Containing clinical costs in a safe manner in hospitals is crucial in the new value-based era of care.
Ian Newmark, MD, chief of the division of critical care medicine at North Shore University Hospital at Plainview (N.Y.) and assistant clinical professor of medicine at Hofstra North Shore-LIJ School of Medicine in Hempstead, N.Y., discussed clinical cost containment in hospitals and some of the barriers to implementing cost-containment strategies at the Becker's Hospital Review 6th Annual Meeting in Chicago May 9.
Reducing patient lengths of stay has been one of the main targets for clinical cost containment in hospitals.
"We've all focused for many years on reducing length of stay because it's considered the ultimate goal," said Dr. Newmark. "That said, many hospitals have hit something of a plateau with reducing lengths of stay because there are some forces that are just outside of our control, so we need to focus on other areas."
Other clinical cost-containing areas hospitals can focus on include reducing unnecessary direct and indirect costs of clinical services, including radiological and laboratory testing, blood transfusions, transitioning patients to less expensive facilities, antibiotic stewardship and palliative care.
"In all of these areas, there is huge potential to reduce costs, which is not really something the administrator with a clipboard can affect," said Dr. Newmark. "These are areas the clinicians really have to affect with the support of the organization's leadership."
One way hospitals can contain costs is by implementing EHR alerting systems that notify clinicians when they've ordered tests or antibiotics with less expensive alternatives.
Some of the biggest challenges facing providers interested in implementing cost-containment strategies include:
1. Capital investment requirements
2. A growing need for data analytics and EHRs
3. Fostering culture changes and physician buy-in at hospitals
4. Fear that reducing costly tests and lengths of stay will lead to medical malpractice litigation
5. Finding competent physician champions, administrative leaders or a clinical optimization officer to spearhead cost containment efforts