Financial Data for the One ISOMP Day Each Month
TABLE 2 : Daily Effect of an Instituting Intentional Structured Opioid Monitoring Protocol ( ISOMP ) Prior to ISOMP During ISOMP Change % Change
Patient Encounter Data in Average Per Day
Paired T-Test P-Value ( Two-sided )
Number of Encounters 18.33 13.78 -4.55 -24.82 % p < 0.00001 Opioid Visits 0.00 6.83 - - - Acute Visits 18.33 6.95 -11.38 -62.08 % - No-Shows 4.11 1.12 -2.99 -72.75 % p = 0.0004 99215 0.17 5.78 5.61 3366.67 % p < 0.00001 99214 7.56 0.94 -6.62 -87.51 % p < 0.00001 99213 7.89 0.11 -7.78 -98.59 % p < 0.00001 99212 2.06 N / A
Work RVUs in Average Per Day Acute Work RVUs 20.32 6.85 -13.47 -66.30 % p < 0.00001 Opioid Work RVUs 0.00 13.71 - - - Total Work RVUs 21.02 20.565 -0.455 -2.16 % p = 0.7322
RVU = relative value unit ; p < 0.05 is significant
Financial Data From All encounters ( 38 months )
TABLE 3 : Overall Effect of Instituting an Intentional Structured Opioid Monitoring Protocol ( ISOMP )
Prior to ISOMP ( 19 Months )
During ISOMP ( 19 Months )
Daily Averages for Entire Period
Change |
% Change |
Paired T-Test |
|
|
P-Value ( Two-sided ) |
Patient Encounters 18.56 18.05 -0.51 -2.75 % - No-Show Visits 3.13 2.75 -0.38 -12.14 % -
Average Per Encounter Work RVUs 1.295 1.507 0.212 16.37 % - Charges $ 192.42 $ 220.89 $ 28.47 14.80 % - Reimbursement $ 92.71 $ 104.82 $ 12.11 13.06 % -
Totals for Entire Period Patient Encounters 4501 4169 -332 -7.38 % p = 0.3368 Work RVUs 5830.67 6281.18 450.51 7.73 % p = 0.3653 Charges $ 866,093.37 $ 920,885.33 $ 54,791.96 6.33 % p = 0.3528 Reimbursement $ 417,293.51 $ 436,982.44 $ 19,688.93 4.72 % p = 0.3909 No-Show Visits 760 636 -124 -16.32 % p = 0.0998
RVU = relative value unit ; p < 0.05 is significant
Table 5a looks at the effect of ISOMP on the 12 subjects electing to stop opioids ( Group B ). Only one patient was lost to follow-up , which allowed monitoring of nearly all weaned patients for non-prescribed opioid use clinically and with drug screens . Total encounters declined by -24.04 % from a
+ 31.25 % increase in opioid management visits offset by a -48.61 % decline in other visits . Total work RVU for this group declined by -17.56 %, as those related to opioids increased + 36.33 %, and non-opioid RVU decreased -46.60 %. The average work RVU per encounter rose by 8.00 %.
Group B was further separated into prewean ( 5.58 months ) and post-wean ( 13.42 months ) data , which is detailed in Table 5b . Monthly total encounters , encounters related to opioids , and encounters not related to opioids were reduced by -44.99 %, -44.58 %, and -45.64 % respectively after the opioid
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