore nine key opportunities where your sepsis task force can improve outcomes—and how Crimson can help. View the infographic »


 

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