IHI Expedition Expedition: Preparing Care Teams for Bundled Payments - - PDF document
4/21/2015 April 21, 2015 Begins at 1:00 PM ET IHI Expedition Expedition: Preparing Care Teams for Bundled Payments Session 3: Collecting Data Using Activity-Based Costing Nick Bassett, MBA Trisha Frick, MS, RN Lucy Savitz, PhD, MBA Molly
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Expedition: Preparing Care Teams for Bundled Payments Session 3: Collecting Data Using Activity-Based Costing April 21, 2015 Nick Bassett, MBA Trisha Frick, MS, RN Lucy Savitz, PhD, MBA Molly Bogan, MA
Begins at 1:00 PM ET
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Akiera Gilbert
Project Office Assistant Institute for Healthcare Improvement
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To join by phone: 1) Click on the “Participants” and “Chat” icons in the top right hand side of your screen. 2) Click the button
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Enter Text Select Chat recipient Raise your hand
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Name and the Organization you represent Example: Sam Jones, Midwest Health
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Molly Bogan, MA
Director Institute for Healthcare Improvement
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At the end of this Expedition, participants will be able to: Describe the benefit of transitioning to a value-based purchasing model Understand and apply activity-based cost accounting methodology to at least
Demonstrate examples of how to engage stakeholders in building a bundle Describe how to customize care team redesign to deliver optimum care under value-based purchasing
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Session 1: Volume to Value; Describe the benefit of transitioning Value- Based Purchasing Lead Faculty: Lucy Savitz & Trisha Frick Session 2: Getting Started with Building a Care Bundle Lead Faculty: Trisha Frick & Nick Bassett Session 3: Collecting Data Using Activity-based Costing Lead Faculty: Nick Bassett & Lucy Savitz Session 4: Engaging Stakeholders in Bundle Design Lead Faculty: Trisha Frick & Nick Bassett Session 5: Care Team Redesign Lead Faculty: Trisha Frick & Nick Bassett Session 6: Case Study: CMS Bundled Payments for Care Improvement Experience Lead Faculty: Trisha Frick & Kathy Luther
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the episode selected?
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Please send your message to All Participants
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Lucy Savitz, PhD, MBA Director of Research and Education Intermountain Healthcare Salt Lake City, Utah Trisha Frick, MS, RN Assistant Director of Managed Care Johns Hopkins HealthCare LLC Glen Burnie, Maryland Nick Bassett, MBA Healthcare Transformation Manager Intermountain Healthcare Salt Lake City, Utah
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~Lucy Savitz ~Nick Bassett
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Activity Based Costing
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process—including finance, quality, and clinical staff
to wheels out of OR)
– Estimates (pre-op prep may be time x avg salary) – Observation (wheels in to wheels out of OR)
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Cost accounting approach concerned with matching costs with activities (called cost drivers) that cause those costs. (1) products consume activities, (2) it is the activities (and not the products) that consume resources, (3) activities are the cost drivers, and (4) activities are not necessarily based on the volume of production. Instead of allocating costs to cost centers (such as manufacturing, marketing, finance)
processing an order, attending to a customer complaint, or setting up a machine.
– Better understand how and where the firm makes a margin/profit – Indicate where money is being spent – Located which areas have the greatest potential for cost reduction.
Developed by professors Robert Kaplan and Robin Cooper of Harvard University in late 1980's.
– Lean observation – Time – motion studies on process of care (multi-sample average vs.
– Episodic bundles (overall average or tiered pricing)
– Accounting for both direct & indirect costs (allocation)
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– Expenses arising in unit where care is provided, directly arising from that care – Could reasonably appear on an itemized bill
– Allocations of expenses from other (overhead) units – Central admin, food services, human resources, PR, etc.
a matter of judgment/choice for many items
– e.g., floor space can be charged as rent (direct) or as a facility overhead allocation (indirect) – BUT all direct + indirect costs must cover all facility expenses
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– Requires comprehensive identification & collection of data – Must be practical – When is the cost data “good enough” – Determining when, where, & how to do this
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activities during a selected window of time/event period (e.g., OR procedure) – Staff involved – Number & duration of interruptions/down time – NB: This data can be used to identify improvement
staff member; then sum
electronic applications
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Efficiency
Recoverable Waste
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Lessons Learned
determination
managing risk
payment
patients to providers
Developed by Kevin Bozic and M. Susan Ridgely “The IHA Bundled Episode Payment and Gainsharing Demonstration”
– Helping design how to do structured observations and identifying segments which make most sense to focus on
– Facilitate Access
– Understands opportunities from vendor contracting perspective
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Insert Relevant Cost Information
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patient preference?
facilities and physicians
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Raise your hand Use the chat
action period, utilize activity-based costing to collect cost data on the care process segment chosen in the last activity.
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Trisha Frick, MS, RN Assistant Director of Managed Care Johns Hopkins HealthCare LLC Glen Burnie, Maryland
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Tuesday, May 5th, 1:00 – 2:00 PM ET
Nick Bassett, MBA Healthcare Transformation Manager Intermountain Healthcare Salt Lake City, Utah
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Director: Molly Bogan mbogan@ihi.org Akiera Gilbert agilbert@ihi.org