Blood from a turnip. Financial models in case management

Area of Science:

• Healthcare Management
• Health Economics
• Clinical Informatics

Background:

• Healthcare systems face increasing pressure to control costs while improving patient outcomes.
• Effective case management is crucial for navigating complex patient journeys and resource allocation.
• Integrating financial and clinical data offers a powerful approach to optimizing healthcare delivery.

Purpose of the Study:

• To evaluate the financial and clinical impact of a comprehensive case management program at Baptist Health System.
• To demonstrate the effectiveness of combining financial cost data with clinical information.
• To highlight the role of case managers in achieving cost savings and improving patient care.

Main Methods:

• Implementation of a comprehensive case management program integrating financial and clinical data.
• Development of a financial model to measure cost at the patient/day level.
• Collaboration between physicians, clinical experts, and case managers to analyze cost information and improve patient care.

Main Results:

• Achieved over $5.4 million in savings within a 3-year period.
• Demonstrated significant improvements in patient care across the continuum.
• Successfully integrated financial cost data with key clinical information.

Conclusions:

• Comprehensive case management programs, supported by integrated data and empowered case managers, lead to substantial financial savings.
• Healthcare institutions can achieve significant clinical process improvements and cost reductions by investing in case management resources.
• The Baptist Health System's model provides a scalable framework for other institutions to enhance efficiency and patient outcomes.