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.

  • Regional Cost Driver ToolUse our Regional Cost Driver Tool to view comprehensive cost and utilization data for your market or compare spending across several markets to prioritize which utilization and cost targets to inflect first.

    Not sure how the tool works? Watch a demo.

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.


Don't miss our next post. Make sure you're subscribed to the Care Transformation Center Blog to receive alerts as soon as content is posted.

  • 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 »


Recent Posts from The Care Transformation Center Blog

How Texas Health Resources is creating 'a science out of well-being'

Don't suggest a healthy behavior—prescribe it

Three things your care model shouldn't do

The unexpected similarity between retail banking and care management


See More Posts on Avoidable Costs

Turn readmissions penalties into avoidable cost opportunities

Our top resources on avoidable costs


Interested in Membership?

Learn more about the Health Care Advisory Board and how we can help your organization. Contact us.