Page 65 - CombinedTest_Neat

Site Performance Summary:
Including our annual periodic inventory adjustment of $1.2 million Lima's
supply expense is under budget by $364K (4.8%). Excluding the annual
inventory adjustment, our Lima supply expense was over budget by $801K
(10.6%) driven primarily by strong volumes in Spine ($173K) and Ortho
($113K) service lines in Surgery and new supply-intensive procedures in
Cath Lab ($243K).
Spinal implants were over budget by $166K (80%) due to high fusion
volumes ($59K) and high stimlator procedures ($86K). Tissue usage for
spine surgeries also added to the Implant-Other negative variance ($49K).
Ortho Implants were over budget by $106K (66%) due to 52% increase in
TJR volumes ($53K) and 400% increase in the supply-intensive Total Joint
revision volumes ($60K).
While overall Cath Lab volumes were lower than previous months, new
specialty procedures have increased supply costs significantly in Cath Lab.
Overall, Cath Lab was just slightly over budget by $25K (4.4%), but the new
Neurointerventional ($56K), Watchman ($54K), and Cardiomem
procedures ($133K) significantly inflated supply costs. Higher utilization of
Impella and Occluders devices in Cath Lab also contributed to the Implant-
Other variance ($51K).
Last, our instrument spend was over budget by $90K due to addition of
more sets to reduce need for flashing of instruments between sets.

Key Challenges: 2-3 key contributors for each expense subaccount
Lima Leader's Summary Med/Surg 307,878 Sets. Incremental Impact $101K Savings
21 Neurointerventionalist cases in Cath Lab- Emboshield, Micro Caths,
Revascularization Devices, misc caths, guidewires, sheaths. Incremental
impact $43K
Reallocation to other expense codes such as Endomechanical and IV/IV

Home Infusion- 6 month usage of enterals/nutritionals held for pricing
dispute. Incremental Impact $106K

Positive variance due to $902K inventory adjustment for Employee
Pharmacy and OP Oncology inventory increases.
Chemo volumes down 15% in December. Higher costs for alternative
Rx
841,645
sources of IV solutions.

(187,153)
impact $157K
Spine- Strong spine fusion volumes ($59K) and high neurostimulator
(165,836) CRM- 10 Loop Recorders ($24K); 7 new Cardiomems ($133K). Incremental
volumes ($86K). Incremental impact $145K
Implants Ortho – Total Joint volumes up 52% ($53K). Revision volumes up 400%
(105,724)
($60K). Incremental impact $113K
Implant Other – Over budget by $128K. Watchman ($51K); 2 Impellas
(128,493) $25K; 5 Occluders $26K; Grafton & Infuse for Spine Surgeries $49K.
Incremental impact $151K
Endomechanical- Reallocation from Med/Surg
(70,318)

Physical Plant/Maintenance- removal of CHI invoices.
43,369
Other Expenses
Instruments- Large volume of misc instrument purchases/replacements to
minimize flashing per Joint Commission standards ($64K). New
(90,645)
instruments for new Neuro & ENT phsysicians ($26K).
Actions Taken/Planned:
Volume Data Summarized Spine Detail by Hardware, Tissue, Service.
rd
Alt Sourcing Total 3 party vendor savings: $5K in savings. MEMData savings= $306
Made good progress in December. Need to finalize several volume and
Revised MOR Tool
budgetary figures.
Cardiomem coding Get Cardiomem account numbers for coding verification