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Case study: University Medical Center of El Paso (UMC)

El Paso, Texas

Snapshot of University Medical Center of El Paso

  • University Medical Center of El Paso (UMC) is a 395-bed teaching hospital serving approximately 2.6 million individuals, the majority of whom are uninsured or enrolled in Medicaid. It’s also the only Level 1 trauma center within a 280-mile radius of El Paso, Texas, making it a critical part of the multi-national community in which it’s located.

    In 2012, UMC applied for and was accepted into the Delivery System Reform Incentive Payment (DSRIP) program. DSRIP is a state run, federally-funded initiative that incentivizes hospitals and other providers to improve health care access and delivery with a focus on Medicaid enrollees and low-income uninsured individuals.

    To receive DSRIP incentive funds, UMC must demonstrate that it has met certain performance metrics, including a reduction in preventable readmissions. This requirement necessitates the need for software that can help UMC measure, analyze, and improve its outcomes. UMC decided to deploy a range of powerful performance analytics from 3M Health Information Systems that enhance and risk adjust claims and EHR data to uncover data insights and address inefficiencies.

How does the 3M Health Analytics Suite aid UMC’s participation in its Delivery System Reform Incentive Payment (DSRIP) program?

"I can find out where we are at every point of the project. It has been a tremendous tool, and we intend to continue to use it as we move forward with DSRIP."

Oscar A. Perez
BS, MA, DSRIP program manager

Using data to drive care innovation

  • Like many providers in Texas—one of 19 states that didn’t expand Medicaid under the Affordable Care Act—UMC was faced with this difficult question: How could the organization continue to treat self-pay patients, including those with high-deductible health plans, without jeopardizing its own long-term financial viability?

    When Texas announced it would participate in the DSRIP program, UMC knew it had to apply, says David Smead, director of care management. Acceptance into the program would be an invaluable opportunity to reach UMC’s most vulnerable populations, reduce readmissions, and improve clinical outcomes—all while potentially qualifying for federal incentive funds that the organization could reinvest into clinical care, he adds.

Taking data analytics to the next level

  • Once accepted into the DSRIP program, UMC turned its attention toward data submission requirements, including the mandate to submit semi-annual reports to the state detailing progress in meeting specified metrics or milestones. For the first five years of the program, UMC analyzed and compiled readmissions data using a basic analytics tool. However, this process was time-consuming, prone to errors, and it required additional staff, says Oscar Perez, BS, MA, DSRIP program manager. When it came time to renew UMC’s existing coding software contract with 3M, the organization decided to add 3M performance analytics as well.

"With the 3M software, I literally push a few buttons, and the readmissions data is available to me within minutes."

David Smead
Director of care management

How 3M performance analytics aids participation in DSRIP

    1. Allows organizations to easily establish baseline metrics
    2. Provides risk-adjusted data for efficient outcomes reporting
    3. Helps organizations identify targeted opportunities to improve access and outcomes

    3M analytic solutions and risk stratification methodologies help UMC dive more deeply into its data to drive process improvement and qualify for DSRIP incentive payments. For example, the 3M readmissions analytics allows UMC to analyze recent readmission trends and easily identify the top five attending physicians with the highest percentage of all-cause 30-day readmissions.

Gaining data insights within minutes—not days

  • 3M performance analytics allow UMC to slice and dice the data more so than it ever could previously. Smead noticed an uptick in UMC’s 30-day readmissions, he was able to drill down into the cause. Within minutes, he identified the problem—patients with end-stage-renal disease who weren’t eligible for extended Medicare coverage. Many of these patients were waiting until they were in renal failure to present for dialysis at which point they were admitted to UMC for treatment. Through data analysis, Smead could determine that without ongoing dialysis treatments, many of these patients would likely be readmitted within a few weeks.

    With its previous software, this type of analysis would have taken days or even longer. “With the 3M software, I literally push a few buttons, and the readmissions data is available to me within minutes,” says Smead.

    In the final year of Phase 1 of UMC’s DSRIP project, the organization evaluated high risk discharge management and observed a nine percent reduction in its readmission rate. With the start of DSRIP Phase 2, they will be establishing new baselines using 3M PPRs, and this will be the methodology used for performance management and reporting going forward.

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