Rural Hospital Success and Benefit Realization in Decreased Length of Stay with Care Transitions Sprint Support

A level III trauma center in the central Midwest United States is a not-for-profit tertiary hospital and one of the top twenty rural and community hospitals in the country. It contains more than two hundred beds. Its primary referral base consists of the twenty-four outlying critical access hospitals (CAHs) across the region and patients seeking care across state lines. Many of the CAHs house Medicare-accredited “swing beds” and provide either inpatient acute care or rehabilitation/long-term-care services.

The hospital holds collaborative relationships for outreach services in more than thirty locations. The healthcare organization offers physician specialty care in the areas of cardiology, orthopedics, general/minimally invasive/and robotic surgeries, ear, nose, and throat (ENT), pulmonology, critical care, and women’s care. Other affiliated specialty programs include rehabilitation, hospice care, a wound and hyperbaric clinic, and a sleep and neurodiagnostic center. Stand-alone cardiology and oncology institutes additionally serve the community and provide outpatient follow-up services for the inpatient population.

Many, if not most, US hospitals and health systems emerged from the pandemic experiencing financial challenges in 2022 and into 2023. Having similar outcomes, this hospital outreached to BRG for assistance. In the first quarter of 2023, BRG professionals engaged with the client to identify sources of benefit opportunity across Revenue Cycle, Workforce, Human Resources, Strategy and Ambulatory Services, Supply Chain (including Pharmacy), Inpatient Length of Stay (LOS), and Clinical Documentation Improvement (CDI). During the baseline period (calendar year 2022), a total of 2,560 excess days were identified, which translated into a $0.5 million opportunity related to excess-day reductions. Although this portion of overall assessed benefit was relatively small, the hospital saw value in working on achieving the projected excess-day reductions.