Transforming Clinical Practice Initiative (TCPi)-Colorado

 

CMS posts each exemplar practice’s achievement to a registry, so all the 140,000 TCPi participants can benefit from the shared knowledge and, it’s hoped, adopt successful practices. Among the HealthTeamWorks-assisted practices, cost-savings data included:

  • A large arthritis clinic began prescribing Medicare Part B patients a biosimilar drug in the office in March 2018.
    • Intervention data from March to July 2018 shows a cost savings of $64,024, averaging $300 savings per patient, which can be extrapolated to $192,072 a year in savings.
  • A large orthopedic practice had a previous protocol to conduct three post-operative images for patients with foot and ankle surgery. In July 2018, a physician implemented a new protocol: complete one post-operative image unless otherwise necessary. By reducing the number of images for postoperative patients, the practice avoided 62 unnecessary images from June to December 2018.
    • Cost savings for one physician is estimated to be $6,324 per year.
    • The practice will spread changes to other 17 physicians. Expected annual cost savings across all surgeons is $107,505.
    • The practice will extend post-operative imaging protocols to additional procedures in 2019.
  • A pulmonary practice used targeted text messaging for COPD patients who are admitted to the hospital to be enrolled in an online “trip wire” program in an effort to reduce COPD readmission. The text messaging system asks patients if they are having any difficulties since discharge.
    • Patients who respond “no” see their mid-level provider within 14 days of discharge, as per the standard protocol for follow-up.
    • Patients who respond “yes” receive a call from an RN within 24 hours of the text response.
    • Patients who do not respond to the text messaging system receive a call from an RN as well.
    • Patients with complexity are seen sooner than the usual 14-day follow-up appointment.
    • On average, readmission for COPD is $10,500. Since implementing this intervention in 2017, fewer following readmissions occurred, resulting in $121,868.89 in cost savings over 2 years.
  • In 2018, a spine care practice ordered 165 images, for which 100 percent of patients are sent to the lowest-cost facility rather than to a hospital location. The average per-image cost from a hospital location is $530-850, compared to $450 at non-hospital imaging center. The savings from ordering imaging in the lower cost setting ranges from $13,200 to $66,000 for 2018.

Interested in learning more about practice facilitation and CHITA services? Call HealthTeamWorks at 303.446.7200, or email solutions@healthteamworks.org.