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paid the lowest physician and facility fees for cases associated with
the fewest complications and readmissions. Interestingly, the lowest-
costing cases also took place in ambulatory settings. The findings
suggest that performing safer surgery and avoiding costly hospital-
izations help to reduce healthcare spending.
"Back-of-the-envelope calculations show that increasing the volume
of outpatient cases by just 10% would have saved approximately $3
million," says Dr. Campbell. "This is an important way to save money
in health systems where there's a gray area between assigning cases
to inpatient or outpatient locations. If we can move the needle so
more cases are performed outpatient, we'll save a lot of money."
This year, the Michigan model will show hospitals what percentage of
cases is done on an outpatient basis with the aim of making the needle
jump. "If we can define and demonstrate which cases can be done on
an outpatient basis safely and cost effectively, more procedures will
move to that setting," says Dr. Campbell. "Collecting safety and cost
data makes a very compelling argument to support that movement."
He suggests that surgical administrators should be motivated to
invest money into improving patient care. "The overall savings will far
outweigh the amount of money you allocate to quality improvement
activities," he says. "It's the right thing to do for patients and you'll
save much more than you spend. That's a compelling argument."
OSM
