slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis PowerPoint Presentation
Download Presentation
WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis

Loading in 2 Seconds...

play fullscreen
1 / 28

WOMACK, FT Bragg, NC Lithotripsy Initiative (Urology) Business Case Analysis Synopsis - PowerPoint PPT Presentation


  • 128 Views
  • Uploaded on

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

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
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.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

WOMACK, FT Bragg, NC

Lithotripsy Initiative (Urology)

Business Case Analysis Synopsis

COL Bobbilynn H. Lee

U.S. Army - Baylor

HCA

agenda
Agenda
  • Background
  • Facility Service Area
  • BCA Synopsis
  • Analysis
  • Questions
womack
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
slide5

Duke University

Medical Center

FT Bragg, N.C.

background
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
slide8

State of the Art

Urinary

Stone Treatment

slide10

Benefit Drivers

State of the Art

slide11

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%

lithotripsy benefits
LithotripsyBenefits
  • Avoid Surgery for Stone (basket, cut)
  • Continuity of care
  • Quick return to work
  • Meet access standards, 4 weeks, one hour drive
performance measures
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
goals objectives
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
measures of success
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
measures of success1
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
alternatives
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
financial implications
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
economic analysis
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
risks and interdependencies
Risks and Interdependencies
  • Projected loss of Urologist

Not Considered:

  • Number of stone cases
performance to date
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
surgeon general s site
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
bca virtues
BCA Virtues
  • Standard of care
  • On track with milestones
  • Extremely well written
  • Beautiful statistics
what went wrong
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
comparative analysis wbamc litho initiative
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
additional alternatives to consider
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
lessons learned
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