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Patient and Product Line Management (PLM)

PLM System Overview

patient product line mgmt PLMWe’ve all been in this situation before. The CEO wants a report showing the profitability of our service lines. You’ve worked for over a week dealing with IT to get all the patient data downloaded for the past 6 months. Unfortunately, given all you have on your plate you really didn’t have time to validate it. You’ve built V-look ups in Excel and come up with a nice looking report in a format a third party told you the CEO wants. You finally have your meeting with the CEO and she wants to see the profitability for the orthopedic service line for the top 10 physicians, by payer and also show the fixed and variable costs by DRG. Your heart drops as you tell the CEO that in order to get this data you’ll have to get another download from IT and will need to redo all of the reports. She asks “how long” and you reply “about a week”.

With the KREG Cost Accounting/Patient Level Management (PLM) system you can provide her with this information in minutes, right on the screen. No more having to go back to IT and waiting a week for a response. With PLM you will point and click and “drill through” the data from service line, to physician, to payer, to zip code, etc. all the way to every patient record in the service line.

Here is what one KREG client had to say about our reporting and analysis capabilities:

There are several reasons why we use KREG’s PLM system, but the main reason is the speed of processing large data requests. Reports that would literally take 8-10 hours to process on our IT system can be completed in minutes on PLM.

An example from this morning was a report where I was able to produce 4 different iterations for the contribution margin for a particular service. It took me slightly over an hour to complete and discuss while it would have taken days on our HIS.

Decision Support Director, of KREG Client

plm profitabilityKREG Information Systems’ Cost Accounting and Decision Support (PLM) solution allows users to determine the true cost, profitability and resource utilization of every charge transaction within your healthcare organization. This includes service lines, DRGs, physicians, managed care contracts as well as individual patients. KREG offers a user friendly, point and click solution with powerful reporting and enhanced calculation methodologies. Our system has been installed in hundreds of facilities across the country either on-site or via our Cloud hosted SaaS solution.

Both options include our turnkey implementation service providing historical data and accurate, reliable and defensible costs for 100% of your charge items as well as automated ongoing imports. This enables our clients to “hit the ground running” from the first training session and maximize the return on investment with KREG as a true business partner.

Although our clients use the KREG solution in different ways, our implementation and training team focuses on leveraging the powerful capabilities of the KREG solution, coupled with years of experience, to deliver results in the following core areas:

  • Profitability, trending and query analysis of service lines, contracts, DRGs, physicians, patients, etc.
  • Dashboard reporting.
  • Up to 40 cost categories.
  • Hundreds of standard data elements plus 50 user defined fields for “point and click” reporting.
  • Best practice weekly/monthly management reporting.
  • Endless ad-hoc drill-through analysis with save capability.
  • No technical database management skills required.
  • No external reporting package skills needed.
  • Initial unit costs can be developed and maintained with or without Kreg assistance.
  • No additional staffing required.

Client Examples

Below are reports which document how KREG clients use PLM on a daily basis.

Volume and Net Revenue Trend Analysis

This client is particularly concerned with their volume trends and provides the information to the Chief Medical Officer and others in the organization on a regular basis. This example shows the Procedure Code grouped by the Surgical Product Line and has cases by year. They use this information to explain monthly variances in net revenues based on drops/increases in volume. They can see where the changes are occurring down to the surgical procedure and payer. If there are significant variances they just “drill down” into the detail to see what is causing the majority of the change (e.g., acuity change, market share change, payer mix change, etc.). They also generate these types of reports to analyze their ancillary volume changes.

patient product line mgmt 01

Quality Reporting

This client participates in a Blue Cross Blue Shield Quality Blue Program. This program emphasizes quality improvement cost reductions through selected measures, like decreasing admissions. Under this program the client qualifies for a boost in their payment rates based on their quality performance metrics. They qualified for the maximum payment incentive which is approximately an increase of $1,800,000 over current year payments.

This client uses the KREG PLM system as the primary source of data to be reported to Blue Cross. Each month they report on multiple quality measures such as readmissions within 3 days, 7 days and 30 days as part of this program. In the report below, you can see the filters that are used to automatically generate these reports each month as well as the information that is generated.

patient product line quality report 01

Lease vs. Buy Financial Analysis

This client was voted the #1 Top Small Hospital in their state in 2012 and has been using our Patient Level Management (PLM) and Management Cost Accounting (MCA) systems for the past few years for many types of financial analyses. They recently conducted a lease vs. buy financial analysis on their Cath Lab and here is what they had to say about their analysis and the KREG system.

We rely very heavily on KREG’s system. We do heart caths in the OR and the Cath Lab. KREG allowed us to really drill down through the data. We realized we would not have been able to do this prior to KREG. We were able to separate the Inpatient and Outpatient cases. We also realized a big part of the charges for the pacemakers were hitting another department, in our case Central Sterile.
KREG allowed us to use the Bill ID number and pull in all those charges. We realized our caths were actually quite profitable and it was our replacement pacemakers that were skewing our numbers. We receive on average $7,500 from Medicare for replacement pacemakers and our average cost of just the pacemakers is $10,500. Prior to KREG, we would not have been able to do any of this. ,

Below is one of the many reports they generated using the PLM database for their analysis. They are currently in the process of working with their physicians and vendors to reduce the cost of replacement pacemakers.

patient product line analysis 01

Contact Info - Georgia

 2 Piedmont Center, Suite 500, Atlanta, GA 30305

(404) 261-5734

(404) 261-6092

Contact Info - Connecticut

 101 Town Green, Suite 100, Wilton, CT 06897

(203) 762-2268

(203) 762-8748

Contact Info - Virginia

 7501 Boulders View Drive, Suite 630, Richmond, VA 23225

(804) 320-3461

(804) 323-3171