Post on 15-Jan-2022
transcript
Location
Benefis is one of the largesthealth systems in Montana,located in the state’s third
largest city.
Employees
Benefis employs more than3,200 employees, includingnearly half of the physiciansin its primary service area.
Market
Benefis holds 97% marketshare in its primary service
area.
System Overview
2
Acute CareInpatient Beds
Long-Term CareBeds
Inpatient HospiceBeds
64
Assisted LivingApartments
56
Low-IncomeSeniorApartments
25
Rural CriticalAccess Hospital
Beds
Rural ClinicsMedicalGroup Hospitals
SeniorCare
HomeHealth
Hospice
137,000
3,000
6,000
Acute and Long-Term Care
Patient Days
Inpatient Surgeries
Outpatient Surgeries
Comprehensive Continuum Annual Statistics*
474,000 Acute Care Outpatient Visits
295 182 20 30,000 Home Care Visits
Statistical Overview
* Based on year-end 2017 figures, rounded to the nearest thousand.3
67.9% 67.9%73.1% 75.7%
12.8% 13.0%
11.0%10.4%
12.1% 12.0%12.8% 11.2%
7.2% 7.1%3.1% 2.8%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2014 2015 2016 2017
Self Pay
Blue Cross
Other Commercial
GovernmentalPayors
Gross Payor Mix
* First year of Medicaid Expansion in Montana.4
How Benefis Health System is Unique
Medicare Breakeven
Benefis is one of the few health systems in the nation to breakeven on Medicare. We achievedMedicare Breakeven in 2012 and have maintained it each year since then.
Ongoing Financial Success, Annual Raises, and No Layoffs
We have not only been financially successful for each of the last 15 years, we have givenraises each year and had no layoffs during that time, despite our high governmental (morethan 75%) payor mix.
Gift of Life Housing
Benefis offers free housing on two of its campuses for the families of patients receivingtreatment at our health system.
Native American Welcoming Center
We accommodate the needs of our Native American patients through a dedicated center in thehospital where they can spend time together in a group, get a complimentary meal, andpartake in cultural ceremonies.
Low Income Senior Apartments
Our comprehensive continuum of care and robust senior care division are furthercomplemented by a partnership that enables us to offer 56 low income senior apartments toarea residents.
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• Becker’s 150 Great Places to Work in Healthcare (received four years in a row)• Great Falls Area Chamber of Commerce Large Business of the Year• Rural Healthcare Awards:
o Montana Rural Healthcare Performance Improvement Network Quality ImprovementAward
o Benefis Teton Medical Center Emergency Department Transfer Communication QualityAwardo Cardiac RecognitionAward
• HealthGrades Awards:o Pulmonary Care Excellence Award (received six years in a row)
o Stroke Care ExcellenceAwardo Top 10% in the Nation for Overall Pulmonary Services (received six years in a row)o Top 10% in the Nation for Stroke Care (received six years in a row)o Five-Star Treatment of Chronic Obstructive Pulmonary Disease (received six years in a row)o Five-Star Treatment of Sepsis (received 12 years in a row)o Five-Star Treatment of Respiratory Failure (received 12 years in arow)o Five-Star Treatment of Pneumonia (received eight years in a row)o Five-Star for Esophageal/Stomach Surgerieso Five-Star for Colorectal Surgeries (received two years in a row)o Five-Star Treatment of Pulmonary Embolismo Five-Star Treatment of Gastrointestinal Bleedso Five-Star Treatment of Stroke (received two years in a row)
Resulting 2017 Awards
0.7
%
2.6
%
3.6
%
3.4
%
3.3
%
3.4
%
3.5
%
3.3
%
3.4
%
3.2
%
-0.1
%
4.0
%
4.7
%
3.9
%4.1
%
3.7
%3.7
%
3.3
%3.5
%
3.6
%3.8
%
5.9
%
3.2
% 3.6
% 3.9
%
4.1
%
4.1
%
3.3
%3.5
%
6.1
%
5.7
%
5.3
%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
-1.0%2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Operating Margin
Budgeted
Actual
Consistently Better than Budgeted OperatingMargin Every Year Since 2003
9
$2
.9
$3
.1
$7
.5
$9
.8 $1
0.9
$9
.6
$6
.6
$5
.2
$4
.6
Mil
lio
ns
Annual Cost Reduction (totaling over $60.2 million since 2009)
Cost Reduction by Year
$12.0
$10.0
$8.0
$6.0
$4.0
$2.0
$0.02009 2010 2011 2012 2013 2014 2015 2016 2017
10
$7
0.6
$7
0.2 $8
1.9
$8
6.9
$7
6.2
$7
9.6
$8
9.3
$8
7.2
$8
1.1
$30.0
$20.0
$10.0
$0.0
$60.0
$50.0
$40.0
$90.0
$80.0
$70.0
$100.0
2008 2009 2010 2011 2012 2013 2014 2015 2016
Mil
lio
ns
Allowable Cost
MedicareReimbursement
Note: Measurementof Medicarebreakeven is themeasure of totalpayments from:Worksheets E Part A,E Part B, E-3 Part II,E-3 Part III, E-3 PartIV, I-4, HHA D Part II,and the MedicarePS&R PaymentSummary Reportless Worksheets D-1for Hospital andSubproviders IPF,IRF, and SkilledNursing Facility.
