Case Study: Medium-Sized Short-Term Acute Care Hospital improves margin and reimbursement with The Craneware Group’s Trisus Healthcare Intelligence

Medium-Sized Short-Term Acute Care Hospital - Customer Case Study

The Craneware Group worked with a medium-sized short-term acute care hospital in a Midwest suburban market, with more than $200 million in net patient revenue and an operating profit margin above 15%. The hospital needed to analyze DRGs with and without MCCs to find where it was losing margin per case, understand variation in physician practice and care delivery, and identify opportunities to improve both quality and financial performance.

Using Trisus Healthcare Intelligence® for margin analytics and operational intelligence, The Craneware Group analyzed DRGs 947 and 948 and found significant improvement opportunities. The hospital’s ALOS for these cases was 4.5 to 5 days longer than CMS expectations, representing about $735,000 in cost reduction opportunity; combined with revenue optimization, total margin opportunity was estimated at $850,000. The analysis also showed 173 cases with an expected loss of $670,000, and some patients could have qualified for higher-paying DRGs such as pulmonary edema/respiratory failure or simple pneumonia.