Kim Petram shared how she was able to secure Xsolis as a partner for your company, but what happens after implementation? During our virtual XCHANGE conference earlier this week, Renee Dunagan, Case Management Supervisor at Citizens Medical Center in Victoria, Texas, shared her journey post–Xsolis: from improving workflows, process, and payer engagements, to the three things she learned along the way.
1. Be Forthcoming with Current Issues
It’s essential to face the facts about what brought your organization to need — well, organization. For Renee, she turned to Xsolis to help with the utilization review process because it wasn’t working as well as it could be. From denied claims to inconsistent case reviews to time-consuming manual processes to lack of insights that impacted revenue — these issues were impact the organization’s bottom line and are incredibly common across the industry.
2. Set Expectations Up Front
You can’t build a plane while it’s flying; you need to build it first. That’s why setting expectations up front is the key to success when it comes to improving the UR process with Xsolis. How can you do this? Here are some ways Renee got her team on board from the start:
- Make the process a group decision – get case managers involved.
- Bring in IT early.
- Don’t forget about your executive team: bring them on board.
- Reach out to payer partners.
Renee stresses that it is beneficial, if possible, to also bring physicians along for the ride as they can benefit from the efficiencies Xsolis provides as well.
3. Embrace the Change and the Vision
Xsolis gives everyone the tools to rule their domain
You have your team on board: now embrace the change and the vision you’ve set together for your future with Xsolis. If you realize you need to adjust your plans during your quest for efficiency, do it! Don’t fear change at any point. For example, Citizens Medical Center transitioned to a dyad model one week before their go-live date with Xsolis. The new model changed how case management was assigned as well as team roles. Why? Because it aligned better with CORTEX to better serve their staff and their patients. They went from a floor-based concept to a hospitalist-based approach, with each case manager assigned to a hospitalist with whom they do patient rounds together.
The results of these last-minute adjustments? Case managers became more efficient and experienced better working relationships when they were partnered 1:1 with hospitalists.
18 Months Later
All I had to do is open my dashboard – Xsolis reads the information from chart, assigns care level score, and provides a color code automatically.
Embracing the change and the vision paid off for Citizens Medical Center and Renee’s team. 18 months after going live with Xsolis, they experienced:
- An appropriate 26% reduction in observation rate
- 36% reduction in medical necessity denials
- 17% increase in appropriate inpatient conversions
It is possible for you and your organization to change how you work for the better and get to great like Citizens Medical Center. Hear more about Citizen Medical Center’s story here.