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Download Can Provider Preference Items be Better Guided by Formularies?
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Can Provider Preference Items be Better Guided by Formularies? Product formularies help drive savings and create standards for multiple items in a large integrated delivery network. Cheri Berri-Lesh, CMRP Value Analysis Manager A picture is worth a thousand words Knee Brace in MMIS (Lawson) Knee Brace in Visual Formulary KNEE PULL UP WITH 1 STRAP ON TOP AND BOTTOM PATELLOFEMORAL BRACING HAS HINGES 211395 211399 211398 211399 211400 211401 211402 211403 211404 211405 211406 211407 211408 211409 BRACE KNEE LITE RT XS TRU PULL • Bifurcated (twopronged) strap pulls the BRACE KNEE LITE RT SM TRU PULL patella into proper BRACE KNEE LITE RT MED TRU PULL alignment reducing pain associated with BRACE KNEE LITE RT LG TRU PULL patellofemoral BRACE KNEE LITE RT XL TRU PULL dysfunction BRACE KNEE LITE RT XXL TRU PULL • Dual Durometer BRACE KNEE LITE RT XXXL TRU PULL Buttress System interfaces directly with BRACE KNEE LITE LT XS TRU PULL the patella applying a BRACE KNEE LITE LT SM TRU PULL consistent corrective force to reduce pain BRACE KNEE LITE LT MED TRU PULL BRACE KNEE LITE LT LG TRU PULL • Independent anchors at the thigh and calf BRACE KNEE LITE LT XL TRU PULL prevent rotation of the BRACE KNEE LITE LT XXL TRU PULL brace BRACE KNEE LITE LT XXXL TRU PULL Insurer and Delivery System Operating Revenue $3B Integrated Delivery Network Member Governed 600,000 Members 25 Medical Centers 9,750 Staff 1,055 Providers Reasons to Consolidate & Standardize To achieve best contract pricing Reduction in variation No durable medical equipment license Some Healthcare Common Procedure Coding System (HCPCS) codes eliminated Create standard process Changing the culture of “if I want it, I get it” to one of collaboration and standardization How it Began! Gemba Process Walk Road to Reducing Variation Representation of Initial Choices Physician Attendance Varied Partner Collaboration Orthopedic Vendor Representatives Key objectives included standardization & cost savings Partnered with Materials Management to captured all product categories and annual usage An opportunity to identify products improvement or elimination Identified products for item and cost savings reduction Orthopedics Soft Goods - Before 720 Items 300 265 250 200 181 150 BEFORE 112 100 42 50 43 31 30 16 Sh ou ld er ec k N Le g an d H Fo ot /A nk le C as t Sh oe s Bo dy Ar m 0 2008 $521,000 720 Items Orthopedics Soft Goods - After 2008 $521,000 720 Items 250 Items 300 265 250 200 181 BEFORE 150 103 AFTER 112 100 50 2011 $419,000 250 Items REDUCTION 42 14 49 43 30 44 19 31 16 17 4 0 Spend = 19.5% SKU = 65% de r Sh ou l Ne ck Le g Ha nd Fo ot /A nk le ho es Ca st S Bo dy Ar m 0 Manufacturers From 84 to 29 Sample of Ortho Soft Goods Visual Formulary Expanding Use of Visual Formularies More commodities added ◦ Wound Care: Advanced & Acute ◦ Cast, Padding & Splinting ◦ Medical Tapes ◦ Disposable vaginal speculum systems ◦ Infection Prevention Product Standards & Formularies Advance Wound Care - Before Advance Wound Care - After Cast, Padding and Splinting Tapes Disposable Vaginal Specula Infection Prevention: Hand Products Infection Prevention: Hand Products Infection Prevention: Face Protection Infection Prevention: Face Protection Infection Prevention: Nonsterile Gloves Partnering with Experts for Visual Formularies Orthopedic physicians, physician assistants & technologists Wound Care RN & University of WA Professor Infection Prevention Team Perioperative Services Safety and Environmental Health Officer Materials Management Specialists The Benefits to a Visual Formulary Standard Work Reduction in Spend Provides Shopping list Clear Communication Visual Formulary Benefits Increases Contract Compliance Patient & Staff Safety Rapid ID of Errors or Defects Summary Challenges addressed Consolidating needs of multiple physicians Working with preferences versus needs Seeking agreement Large geographic area Finding quality pictures Formatting for ease of viewing Summary Steps/process created Order history review Collecting multiple product samples Product demonstrations road shows MMIS cleanup including description improvements Formatting images Entering into Excel Engaging with staff & active listening Summary Key players involved Materials Management Participating departments Vendors Distributors Physicians & nurses Infection Prevention Summary Outcomes achieved Established supply formularies Visual communication tool used as shopping list Defines best practices Managed by Value Analysis Program Reduced costs & SKU’s Promoted Lean visual systems in other areas Summary Pre-requisites Product familiarity Engaged vendors and distributor Engaged Materials Management staff Support of Purchasing & Contracting Staff Questions? Contact information Cheri Berri-Lesh [email protected]
