The second prioritization approach is to use a custom list of balanced criteria that gives meaningful weight to both cost and quality. While this option is slightly more time- and resource-intensive than the “easy button” approach, it won’t overextend your organization’s bandwidth if you approach it strategically.
Select a set of criteria to filter CVR opportunities
First, you need the right set of criteria that collectively factor in cost, quality, and ease of execution. The goal is to choose opportunities that will: net significant cost savings, be at worst be quality neutral and at best improve quality, and have the ‘do-ability’ factor (e.g., clinician engagement, available capacity, etc.).
Below are some sample prioritization criteria. We recommend picking at least one option in each category to meet the triple aim.
Cost per case
Variation in cost per case
Gap to benchmark (e.g. for utilization, cost per case)
Number/volume of patients impacted
Gap to benchmark (for readmissions, mortality, complications, or other quality metric)
Ease of execution
Physician engagement level
Availability of physician champion(s)
Level of effort/change required to standardize
Weigh cost criteria against other prioritization criteria
The second step is appropriately weighting the chosen prioritization criteria.
Some organizations introduce cost criteria by modestly weighing it between 10% and 30% of the overall criteria. Other organizations that have more aggressive cost savings targets weigh cost as high as 50%. There’s no right or wrong answer—it largely depends on your organization’s CVR ambition and cost savings goals. The key is to have a weighting that the entire executive team can get behind.
Apply cost criteria as your first filter
The final—and perhaps most important—consideration for this approach is the order in which you apply the criteria you’ve selected. We highly recommend using the cost criteria as the first filter for an initial cut of CVR opportunities. Then, further narrow the list with the quality and ease of execution filters you’ve chosen.
There are two main benefits of using cost as the first filter of CVR opportunities. First, it guarantees that your final list of conditions will net significant cost savings. Second, screening by cost opportunity before engaging clinicians sets clinicians up well to focus on the quality opportunity.
While some organizations have the analytic capabilities to do the initial cost cut of CVR opportunities themselves, many tell us it is the most time-consuming step of prioritization. It can be challenging to gather consistent cost data across every facility and every service line. To help, we’ve created a tool that does the initial cost cut for you in seconds: The CVR Opportunity Assessment.
Using your organization’s Medicare Fee for Service data, The CVR Opportunity Assessment will:
- Identify excess costs and excess days at your selected hospital(s), which translates to the potential cost savings and LOS reduction opportunity from reducing care variation.
- Identify the primary service lines, MS-DRGs, and cost centers that are driving those opportunities—and rank order them.
- Compare your organizations’ costs to custom benchmarking groups—including national performance, your own internal performance, a custom benchmarking group that you create yourself within the tool, and top-quality performers.
To size your organization’s CVR cost savings opportunity, access the CVR Opportunity Assessment.