When executive leadership at ProHealth Care sought to expand data and analytics capabilities to strengthen fact-based decision-making, the health system turned to Syntellis’ Axiom™ Cost Accounting and Decision Support.
The health system has used Axiom™ Long-Range Planning since the late 1990s, so ProHealth deeply trusted Syntellis’ effective, intuitive solutions.
“Our senior leadership wants to make informed decisions on our entire network of services,” said Brad Treichel, Vice President of Finance and Administration. “So when we looked at what decision support had to have, we reconsidered how we were bringing information into the system. We had to think two to three years down the road. If we want a joint venture, or we want an independent group to share information with us — open up a business associate agreement, give us their financials, give us their volumes — we need a system that can support that type of evolving environment.”
With Axiom, the integrated health system in Wisconsin has the right tools to make better decisions related to changing healthcare policies, service line delivery, and value-based population health management across the continuum of care.
Service Line Planning: Knowing What to Provide and Where
ProHealth’s two hospitals, numerous clinics, home health and hospice program, and assisted living centers discharge about 17,000 inpatients annually and conduct 400,000 ambulatory care visits. ProHealth’s medical group employs 170 physicians out of a medical staff of 700. It also participates in a regional accountable care organization (ACO) and its own ACO, ProHealth Solutions, in conjunction with its independent medical staff that involves shared savings, pay for performance, and other risk-based contracts driven off a common EHR platform.
Axiom Cost Accounting and Decision Support empowers the finance team to efficiently analyze and report on service line costs, then incorporate them into strategic plans. The previous cost accounting system required extensive data aggregation and manual manipulation to group service line results by the applicable definition (i.e. diagnosis, procedure, provider, and others).
Axiom integrates definitions into the software table structure, so they’re easily updated and applied to the data. Treichel says this helps decision support teams quickly respond to reporting requests. Consistency and the assurance that definitions are congruent with organizational objectives ensures that encounters are not duplicated or omitted in the service line reports.
Axiom Cost Accounting and Decision Support has expanded ProHealth’s capabilities to provide service line profitability reporting across all patient services, including its hospitals, outpatient centers, medical group clinics, and home care and hospice services. By looking at provider-specific costing, the finance team can assess individual physicians or other clinician profitability at all service locations.
Clinical Performance Improvement: Engaging Physicians With Reliable Data
Utilization reporting through the Decision Support System helps service line and operations directors provide physicians with actionable information on variations in care and improve physician preference-item adherence and care pathway planning. The viability of the data increases physician buy-in, Treichel said. Clinicians are eager to review the analyses and have provided constructive feedback on how to further enhance reporting.
Strategic Pricing: Making Informed Contracting Decisions
In negotiating contract agreements with payers, ProHealth’s managed care team relies on the Decision Support System to provide service-specific data on care delivery costs. This information helps model contracts to assess proposed rates against the organization’s actual costs. As more risk-based payment models develop, the costing data will be increasingly important in analyzing and improving the hospital system’s cost structures for associated services, Treichel said.
“Our perspective was, we really want to see best practice and make this the best cost accounting and decision support system that we can,” Treichel said.
“With any implementation, the data is the key, and with Syntellis’ help, we’re bringing in all the data elements that we need to ensure that our organization can do the type of reporting that’s required. We now have a product that is meeting our current needs and capable of growing with us as future needs are defined.”