Reduced surgery cancellations by 50%

Published

Result

We were able to reduce rescheduled and cancelled surgeries by 50% for one of our specialist provider group clients. Our surgery scheduling team and our own surgery scheduling software were used to achieve these results.

Problem 

As expected, surgeries are a major revenue source for group practices. Our client had 12 providers and 5 surgeons. The surgeons have surgery privileges at 4 ambulatory surgery centers, with varied block times and surgery dates per month. Our client had 3 offices and a surgery scheduler at each office location.

Despite being fully staffed, the management team noticed that 30-40% of surgeries were being rescheduled and/cancelled for each surgery day per week. 

The problem was exacerbated by the fact that the offices serviced medically underserved areas that have patients with severe pathologies. These patients are typically not very engaged in their own health.

We spent some time analyzing the client’s surgery scheduling processes. The problems were the same as we anticipated (based on our experiences with other MSO clients).

  1. Surgery scheduling  spreadsheets were not helping because of the volume of surgeries being managed.
  2. Surgery comanagement was not tracked properly and transition of care was not being managed.
  3. Prior authorizations were being mismanaged. Despite surgery CPT and ICTs being from a standard, common list – there were many denials due to lack of adequate documentation. This delayed the surgery. Prior authorization validity dates were not tracked well either.
  4. Our client’s staff pushed the burden of medical clearances and pre admission tests to patients. This never works well for constituents of medically underserved areas (based on our experiences). Surgeries were, expectedly, delayed or canceled because patients never followed through with the surgery pre-requisites.
  5. Pre-Surgery counseling was not enforced despite the patients being disengaged in their own care. This led to cancellations on the day of the surgery as well.
  6. There was too much back/forth with each surgery center’s scheduler due to inadequate documentation (surgery pre-requisites).

Solution

We approached the problems in the following ways using our surgery scheduling team and Surgerical – our own surgery scheduling software.

  1. We replaced cumbersome surgery scheduling spreadsheets with our in house surgery scheduling software. Since the software also has referral management capabilities, this helped our surgery schedulers with surgery comanagement as well.
  2. Our surgery scheduling team handled all prior authorizations. We use our software to track prior authorization status, validity dates and our schedulers never miss a TODO item.
  3. Our scheduling team triaged with each primary care and specialist office to get necessary appointments . We also ensured that all clearances, test results were obtained on time.
  4. We also triaged with the patient’s pharmacy to ensure that the patient has the necessary medications. In addition to this, we ensured that the patient adhered to the prescribed medication and diet regime as well.
  5. We made sure that each patient had adequate transportation arranged for the day of surgery and also had an escort available to pick up the patient post discharge. Depending on the patient’s need, we triaged with Medicaid transportation providers as well.
  6. Our surgery schedulers stayed in constant touch with the patients, counseling them about the surgery process. They keep the patients informed about the status of their surgery scheduling steps – this in turn kept the patients engaged as well.
  7. Post discharge, we ensured that the patient had the post operative appointments scheduled. Additionally, our team triaged and scheduled transition of care appointments as well. We followed up with each patient to eliminate noshows for each post operative appointment.

Net result – We were able to reduce rescheduled and cancelled surgeries by 50%.

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