Our client an 900 bed Academic Medical Center was in the midst of a case management program redesign and expansion effort. This required an expansion of both ED and inpatient case management programs leaving the organization significantly understaffed which negatively impacted the implementation of their plan. Due to the increased demand and shortage of talent in the care management space, the organization struggled to quickly build out their team so they turned to Meleeo Healthcare Solutions.
Meleeo quickly responded delivering a stabilizing team of experienced interim case management professionals. This teams presence allowed the client to move forward with their implementation as planned. Once the stabilization team was in place we started the process of identifying and delivery more than 10 full-time professionals to backfill the positions currently being covered by the stabilization team. Understanding the tremendous shortage in experienced acute care case management talent the Meleeo team identified an experience profile for a group of professionals who have the necessary mix of clinical and soft skills to quickly assimilate into the case management department. This profile coupled with an educational program has been successful in providing a sustainable solution for the client and effectively eliminated their talent challenges.
A Children’s Hospital with a high volume of ED visits had been unable to adequately staff their ED with UR support outside of normal business hours. Data indicated a high influx of patients in the evenings and weekends resulting in a high denial rate.
Leveraging a managed UR solution for their coverage gaps on evenings and weekends. The adequate coverage and implementation of a robust reporting system allowed for better management, tracking and prevention of denials while providing valuable insight for physician documentation improvement. As a result, revenue increased $1.7 million in one year through appropriate identification of patient status, resulting in a 4% increase in net patient revenue. Ancillary benefits included an increased understanding of pediatric care guidelines, documentation improved, observation rates reached appropriate levels.
Our client a large national for-profit health system was struggling with inexperienced leadership and turnover at the site level. This caused multiple facilities throughout the system to fall out of compliance with corporate performance expectations. Due to the increased demand and shortage of talent in the case management space the organization struggled to identify appropriate talent so they turned to Meleeo Healthcare Solutions.
Meleeo quickly responded delivering a stabilizing team of experienced interim case management leaders to multiple facilities throughout the country to operate as Directors of case management. The team quickly assessed operations, delivered a 30 day review of people, process and technology for the site and corporate leadership then began implementing changes. Initiatives included LOS reduction, ED program expansion, OBS rate reduction, technology implementation, mentoring of junior leaders, model redesign and implementation. Actions taken resulted in decreasing OBS LOS by 48% at one facility, Decreased denials by 15% at another, Reductions in LOS ranging from .5 – 1.5 days in 3 months. Overall process improvements and cost reductions resulted in an over $2.5 Million return on investment to the health system.