Brian Geyman has had a long career in utilization management (UM), spanning over 15 years. When he came to Kingman Regional Medical Center in Kingman, Arizona, in early 2021, he had some well-tested notions about which UM tools and processes are effective and which are not.
“MCG or Interqual? It’s not working,” said Brian.
This made him eager to learn more about the Xsolis CORTEX platform, now known as Dragonly, already in use at Kingman, which he was previously unfamiliar with. The more he learned, the more hopeful he became about improvements that could be made, just by fully using all of the functionality XSOLIS already brought to the table.
“What I was super excited about with Xsolis is that it’s completely different than what most of us in the utilization review world are used to … but achieves where you want to go,” said Brian.
Upon his arrival, Brian immediately wanted to increase productivity – the volume of cases, or patient admissions, his team was able to get through in a day – and he reached out to Xsolis to see how they could help. Immediately, several processes were redesigned to increase the volume of patient case reviews by 60%.
These sorts of quick but sustained wins resulted in CORTEX becoming their primary utilization review system.
User-friendly, one-stop-shop that aces the competition with reporting
Brian describes Xsolis’ reporting as “crucial,” because their EMR was limited in its reporting capabilities.
“Having that (reporting) piece was the very first benefit that I felt personally, and that has been directly related to benefits to the hospital as well,” Brian said.
Observation length of stay (OBS LOS) was something senior leadership was laser-focused on at the time, for example. And according to Brian, they were able to leverage Xsolis reporting to trend much lower than the geographic norm. Their extended OBS rate (for stays over 48 hours), as another example, has decreased by 26%.
Brian meets regularly with Xsolis account managers to drive improvements across many other areas, and Kingman has also added more services to include Xsolis’ award-winning Physician Advisory Services and Denials Management. For example, they were able to successfully overturn denials with over $100K recovered in just the first 90 days of Kingman’s engagement with Xsolis’ Denials Management team.
“Xsolis has been so user-friendly for my team, it has everything they need,” said Brian. “It’s a one-stop-shop, so they can do more reviews in less time and be confident they’re putting patients in the right status.”
Payers: The more we work together, the better
This new, more confident and efficient approach – removing guesswork to improve utilization management and its outcomes – has been further enhanced because Kingman’s biggest commercial payer, Humana, was already on board with Xsolis. This was yet another competitive advantage with using Xsolis in Brian’s opinion, and he lit up at the possibility of improved payer relations, reaching out to Xsolis and Humana in his region to get them connected.
Just a couple months into going live with Humana, Brian said they were already seeing benefits with more open lines of communication. “As more payers come on board, I think the more of us that are working together in that light, the better it will be for both sides,” he said.
With results that speak for themselves – layers of benefits, like bricks, that stack on top of one another over time to make a significant, positive impact to the broader organization – Brian says Xsolis’ service is the glue holding those bricks together. It’s all worked together to cement a positive and recommended experience to others who may be considering it.
“The Xsolis team is absolutely amazing to work with,” said Brian. “They have gone out of their way to help me with processes and really try to understand what challenges we’re facing and help me figure out solutions to overcome those challenges. They truly care about their clients.”
Learn more about what’s possible when great service and technology solutions can be shared by both payers and providers