Surgical Best Practices

Focus: 

To determine costs saved through increased efficiency of surgical care in Washington state

Anticipated Impact: 

A comprehensive analysis to determine health-care cost savings due to implementation of three SCOAP procedures using actual payment data

Abstract: 

The Surgical Care and Outcomes Assessment Program (SCOAP) is a collaborative of health-care professionals using performance data, interventions, and checklists to improve quality and reduce health-care costs. A 2007 LSDF grant to the University of Washington, led by David Flum in collaboration with the Foundation for Health Care Quality, significantly expanded SCOAP’s reach and impact. SCOAP is currently used by 57 hospitals (85% of Washington's surgical care). Calculated savings through 2008 from reduced complications and more efficient care exceed $50 million. The actual figure is likely higher, although difficult to derive. LSDF made a supplemental grant award in 2010 to expand and refine the analysis of health-care cost savings.

The supplemental award will allow:

  • Addition of data for 2009 and 2010, when many more hospitals were participating, using three surgical procedures as examples.
  • A comparison of costs before and after hospital participation in SCOAP, to isolate the cost savings due to SCOAP. A representative sample of 10-15 hospitals will be used.
  • Collection and analysis of “payer” and pharmacy data. Payers include all commercial health-care insurers in Washington and Washington state’s Medicare. Creating these data linkages will permit analysis of actual payments for procedures, rather than using an extrapolation of unnecessary costs presumed not to have been incurred because of SCOAP participation.

The key objective is highly accurate data demonstrating the resource use and cost savings due to SCOAP. Among other uses, these data will support further expansion of SCOAP and promote participation by hospitals and payers.

See also:

Surgical Best Practices

Grant Update

Principal Investigator:
David Flum
Grantee Organization:
University of Washington
Grant Title:
Impact of SCOAP on Health-Care Resource Use and Cost
Grant Cohort and Year:
2010 Grant Award Supplement (06)
Grant Period:
10/16/2010 - 10/15/2012 (Completed)
Grant Amount:
$182,882
This project is examining the impact of hospital participation in SCOAP on clinical outcomes and hospital costs for three surgical procedures (elective colectomy, gastric bypass, and non-elective appendectomy). In previous reports submitted to LSDF internal audiences, we analyzed resource use and costs in all Washington State hospitals comparing SCOAP participants to non-SCOAP participants. We demonstrated that based on these three surgical procedures SCOAP hospitals showed savings in excess of $50 million when compared to non-SCOAP hospitals for the same three year time period, 2006-2008. Analyses funded by this award incorporated up-to-date CHARS information and data from the 6 major payers in Washington State. A final report incorporating all new sources of data was submitted June 15, 2012. This report confirmed previous results that indicated procedures done in hospitals enrolled in SCOAP are associated with lower health care costs. Payer data showed significantly lower payments for procedures done in SCOAP-enrolled hospitals for all three procedures types. The data also demonstrated payments for procedures at SCOAP hospitals were lower than payments for those same procedures at the same institution before joining SCOAP.

Impact in Washington

Location of LSDF Grantee
Locations of Collaborations/Areas of Impact
Seattle
Issaquah
Aberdeen
Anacortes
Bellevue
Burien
Colfax
Colville
Coupeville
Davenport
Edmonds
Ellensburg
Everett
Federal Way
Grand Coulee
Ilwaco
Kirkland
Longview
Morton
Moses Lake
Mount Vernon
Olympia
Omak
Othello
Port Angeles
Port Townsend
Puyallup
Redmond
Renton
Richland
Shelton
Spokane
Sunnyside
Tacoma
Vancouver
Wenatchee
White Salmon
Yakima
Joint Base Lewis-McChord
Sedro-Woolley
Lakewood
Enumclaw
Gig Harbor
Auburn
Bellingham
Forks
Prosser
Walla Walla

Legislative Districts:
3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 19, 20, 21, 22, 24, 25, 26, 27, 28, 29, 30, 31, 32, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 45, 46, 47, 48, 49

Health Impacts

Surgical Best Practices

Mar 21, 2010
The Seattle Times
Jun 25, 2008

WHO Safe Surgery Initiative Launch Coincides with SCOAP Research
Seattle Times  |   Seattle P-I  |   New York Times  |   National Public Radio