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Site Performance Summary:


                                             Overall supplies over budget by $1,526,065. The annual periodic inventory
                                             adjustment attributed to $793,921 of the variance. The remaining variance
                                             was driven implants due to volume increases in high cost procedures
                                             including 24  spinal fusions ($261K),11 knee revisions ($155K), 4 External
                                             Fixations ($101K), 5 Watchmans ($85K) and 5 Occluders ($47K).

                   Key Challenges: 2-3 key contributors for each expense subaccount
                                             Periodic inventory adjustment was unfavorable for Cath Lab totaling $453K



                                             Periodic inventory adjustment was unfavorable for surgery totaling $137K
                            Med/Surg
                             ($453K)

                                             3 DNE External Fixation totaled $51K
                                             1 large Stryker External Fixation procedure totaled $50K


                                             Periodic inventory adjustment was unfavorable for pharmacy totaling
                                             $387K
                               Rx
                 Leader's Summary
                             ($252K)



                                             Implant other over $533K and over prior year $266K. Main drivers of this
                                             variance include $132K in cardiology implants (5 Watchmans and 5
                                             Occluders), $56K for 28 wound care grafts, $50K in biologics used in spine
                                             procedures, and $42K in bone products used in podiatry procedures.

                            Implants
                             ($831K)         Increase in knee revisions from 6 in 2016 to 11 in 2017 adding $83K
                                             Average cost per knee implant down $464 due to the new joint contract.

                                             Increase in spinal fusion procedures from 14 in 2016 to 24 in 2017
                                             Cost per procedure up slightly from $8,745 in 2016 to $8,817 in 2017

                                             Blood Expenses were over budget by $94K. However, spending in line with
                                             run rate and 2018 budget


                                             Instruments over budget by $42K. Reclassification of supplies previous in
                                             other categories made up $24K of the variance. One large Progressive
                         Other Expenses      Medical tray for the cardiovascular service line added $11K to the variance
                              $10K
                                             Favorable variances driven by Physical/Plant Maintenance ($40K) due to
                                             the transition to GE for clinical engineering, freight ($85K) due to
                                             reclassification of LUM services charges to purchase services, and
                                             laundry/linen ($34K) due reclassification of linen rentals to purchased
                                             services.
                   Actions Taken/Planned:
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