Proactive Management of Care Progression With ProHealth Care

ProHealth Care was able to realize $3.4 million in annualized benefits through the development and implementation of a proactive management approach to care progression and patient flow. Huron enhanced the ProHealth Care case management model and implemented enabling technology to drive accountability and enhance care progression management.

Challenge

With reimbursements under growing pressure, ProHealth Care sought to increase efficiency and reduce costs in clinical operations, while maintaining or improving quality. Financial improvements were important to long-term goals of investing in clinical programs, facilities, technology and people to advance its mission of providing outstanding care in a highly competitive market.

Approach

Huron’s healthcare professionals partnered with ProHealth Care to provide proactive management of care progression and patient flow, ensuring that all patients receive appropriate care in a timely fashion. By reducing length of stay and optimizing patient management processes, Huron helped ProHealth Care achieve $3.4 million in annualized benefits.

Optimizing processes: Huron worked with ProHealth Care to implement a patient status management program so that patients from all points of entry receive timely and appropriate care. Comprehensive interdisciplinary meetings, with appropriate participation from relevant disciplines and effective follow-up, ensured efficient, high-quality care. The engagement team also implemented Clinical High-Risk Meetings and a secondary review process related to medical necessity, including development of a physician advisor role.

Increasing safety and quality:The Huron team enhanced ProHealth Care’s case management model to ensure that patients receive the right care at the right time. This effort helped eliminate tests and treatments that were not medically necessary. In addition, the team improved patient flow by redesigning the admission order process for patients admitted from the Emergency Department — further ensuring the appropriate level of care and medical management. Huron also created and implemented a framework to better manage ProHealth Care’s observation population.

Implementing new tools: Huron implemented enabling technology, supplementing existing ProHealth Care information systems. This provided the data to drive timely, effective decisions on patient throughput. The tools gave leadership and staff the ability to increase accountability and support proactive management of care progression.

ProHealth Care, a community-based healthcare system in Southeast Wisconsin, includes three hospitals, 15 primary care clinics, and a network of nearly 1,000 physicians and 4,800 employees. The system treats more than 400,000 patients per year and has an annual net patient revenue of more than $500 million.

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