Value based care and bundled payments: Anesthesia care costs for outpatient oncology surgery using time-driven activity-based costing
| Autor: | Katy E. French, Alexis B. Guzman, John C. Frenzel, Thomas W. Feeley, Augustin C. Rubio |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Time Factors Value based care Staffing Article 03 medical and health sciences 0302 clinical medicine Cost Savings Anesthesiology Humans Medicine Anesthesia 030212 general & internal medicine Baseline (configuration management) Activity-based costing health care economics and organizations Episode of care business.industry 030503 health policy & services Health Policy Bundled payments Health Care Costs United States Surgery Surgical Oncology Ambulatory Surgical Procedures Health Expenditures 0305 other medical science business Cost of care |
| Zdroj: | Healthcare. 4:173-180 |
| ISSN: | 2213-0764 |
| DOI: | 10.1016/j.hjdsi.2015.08.007 |
| Popis: | Background With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. Methods Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures. Using the anesthesia record, drugs, supplies and equipment costs were identified and calculated. The current staffing model was used to determine baseline personnel costs for each procedure. Using the costs identified through TDABC analysis, the effect of different staffing ratios on anesthesia costs could be predicted. Results Costs for each of the procedures were determined. Process time and costs are linearly related. Personnel represented 79% of overall cost while drugs, supplies and equipment represented the remaining 21%. Changing staffing ratios shows potential savings between 13% and 28% across the 11 procedures. Conclusions TDABC can be used to estimate the costs of anesthesia care. This costing information is critical to assessing the anesthesiology component in a bundled payment. It can also be used to identify areas of cost savings and model costs of anesthesia care. CRNA to anesthesiologist staffing ratios profoundly influence the cost of care. This methodology could be applied to other medical specialties to help determine costs in the setting of bundled payments. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect