Client Background

This client comprises a hospital and clinics that provide psychiatric and behavioral health services to adults and children in a large urban setting on the West Coast.

The Situation

The client was facing access barriers causing delays in patient care. Programs that were in demand and among very few available in a high-population urban setting had unacceptably low census.

Of the 35 requests per week coming in for both programs:

• 16 were diverted
• 14 were willing to wait
• 5 deemed not appropriate for enrollment

Patients and families were frustrated with the slow registration process, insurance eligibility determination, and securing prior authorizations for treatment, all of which caused them significant anxiety.

Before interventions, the low census threatened the programs’ financial viability, and there were high levels of staff burnout. However, once patients came into the programs, patient satisfaction scores were outstanding, with Press-Ganey scores showing 96.9% of patients likely to recommend the care they received.

The need to bring more patients into the program was high, and leadership needed to maintain these excellent results.

The Solution & Results

The client engaged the Lean Health Care Practice of Moss Adams to facilitate rapid improvement with care teams. Teams evaluated barriers to flow and tested solutions. Intensive improvement efforts transformed the registration, scheduling, and eligibility processes and removed obstacles patients faced inquiring about admission.

Results were significant, as diverted requests decreased over 50%, from 16 to seven.

Net annual revenue increased by nearly $6 million per year by:

• The Intensive Outpatient Program (IOP) increased its census to 27 from 13
• The Partial Hospitalization Program (PHP) nearly doubled its census from four to seven patients for each four-week cohort
• The Acute Inpatient Program (AIP) increased its average daily census from 12 to 19

Access barriers were eliminated, allowing for a more efficient and effective registration process.

To remedy provider burnout, leadership introduced an upskilled medical assistant role to free time for the physician.

Leadership also implemented tools and methods including daily status reports and daily huddles and establishing visibility boards that prominently displayed performance and care metrics, to ensure transparency and constant focus on their true north.

The program became financially viable, and staff burnout decreased overall.

The client plans to build on these improvements to:

• Reduce uncompensated days to less than 5%
• Accelerate referrals
• Increase provider caseload by 40%
• Reduce average length of stay to 10 days for the PHP and 30 days for the IOP
• Sustain Press Ganey likelihood to recommend scores at 96.9%

We’re Here to Help

For more information on how lean improvements can help your behavioral health program expand access and reduce burnout, please contact your Moss Adams professional.

Additional Resources

• Health Care Consulting Services
• Lean Health Care Services