1 / 28

WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis

WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis COL Bobbilynn H. Lee U.S. Army - Baylor HCA. Agenda. Background Facility Service Area BCA Synopsis Analysis Questions. Womack. Fort Bragg, North Carolina Tricare Region 2

fawn
Download Presentation

WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis COL Bobbilynn H. Lee U.S. Army - Baylor HCA

  2. Agenda • Background • Facility Service Area • BCA Synopsis • Analysis • Questions

  3. Womack • Fort Bragg, North Carolina • Tricare Region 2 • Medical Center w/ Level I ER • Approximately 157,000 beneficiaries • Clinic Facilities • Joel Health and Dental • Robinson Health Clinic • Clark Health Clinic

  4. Lead Agent Region Two

  5. Duke University Medical Center FT Bragg, N.C.

  6. Business Case Analysis

  7. Background • No ESWL at Bragg • National Standard of Care • Not meeting Tricare Access Standards • 80 miles, 3-5 week delay • Patients electing stone surgery • Longer recovery

  8. State of the Art Urinary Stone Treatment

  9. Benefit Drivers State of the Art

  10. Stone Composition Calcium Oxalate Monohydrate- 97%, protein and blood 3%  Calcium Oxalate (Monohydrate form-10%, Dehydrate form-59%), Calcium Phosphate (Carbonate form- 7%, Hydroxyl form-21%), protein and blood-3% (Gall stone)- Cholesterol- 96%, Calcium Bilirubinate- 2%, Mixed Bile Pigments- 2% Calcium Oxalate Monohydrate- 98%, protein- 2%

  11. LithotripsyBenefits • Avoid Surgery for Stone (basket, cut) • Continuity of care • Quick return to work • Meet access standards, 4 weeks, one hour drive

  12. Performance Measures • 32 procedures annually • Direct care - 60 stone cases in OR per year • 60 other cases could be done by freeing up OR space

  13. Goals & Objectives • Recapture $48,902 Revised financing • Cost avoidance $214,920 for 90 OR procedures • Eliminate 60 urology invasive procedures a year • Free up 60 surgical suite rooms annually Increased satisfaction due to access • Third Party Reimbursement $22,222 annually • Recapture 96 ESWLs per year (8/mo) • Recapture 58 surgical cases / year

  14. Measures of Success • Prime/ AD Beneficiaries: • Surgical procedures / OPVs in MTF increase • Surgical procedures/ OPVs provided by Network provider increase • Decrease Revised Financing, Supp care

  15. Measures of Success AD and Prime Pts • 95% reduction in network ESWLs • 95% reduction in stones done in OR • Minimum of 58 fewer referrals to network annually

  16. Alternatives • Equipment Purchase $350,000 • Resource sharing not an option • Surgery Not Considered: • 1986 Send Urologist to downtown facility • Mobile lithotriptor • Joint Venture with regional facilities

  17. Financial Implications • Recapture $48,902 MCSC Rev Fin • 60 OR rooms available = $ 214,920 Cost Avoidance • $1,929/procedure =$22,222 Sup Funds • 96 procedures @ $1,700/proc, $163,200/yr

  18. Economic Analysis: • 3 year investment $489,600 • Net ROI on 3 year investment:$225,200 • Annual target recapture • 96 OPVs • 60 Surgical Procedures • $501 more expensive per procedure than outsourcing

  19. Risks and Interdependencies • Projected loss of Urologist Not Considered: • Number of stone cases

  20. Performance to Date • Started 22 October 2001 • Breakeven 1 Feb 2002 • Reached target • OPVs 145/ mo; target 75 OPV/mo • ESWLS 34/ mo; target 27/mo

  21. Surgeon General’s Site • Army medical command knowledge exchange • https://ke.army.mil/ • BCAs, all forms, follow-ups • FY 03 Group 2 Venture Capital submissions

  22. BCA Virtues • Standard of care • On track with milestones • Extremely well written • Beautiful statistics

  23. What Went Wrong • Pay $500 more Per Procedure • Lost Urologist • Workload decreased, no cost avoidance or refinancing recapture • Unable to free up OR room, no increase in OR cases • How many stone cases

  24. Comparative AnalysisWBAMC Litho Initiative • Ureteroscopy (surgery) cost vs. ESWL • $134k(3k per) 40 pts vs $26,000 (1k per) 23 proc • Solicited VA pts as well

  25. Additional Alternatives to Consider • Send military urologist downtown, • save professional fee • Will work for other procedures, Tread mills, etc • Joint venture with regional facilities for mobile unit

  26. Lessons Learned • Look for model, its all been done before • Don’t allow faulty assumptions • Even the best written can be entirely wrong • When in doubt, call a fellow Bear

More Related