The average cost of care for many common heart conditions at Baylor Jack and Jane Hamilton Heart and Vascular Hospital (BHVH) in Dallas is significantly lower than other area hospitals, according to a recent breakdown published by D Healthcare Daily.
For example, the average cost of care for acute heart attack patients (those discharged with major complications) at BHVH was about $23,000 versus nearly $100,000 at another local hospital, reported D Magazine’s health care blog, which based the analysis on data from the Centers for Medicare and Medicaid Studies (CMS).
For cardiac catheterization procedures (not for acute heart attack with major complications), BHVH’s average cost was approximately $33,000 compared to more than $141,000 at another Metroplex facility, the report said. The publication also found significant cost savings at BHVH for atrial fibrillation.
In addition, a detailed study* of CMS pricing data reported earlier this year, found that the median pricing across all care services at BHVH was about 30 percent lower than the median prices of four top local competitors, and about 20 percent lower than the national median.
Turning Quality Up and Cost Down
Nancy Vish, PhD, RN, president and chief nursing officer of BHVH, said the savings were not achieved by cutting corners.
“We never, ever approach decisions with the mindset of ‘how can we save money,’” Vish said. “We’ve always gone in with the mindset of, ‘what is best for this patient?’ And when you focus on identifying and consistently using best practices, cost reduction is a positive side effect.”
The focus on providing evidence-based care during each patient encounter has led to outcomes that consistently place BHVH near the top of national quality performance metrics. It has also resulted in awards from both state and national organizations.
In 2014 thus far, BHVH has received the Texas Award for Performance Excellence, the state’s highest honor for quality and organizational performance. It also has achieved the 2014 Mission: Lifeline® Gold Achievement award from the American Heart Association for its efforts to provide prompt, evidence-based care for heart attack patients. Becker’s Hospital Review also named BHVH among the nation’s “100 Hospitals with Great Heart Programs” for 2014.
Engaging Employees in Efficiency
Eliminating inefficiencies and waste by negotiating pricing with vendors/suppliers, reducing duplication and effectively managing inventory are other ways BHVH is creating value for patients and controlling costs.
“We’ve been able to create a culture of continuous improvement by constantly challenging our processes and the way we do things,” said Vish. “And it takes staff buy-in and understanding to do that. That’s why all of our employee meetings cover our quality and safety metrics as well as our finances, because it takes everybody.”
Of course, it also takes much communication and engagement with staff to give them the tools they need to take responsibility for effectively managing the hospital’s resources.
“Understanding and incorporating business elements into clinical practice is part of today’s health care environment,” said Vish.
Engaging employees to empower them to be good stewards of BHVH’s resources appears to have contributed to another positive side effect: high employee satisfaction rates.
During their last employee survey, 92 percent of employees said they would recommend BHVH as a “good place to work.” Additionally, BHVH achieved a 93 percent on the employee engagement index. The index measures employees’ confidence in leadership, how well they feel communicated with, and how clearly they feel that they understand organizational goals and what is expected of them. When benchmarked against other health care organizations from around the nation who use the survey, BHVH scores nearly 20 percentage points higher.
That’s one of the reasons BHVH has been named by Becker’s Healthcare as one of the “Top 150 Places to Work in Health Care,” and why Modern Healthcare magazine has named the hospital among the nation’s “Best Places to Work in Healthcare.”
Quality care at a lower cost delivered by happy employees has added up to some of the highest patient satisfaction scores of any hospital in the country.**
“We’ve scored in the 95th percentile for inpatient satisfaction for more than five years and a big reason for that high score is because we have great patient outcomes and our people love to work here,” said Vish.
*The Hospital Charge Index, developed by Cleverley + Associates, compares the Medicare charge per discharge and Medicare charge per visit at the hospital (both adjusted for case complexity and wage index differences) to the US median value for each measure. The result is the most objective overall charge comparison available.
**Measured against hospitals using the Press-Ganey database to track patient satisfaction.