How can restructuring within a hospital help the bottom line? That question was paramount as administrators, cardiovascular (CV) service line executives and others discussed reinventing service lines, creating co-management agreements and using the latest technological advances to help hospitals save overhead during MedAxiom’s CV Service Line Management Symposium June 6-8 in Chicago.
“It’s not about integrating, it’s about partnering,” said Patrick White, president of MedAxiom, at the event’s kickoff. Partnering was one of several themes emphasized by presenters. Below are some topics addressed at the three-day conference.
Physicians, admins must partner to reform care
Hospital administrations constantly look for ways to remain financially viable; however, the most difficult task may be getting physicians to help share in cost-saving responsibilities. Reginald J. Blaber, MD, of Lourdes Health System in Camden, N.J., said physicians won’t come on board until they know how change will impact quality.
Blaber outlined how leveraging physicians’ roles with administration can lead to alignment and ultimately improve value. However, he admitted that shifting to collaborative partnerships will be challenging. The reason for this may be that physicians are put off by the bureaucracy and red tape seen at the administration level.
|5 Tools for Creating a Successful CV Enterprise|
|1. Ensure physician engagement and leadership;
2. Foster physician-driven reductions in variation of care;
3. Foster care team development (chronic disease management);
4. Leverage information technology; and
5. Commit to having a transparent performance environment.
“We now need to decide whether we will do things the way we have always done them—cut costs and blame the other guy—or innovate our way out of the current predicament. In the long history of humankind (and animal kind, too), those who learned to collaborate and improvise most effectively have prevailed,” Blaber said, citing Charles Darwin.
While administration and physicians have rarely seen eye to eye, Blaber said it will be important to come together for the good of the patient. At Lourdes, staff did this by creating a co-management program. But it also is essential to stay focused on core measures, adherence to evidence-based guidelines, patient satisfaction and resource utilization.
“You can’t talk about costs without also talking about quality … physicians will stop listening,” Blaber summed.
How to build successful CV service lines
When building regional CV service lines, focus on cost, speed and quality, said Gregory D. Timmers, CEO of Prairie Cardiovascular in Springfield, Ill. Master two of these goals and the third will come soon after, he suggested.
At Prairie Cardiovascular, 62 cardiovascular physicians practice at 57 clinical locations and log 5,000 hours and 270,000 miles in travel time per year. Timmers outlined how systems can help build volume for their CV programs by working from the ground up.
“What we have done is basically consider these tertiary campuses as locations where we can assimilate a critical mass of physicians with their expertise,” said Timmers. “When you have new campuses and non-hospital-based campuses, the tendency is to recruit a person on a fellowship at this location.”
Physicians now appreciate the opportunity to plan and start new service lines. Prairie uses a simple motto: learn, be nimble and evolve; but with the changing times, this motto has transformed into quality, cost and speed.
Timmers said that professional service agreements have become a key element at Prairie. Development of the health network has focused on three goals:
- Enhance community clinics and referral relationships;
- Enhance customer service and accessibility; and
- Increase brand awareness.
Remote monitoring improves care, revenue
Setting up a telemonitoring program for the 1,900 device patients cared for at the Heart Center of the Rockies in Fort Collins, Colo., was no easy feat for Lisa Diederich, RN, a certified cardiac device specialist, and colleagues. Yet, it transformed patient care while improving the bottom line, said Diederich.
The reimbursement scenario is potentially favorable, too. In fact, 2012 reimbursements for remote monitoring vs. in-clinic monitoring are $62.57 and $38 (with no programming), respectively. These same reimbursements for ICDs are $94.77 vs. $66 (with no programming), respectively.
Pacemaker and ICD revenue generated from telemonitoring