* Based on Allowable Cost
$59.6$63.9
$74.9$77.5
$83.3 $82.9
$90.1$93.2
$88.2
Medicare BreakevenFirst Achieved in 2012
ReimbursementPercent of Cost*
84.4% 91.1% 91.4% 89.3% 109.3% 104.1% 100.8% 106.9% 108.7%
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FALLS WITHINJURY
ALARM FATIGUE
NURSE FATIGUE
OVERTIME/PREMIUM PAY
BOARDING OFPATIENTS
DRUG USE
BEHAVIOR HEALTHPATIENTS
REMOVED CNAsFROM THE FLOOR
ELOPEMENT
FALLS
SUICIDEIDEATION
CAREGIVER ATRISK OF HARM
LARGE NUMBEROF 1:1s
Our Journey to AvaSys:First the challenges
Researched Best Practice versus being approached
• CNO read articles about AvaSys reducing costs
• Several peer-reviewed articles
• Hot topic at national nursing conferences
Site visit to Sacred Heart Medical Center in Spokane
• Multidisciplinary team
• Looked at it “live”
• Idea to get Foundation funding
Burtson, PL, & Vento, L, Sitter reduction through mobile video monitoring; a nurse-driven protocol and administrative Oversight. The Journal of NursingAdministration, July/August 2015
Cournan, M., Improving safety through video monitoring. Rehabilitation Nursing, Oct. 26, 2016
Votruba, L et al, Video monitoring to reduce falls and patient companion costs for adult inpatients. Nursing Economic$, July/August 2016
Our Journey to AvaSys:Doing our homework
Started with 12 cameras
• Wall mounts versus mobile cart
Relatively easy buy-in• Medical staff
• Nursing staff
Not only used with 1:1 patients but alsowith high risk fall patients
Developed a scorecard for monitoring
Our Journey to AvaSys:The purchase and implementation
Success breeds success
Monitor results
Reported results
• Hospital Quality and Patient Safety Committee
• Board Outcomes Committee
• Benefis Health System Foundation
Our Journey to AvaSys:Monitoring and sharing success
•
Background
The AvaSys Telesitter is a remote
patient observation system that
enables continuous audio and visual
monitoring of patients from a central
station. It allows staff to immediately
and directly intervene when a patient
is at risk of self-harm.
Ability to monitor more patients at a time for falls inattempt to reduced falls and falls with injury.
Improved nurse satisfaction as nurses are spareddisruption of workflow and emotional impact of falls.
Improve staffing efficiencies as nurses can be out on thefloor instead of watching patient one-on-one.
New Technology: AvaSys
53%
Opportunities for use of AvaSys
Benefis (n=742) vs. All Participating Hospitals (n=76,646)
67%
FALL PREVENTION
20%7%
OTHER
3%4%
ELOPEMENT
2%3%
DELIRIUM/RESTLESS
10%4%
SUICIDE PRECAUTIONS
9%13%
SAFETY OF TUBES/LINES
2%2%
ALCOHOL WITHDRAWL
1%1%
AGGRESSIVE/VIOLENT
*Courtesy of ORNA Online Reporting of Nursing Analytics
Example of how data helped target trainingfor Benefis Staff
*Courtesy of ORNA Online Reporting of Nursing Analytics
21 2120
3132.5
30
15
25
23
30.5 31
21.7
JAN MAY
Number of FTEs Reduced or Better Utilized in 2017
Resource Support
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