As hospitals contend with mounting cost pressures, reducing low-value care has emerged as both a clinical and financial imperative.
During a recent Becker’s Healthcare webinar, leaders from Fairfax, Okla.-based Ardent Health and Premier’s Stanson Health shared how they achieved measurable ROI in just 90 days by implementing a systemwide clinical decision support program.
Here are four key takeaways:
1. A systemwide approach
Low-value or unnecessary care may account for more than $300 billion in U.S. healthcare spending annually. Ardent Health partnered with Premier to implement a clinical stewardship platform that combined real-time decision support with provider-specific analytics to tackle these costs.
“Every order has to have a qualitative impact and every order has to have a cost impact,” said Mukul Mehra, MD, senior physician executive of clinical decision support at Premier.
This framework allowed Ardent Health to score each order based on clinical value and institutional cost, targeting services such as IV albumin use and unnecessary lab testing.
2. The key to rapid adoption
To influence behavior without disrupting care, Ardent Health used passive and active “nudges” embedded in the electronic medical record. These interventions surfaced cost, clinical alternatives and updated guidelines at the moment of ordering.
Providers responded to passive nudges 21% of the time and to active alerts 41% of the time, well above industry norms.
“What stewardship is doing at Ardent Health and at other institutions is actively maintaining the content, costs and reviewing the clinical literature,” Dr. Mehra said. “We are maintaining the costs and getting updated cost files as often as weekly and then we’re using analytics to guide which providers should see what nudges.”
3. ROI validation
Ardent Health set a success threshold of $32.50 saved per admission. The initial pilot at UT Health East Texas surpassed expectations, delivering $97 in savings per admission.
Eventually, the program scaled across all Ardent Health hospitals. By comparing pre- and post-intervention usage rates and leveraging institution-specific cost data, Ardent Health validated both immediate and learned behavior changes.
“We didn’t just meet the goal, we exceeded it,” said Susan Hughes, vice president of case management at Ardent Health. “Being a good steward of resources is a constant effort. This project really solidified our relationship in that this process was working for us.”
4. Successful change management
While much of the impact came from physician engagement, Ardent Health also empowered case managers and nurse leaders with access to the same data. Ms. Hughes emphasized that the platform supported discharge planning and throughput by identifying potential barriers earlier.
Ardent Health now incorporates nudge data into quality metrics and performance incentives at select hospitals. By combining clinical transparency, tech-enabled workflows and collaborative change management, the health system created a sustainable model for reducing low-value care and boosting financial performance.
“This journey reflects what’s possible when you have collaboration and work together to meet your goals,” Ms. Hughes said. “We’ve proven that innovation and collaboration can drive meaningful results that positively impact our hospitals, our patients, providers and the communities that we serve.”
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