Special Report - Mitigating Medicare Cuts: Successful Strategies and Case Studies

 

Case Studies & Examples 

Telehealth-enabled rural infusion (keep oncology care local)

1. A multi-state “Rural Virtual Infusion Program” used tertiary-center tele-oversight to train rural infusion teams, yielding >1,000 local visits and large travel/time cost savings for patients.
   URL: https://www.ruralhealthinfo.org/project-examples/1055 Rural Health Info

2. Lean/Continuous Improvement at scale (enterprise operating system)
   Cleveland Clinic’s Continuous Improvement Model (CCIM) formalizes Lean/Six Sigma methods so “every caregiver is capable, empowered, and expected to make improvements every day.”
   URL: https://my.clevelandclinic.org/departments/patient-experience/depts/continuous-improvement Cleveland Clinic
   One-page CCIM reference (PDF): https://my.clevelandclinic.org/-/scassets/files/org/clinical-transformation/cc-improvement-model Cleveland Clinic

3. Value-based care via MSSP ACOs (shared savings for quality + cost)
   CMS program overview and “About” page (eligibility, participation options, national footprint).
   URL: https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos CMS
   URL: https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/about CMS
   Program data portal: https://data.cms.gov/medicare-shared-savings-program CMS Data

4. Partnerships/M&A to preserve access and scale fixed costs
   AHA/Kaufman Hall analyses: partnerships can expand services, stabilize distressed hospitals, and improve access—especially in rural markets.
   PDF: https://www.aha.org/system/files/media/file/2021/10/KH-AHA-Benefits-of-Hospital-Mergers-Acquisitions-2021-10-08.pdf American Hospital Association
   Fact sheet (web): https://www.aha.org/fact-sheets/2023-03-16-fact-sheet-hospital-mergers-and-acquisitions-can-expand-and-preserve-access-care American Hospital Association

5. Cut waste, not staff (structured waste-reduction frameworks)
   IHI’s “Trillion Dollar Checkbook” compendium catalogs practical levers to eliminate non-value-added waste and repurpose savings.
   PDF: https://www.ihi.org/sites/default/files/2023-10/IHI-Leadership-Alliance_Trillion-Dollar-Checkbook-Reduce-Waste.pdf Institute for Healthcare Improvement

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Recommendations 

1. Stand up/expand outpatient infusion & other OP services
   Replicate tele-supervised rural infusion to keep high-value care local and reduce patient leakage.
   Reference: https://www.ruralhealthinfo.org/project-examples/1055 Rural Health Info

2. Institutionalize Lean daily management (safety, throughput, cost)
   Adopt CCIM-style daily huddles, visual management, and problem-solving to raise RVUs per FTE and reduce variability.
   Reference: https://my.clevelandclinic.org/departments/patient-experience/depts/continuous-improvement Cleveland Clinic
   Quick reference (PDF): https://my.clevelandclinic.org/-/scassets/files/org/clinical-transformation/cc-improvement-model Cleveland Clinic

3. Enter/optimize an MSSP ACO track (shared savings upside)
   Start with the CMS overview and About pages; use Program Data to benchmark peers and markets.
   References:
   https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos CMS
   https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/about CMS
   https://data.cms.gov/medicare-shared-savings-program CMS Data

4. Pursue regional partnerships for economies of scale
   Use AHA/Kaufman Hall materials to frame benefits and stakeholder talking points, especially for CAH stability, specialty access, and purchasing scale.
   References:
   https://www.aha.org/fact-sheets/2023-03-16-fact-sheet-hospital-mergers-and-acquisitions-can-expand-and-preserve-access-care American Hospital Association
   https://www.aha.org/system/files/media/file/2021/10/KH-AHA-Benefits-of-Hospital-Mergers-Acquisitions-2021-10-08.pdf American Hospital Association

5. Build RVU-based productivity dashboards from CMS PFS data
   Use CMS’s PFS look-up and RVU files (open access) to track work RVUs by CPT, configure service-line benchmarks, and inform staffing templates—no paywalled sources required.
   References:
   Overview: https://www.cms.gov/medicare/physician-fee-schedule/search/overview CMS
   Search tool: https://www.cms.gov/medicare/physician-fee-schedule/search CMS
   RVU files: https://www.cms.gov/medicare/payment/fee-schedules/physician/pfs-relative-value-files CMS

6. Run a structured waste-reduction portfolio (“cut waste, not staff”)
   Prioritize high-yield opportunities using IHI’s compendium to protect margin while sustaining quality and access.
   Reference: https://www.ihi.org/sites/default/files/2023-10/IHI-Leadership-Alliance_Trillion-Dollar-Checkbook-Reduce-Waste.pdf Institute for Healthcare Improvement

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Footnote

National Daily Hospital Executive Briefing is prepared jointly by Compirion Hospital Solutions and ChatGPT5. All information is sourced from publicly available research and news reports. Hospitals should validate applicability before implementation.

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