Navigating the New World of Quality-Based Reimbursement with Healthcare Analytics

Quick facts

Industry: Healthcare
Location: Cumberland, Maryland
Number of Beds: 205
Website: https://www.wmhs.com/
Solution: Diver Platform

Key goal

Under quality-based reimbursement, Western Maryland did not fare well in FY 2012, losing a total of $1.2 million in revenue due to its low performance on core measures, patient satisfaction, and potentially preventable conditions.

In order to improve its bottom line, Western Maryland outlined several key initiatives, which included, in part:

  • Shifting emphasis from volume to value
  • Reducing admissions and readmissions
  • Providing care in the most appropriate location
  • Reducing variation in quality
  • Reducing utilization rates in the emergency department, inpatient, observation, and ancillary
    Improving chronic care delivery

To achieve success, Western Maryland determined that it needed a business intelligence and analytics solution to better leverage its data.

The health system wanted a solution that could be deployed quickly, would let users create their own dashboards and data views, and had the horsepower to aggregate data from multiple systems for better visibility.

The solution would need to integrate data from Western Maryland’s data sources, which included: the MEDITECH electronic health records system, eClinicalWorks for ambulatory patient information, 3M for coding and care management, and Kronos for time and attendance.

The hospital looked at major business intelligence players, including…