western maryland health system case study

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Western Maryland Health System Navigates the New World of Quality-Based Reimbursement with Healthcare Analytics

Western Maryland Health System

Case Study



Located in Cumberland, Maryland

205 beds Services a rural area

across three states: Maryland Pennsylvania West Virginia

Solution: The Diver Platform

Fast Facts



Maryland was the first state in the nation to be granted a waiver from Medicare rules, providing flexibility to implement its own quality-based program.

In the first year under the quality-based Maryland reimbursement model, Western Maryland ranked 46th out of 46 hospitals.

Due to its low performance, in fiscal year 2012 Western Maryland lost $1.2 million in revenue under quality-based reimbursement.

Background


The Challenge

In order to improve its bottom line, Western Maryland outlined several key initiatives,

To achieve the initiatives the health system wanted a business intelligence solution that: Could be deployed quickly Would let users create their own

dashboards and data views Could aggregate data from

multiple systems for better visibility


The Solution

Western Maryland used Diver to:– Track Quality Indicators, specifically mortality and

potentially preventable conditions– Get an accurate read on readmissions – lowering 30-

day readmissions is critical to improving patient outcomes under the Maryland model

– Figure out why patients were returning and how post-discharge follow-up care could be improved


The Results

Before AfterIn terms of quality-based reimbursement measures, Western Maryland ranked last out of 46 Maryland hospitals.

After implementing Diver, Western Maryland climbed to first place in the state.

In 2011 there were 1,972 high-utilization patients who accounted for $140 million in costs.

By 2014 there were 1,300 such patients with associated costs of $80 million.

In fiscal year 2012 Western Maryland lost $1.2 million in quality-based reimbursement.

In fiscal year 2014 Western Maryland gained $1.3 million in quality-based reimbursement.

Western Maryland was also able to drive down its readmission rate to 11.72% - well below the Maryland average of 13.9%.


Learn More

For more details on Western Maryland Health System’s

experience, visit: http://www.dimins.com

/case-studies/western-maryland

-health-system-case-study/

http://www.dimins.com/case-studies/western-maryland-health-system-case-study/




