1. Value Analysis in the Hospital Laboratory Terry McIntire
MT(ASCP) Value Analysis Coordinator JPS Health Network
2. JPS Health Network 6000 employees Level 1 trauma center 537
beds Over 50 clinics > 4,500,000 laboratory tests per year
3. Value Analysis Program Organized and Started by Owens and
Minor in Oct 2012 o 6 Value Analysis Teams o 1st Full Year o $2.55
million annualized savings $0.46 million Laboratory o 113
Initiatives implemented 14 Laboratory Initiatives
4. VAT Program Structure 4 Cardio/ Imaging VAT Peri- Op VAT
Support Services VAT Patient Care VAT VASC Admin Services VAT
SUPPLY CHAIN MANAGEMENT SUPPORT Lab VAT AD-HOC SUPPORT Bio-Med
Infection Control Finance Risk Management Decision Support
Facilities HR Performance Acceleration RX (P&T) IT
5. Value Analysis Program Transitioned from O&M to JPS in
October 2013 2 Value Analysis Coordinators growing to 3 in near
future o 6 Value Analysis Teams have grown to 9 o 2nd Year to Date
(year ends in September) o $7.58 million YTD annualized savings
$2.44 million Laboratory o 132 Initiatives implemented YTD 21
Laboratory Initiatives implemented YTD
6. VAT Program Structure 6 Cardiology Radiology VAT Peri-Op VAT
Support Services VAT Patient Care VAT VASC Admin Services VAT VALUE
ANALYSIS COORDINATORS - SUPPLY CHAIN MANAGEMENT SUPPORT Lab VAT
AD-HOC SUPPORT Clinical Engineering Infection Control Finance Risk
Management Decision Support Facilities HR Performance Acceleration
RX (P&T) Service Contracts VAT IT VAT
7. Look at Reference Laboratory Testing Quick savings Hot List
Review often. Have new tests been added at non discounted prices?
Are panels ordered when only individual test is needed? ANA test vs
profile is good example Vitamin D There is more than one and more
than one way to measure 25-OHD less expensive and ordered most
frequently 1,25 OHD more expensive, frequently ordered in error JPS
saved $84,000 per year by internalizing
8. Quick savings continued Is that super accurate test really
needed? If using a bucket gives the results needed, why spend for
mass spectrometry?
9. Quest by any other name. Hospitals frequently have multiple
accounts all belonging to same Corporation Are all really needed?
Are the charges different for the same test from the different
divisions of the Corporation? $75 vs $15 for same test was
discovered at JPS $290,000 annual savings for JPS Could switching
to a different division of the same lab produce savings?
10. Keep Looking at Reference Labs Labs will almost always bid
below GPO pricing Better pricing may be obtained without changing
labs JPS saved $400,000 per year by putting out RFP and changing
labs another $200,000 might be possible Reference Lab RFP
11. You use how many labs??? Do you really need 30+ reference
labs? The major laboratories offer much of the testing done by
secondary labs Get help from pathology with physician preference
labs Prices are negotiable with secondary laboratories. begin by
asking JPS obtained 25% discount from Prometheus just by
asking
12. Pathology Reference Labs Many tests formerly done by niche
labs are now offered by bigger players at lower prices Consolidate
to fewer labs Internalize testing
13. Why send it out? Internalize high volume assays. Can your
molecular lab do that assay? PCR testing has become simpler, but is
still expensive if sent to a reference laboratory TB blood test
save $30/test Vitamin D earlier slide
14. Why Keep It In-house If the test is done infrequently Can a
reference lab meet your turn around time need? Is it worth the
reagent, QC material and tech time cost? Negotiate reference lab
price before sending first specimen.
15. Point of Care Control point of care testing Is there a real
need for this test to done if it is 3-5 times more expensive than
if done in-house? JPS limited the number of A1c tests done POCT
Volumes and variety of assays keep increasing. More competitors in
market JPS switched to better technology and still saved $90,000
for CLIA waived POCT Flu kits
16. Butterflies Limit use of butterflies for phlebotomy $81,000
savings
17. Courier Service Switched from contract couriers to JPS
couriers Eliminated courier runs when testing not affected If
testing only done once per day for a send out to another hospital,
just send the specimens once per day $25,000 savings at JPS
18. Blood Bank Quick and Easy Obtain credit from local blood
bank for blood drives conducted at your hospital for JPS ~ $6,000 -
$8,000/year
19. Blood Bank Waste Reduction Process changes PAR reduction
Return soon to expire units to Blood Bank vendor $150,000 savings
for JPS
20. Blood Bank Blood Utilization Reduction Work with Medical
Staff on transfusion policies Set thresholds for transfusions Over
$500,000 annual savings for JPS
21. Whats next? Reagent deals for high volume assays
Consolidation of satellite labs Look at national market for blood
products Keep looking at Reference Laboratories Just keep
working
22. Questions Comments Suggestions When was the last time you
did something for the first time?
23. Terry McIntire MT (ASCP) Value Analysis Coordinator JPS
Health Network 1500 S Main St Fort Worth, TX 76104 817-702-1452
[email protected] http://www.linkedin.com/in/tdmcintire
www.twitter.com/tdmcintire