Background and challenge
The client, a leading regional multispecialty group with primary care physicians and specialists, was capitated for its member population and has identified concerning trends in hospital admissions and bed days. L.E.K. Consulting was engaged to identify the sources of underperformance and develop a performance improvement plan that addressed controllable sources of variation, including in its primary care group.
Approach and recommendations
We first identified the root cause of performance variance by comparing admission rates among like cohorts across different regions and found high and low performers within each region. Extensive interviews of client personnel as well as rigorous analysis of site admission data, process maps, PCP admission rates and hospitalist access revealed four key sources of variance.
Next, we developed a performance improvement plan comprising trackable initiatives to address controllable sources of variation. Initiatives were based on organizational and industry best practices to proactively manage the high-risk population, coordinate care of sick patients and avoid unnecessary ER admissions. We also developed a framework to track and monitor the controllable sources of performance variation.
Our rigorous, data-driven analysis and deep industry experience enabled L.E.K. to identify sources of performance variance and develop a performance improvement plan. The improvement plan provided specific, trackable activities and enabling practices for PCPs, ERs and hospitalists to target controllable variance. The client implemented the plan and leveraged our tracking framework to demonstrate improvement and develop methodologies for ongoing assessment. The client demonstrated continuous improvement and was acquired by a leading healthcare services organization in a multibillion-dollar deal.
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