Outcome improvement example:
Mohs surgery for skin cancer

Planned Improvement


Objectively asses whether Mohs surgery, which appears 20-40% more expensive to payor can be considered a best practice and should be more widely adopted.

Actual improvement


Demonstrated that:

•Actual cost was not more expensive when taking full cycle of care into account (e.g. readmissions and treatment by plastic surgeon).

•Outcomes for patient was significantly improved:

- No waiting time for results

- First time right / higher cure rate (~95%)

- Virtually eliminated need for plastic surgery

Mohs surgery is now being rolled out to other hospitals within the network



•Mohs surgery is a precise surgical technique used to treat skin cancer. During Mohs surgery, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains.

•Initial analysis appeared to suggest Mohs surgery was 20-40% more expensive than traditional surgery with unclear benefits.

•Doctors were convinced Mohs delivered better results based on scientific studies, but did not have facts to substantiate outcome claims in Holland and no clear idea what the additional cost was.

•Payors were skeptical about a significantly more expensive treatment option.