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Kentucky     Variance    % Variance    Prior
 Key Performance Indicators  Net Patient Revenue                            1,135                           20.0%  ($1,254,391)  -30.3%  $22,177,541
 Actual
  Budget
 Metric
                                         $4,906,009
    $4,941,692
 $5,886,666
 Supply Expense
                               -19.1%
                 ($944,974)
                                -5.1%
   $24,721,727
 $23,467,336
 Supply Expense % Net Patient Revenue
                    5.1%
                                25.5%
 25.1%
                                            22.1%
                   ($608)
                                           $2,003
 $2,612
 Supply Expense per EIPA
      $2,004
       1,110
                     25
                                 2.3%
                                            1,119
 Total Admissions
       4,896
                                            4,781
 Total Patient Days

 5,165
                    269
                                 5.5%
                                            2,450
                                -8.6%
 2,254
                    (212)
       2,466

 Total EIPAs
 IP Surgeries

 598
                                 4.4%
        573
                     25
 OP Surgeries
                                             522
                                             764
                                -6.5%
        825
                     (54)
 771

 Total Surgeries
 Outpatient Cath Lab Procedures                               173                              253                               (80)  -31.6%                              242
                                 0.0%
        103
 103
                                              99

                     -
 Site Performance Summary
 KY Supply is unfavorable to budget by $917K with increases in Admission by 2%, outpt surgeries 4.4%, cath lab 3%, and Total Gross
 Revenue 2.1%.  Experienced decreases in ED by 4%, Observations 1%, Inpt surgeries 31%, and MRI 12%.  The primary driver of the
 variance is due to the pharmacy drug supply spend running over budget by $539K.  This is essentially due to one patient that has used
 $433k of Feiba, antihemophilic agent, during his stay.  The pharmacy also received $217K in missed invoices from FFF that should
 have went into 2017.  The secondary driver is Implant other, unfavorable by $404K.  This is mainly due to an increase in Impella &
 AAA procedures; 8 impellas totaling $200k vs 2 in Jan 2017 and 6 AAA cases totaling $66K vs 2 in 2017.   Cardiology implant utilization
 is up 50% (187K) in CRM devices and 35% (29K) in our stent utilization over January 2017.  Flu related expense has increase supply
 spend in KY region by $37K.  Non-Medical supply is unfavorable due to $16K in IT equipment vs $700 in 2017.  Acheived savings in 3rd
 party $11K, 340B program $80K, Bulk buys $7K, and Aquamantys utilization savings at $4K.
 Key Challenges
 Kentucky Leader's Summary
 OR- Aquamnatys utilization is at 42 with 42 hips.  Savings of $4,320 on knees.
 Increased spend of $5k over last January on isolation supplies; isolation gowns, masks,
 Med/Surg
 stethoscopes and disposable bp cuff.
  Cath lab- 4 Cryocaths were placed totaling $18K vs 1 in 2017
 One patient on Feiba an antihemophilic agent spend is $433k for the month.  Reimbursement
 will be $472K.
 Rx
 FFF Invoices from 2017 totaling $217K.
 340B savings of $80K
 Cardiology Implants:  50% incremental usage in Pacemaker/leads (187K).  Stent utilization is up
 35% ($29K).
 Spine & Ortho Implants:  Increased Spine cases to 63 vs 54 last year.  2 Stimulator totaling $47K
 Implants  vs none last year.  Increased Ortho cases 116 vs 113.  Decreased Stem extenders by 12 ($10k).
 Implant Other:  8 impellas placed ($200K) vs 2 ($50K) last January.   4 AAA cases total $47K vs 2
 last year.  2 shunts placed at $10K vs none last year.
  Minor Equip:  $8K for two treadmills.  Will be reimbursed by Foundation.  $2,600 for Centrifuge
 equip at M&W.  Sleep Center Home sleep test was not repairable- $3,900
 Other Expenses
 Lab:  $21K in flu test kits ($15,080 Lourdes/$6,530 at Marcum) vs $6,906 in Jan 2017.
 Non-medical Equipment:  $15,946 in IT equipment vs $700 last year
 Actions Taken/Planned:
 Plan to be in line with all Med/surg product changes before the end of the month.
 3rd party savings at 10,822.  Bulk buy savings $6,390.
 Ortho Surgeons have stopped using Aquamnatys on the knees (90 days now) and they are
 being more careful of whom they use Extended Stems on.  Watching BMI and the reps have
 been made aware this product is not to be one opened in a case unless the surgeon specifies.
 Dr. Patel has been the biggest change.
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