It’s no secret that the shift to value-based is leading more physicians and nurses to be employed by hospitals.
Physicians who a lot of Medicare
Patients feel the height of these effects, because Medicare reimbursement rates have not kept pace with inflation.
So how can physicians and nursing facilities manage their bottom line while losing money caring for this growing group of patients? Some will simply take care of fewer patients, which will reduce overall revenue in an effort to minimize the financial impact.
However, there are things doctors and nurses can do to balance out the loss and actually improve margins during the slow transition to value-based care.
Overcome the Obstacles
First things first, you’ll need the right infrastructure and tools to make sure you’re accurately tracking all patients so you can measure your performance and revenue. While this happens annually or quarterly, hospital CEOs and CFOs should be regularly accessing and evaluating this data in order to make continuous adjustments.
Once you’ve synthesized all this information, you’ll want to rethink your traditional KPI’s associated with fee-for-service. Rather than focusing on traditional, one-dimensional metrics like headcount in beds or the number of surgeries, you’ll need to get the full picture of your quality metrics.
Focus on things like:
- Cost per case
- Readmission rates
- Length of stay
- Complication rates
When you dive deeper into the data, you will probably find there are plenty of areas you can improve. Are there specific diagnoses codes that you struggle with? Are there other fact ors that contribute to readmission rates that might not be happening at your hospital?
Improve Care Coordination
Readmission rates are a major metric that is evaluated by CMS. However, even if you provide the best care, a patient could still be readmitted because they aren’t following-up with their primary care provider. Skilled nursing facilities and home health solutions are also important factors to evaluate the quality of a patient’s care after they leave your hospital. Choosing the right partners and holding them to a high standard will help lessen readmissions and provide better continuity of care.
Become More Efficient
You might find that the length of stay is longer for patients that receive an MRI, for example.
If you only have one MRI for both inpatients and outpatients, your teams may be prioritizing outpatient diagnostic tests simply to accommodate business hours. But that leaves inpatients to wait until evening (around 8 pm) to get their MRI, which increases overall length of stay.
Other Strategies to Optimize Revenue
Expand access points- free-standing ERs; outpatient diagnostic centers and urgent care facilities can all increase your volume of services you provide without the additional costs and potential penalties from inpatient stays.
Telehealth technology
Physicians or nurses that travel between hospitals, practice offices and outreach
Clinics can reduce travel time and see more patients through virtual visits. Offering convenient telemedicine services can also be a market differentiator and attract more patients with commercial insurance that prefer the convenience of virtual visits.
Focus on specialization
By developing signature services you can focus on recruiting top-notch physicians and creating centers of excellence. Especially for procedures like joint replacement and bariatric surgery, you will draw patients that are potentially willing to pay more for a unique, high quality experience.
Ultimately, all of these efforts will result in better access to high quality care for your patients, which will improve your composite scores and increase reimbursement potential.
About CareSkore
CareSkore's mission is to help caregivers provision the best care and experiences to their patients. The company sits at a cross section of the latest in healthcare and technology, and has built tools that lead to measurable improvements in Population Health through targeted patient engagement.
Jaspinder Grewal is the current CEO of CareSkore (www.CareSkore.com). He is a young entrepreneur and his company just raised $4.3 million. Joe Montana, the former QB is an investor in CareSkore. Mr. Grewal is trained as a computer engineer and holds an MBA from the University Of Chicago Booth School Of Business. He has 13 years of experience working with large health systems, managing technology, and operations.