Page 132 - CombinedTest_Neat

Site Performance Summary:
St. Elizabeth Boardman's supply expense is under budget budget by $546K
(21.3%) including adjustments per the recent inventory count. Excluding
these adjustments the facility was $23K (.9%) over budget on a mix of low
inpatient and high outpatient activity. Outpatient surgery volume was
strong, coming in at 55 cases (15%) ahead of budget, while inpatient cases
missed by 32 (20%). The primary driver of the overall expense variance was
implant expense, both total joint and implant other. Tendon/nerve biologic
product use is on the increase, with a total of $30K impact in December.
Facility to review this category as well as Propel drug-eluting sinus
procedure ($16K in December) for effectiveness and contribution margin.
Orthopedic expense has shown some improvement with the demand match
tool, however need to push for adoption beyond Dr. T. Boniface. Drugs
exceeded budget by $56K due in part to the new outpatient Pharmacy that
opened in November and 340B ramp-up expense. Medline LUM fees were
($52K) and Omnicell freight expense ($42K) were reclassed, resulting in an
St Elizabeth Boardman Leader's Summary
$88K positive variance.

Key Challenges: 2-3 key contributors for each expense subaccount
IVs and IV sets exceeded budget by $21K as the facility purchased inventory
to support the Braun IV conversion. It is estimated that half of this overage
can be attributed to the conversion.
Med/Surg $49K in Newborn Metabolic Screening Kits were erroneously expensed to
Medical Surgical and were reclassed.
A Radiology supply room experienced flood water damage resulting in $5-
7K expense to replace wasted supplies.
Outpt Infusion meds up $12k total; Nucala $23k, Ocrevus $16k (new MS
Rx drug), Entyvio $10k, Remicade down -$39k, Xolair down -$31k
Surgery meds up $23k, Neostigmine up $23k
Ortho came in over budget by $21K (10%), however is in-line with volume.
Average price per knee $4,203. Stryker: $3,969 Zimmer: $4,698
Avg price per hip: $4,623 Stryker: $4,625 Zimmer: $4,621
It appears there is opportunity to improve on device matching as facility is
not hitting the 80/20 Standard:Advanced construct ratio.
$13K Revision hip performed in December, revisions not common at this
site
Implants
Two physicians are using biologics for hand case tendon/nerve repair -
Axogen and Integra, facility to review - pricing, reimbursement,
effectiveness. $30K spend in December
Propel drug-eluting implant volume is running a consistent $16K+ per
month. This portion of the ENT business requires contribution margin
review. $17K urology neurostim implanted in December - review
contribution margin and monitor going-forward
Red Cross blood expese exceeded budget by $17K. Blood is transferred
from St. Elizabeth to other MHY acute care facilities by Red Cross - the
vendor was behind in "truing-up" expense, credits have been applied to
SEYH, additional expense hitting SEBH and SJWH.
Other Expenses
Freight came in $88K under budget due to $52K in Medline LUM fees
reclassed from freight to purchase services, as well as a $42K Omnicell
freight charge credit
Actions Taken/Planned:
Strong hernia volume at Boardman, work to better understand/track spend.
Volume Data
Volume/expense lost in the wide Implant Other bucket.
Alt Sourcing
Capital Avoidance