More hospitals are recognizing the benefits of tapping an on-site physician adviser to help improve revenue cycle processes in an increasingly challenging financial landscape.
In 2006, about 10 to 20 percent of hospitals had an on-site physician adviser, according to Ralph Wuebker, MD, CMO of physician advisory services for Optum360. Today, he estimates about 70 to 80 percent of hospitals have an on-site physician adviser to help with medical necessity reviews, coding and length-of-stay goals.
During a Sept. 21 session at Becker's Hospital Review 4th Annual Health IT + Revenue Cycle Conference in Chicago, Dr. Wuebker shared three tips for maximizing the benefits of an on-site physician adviser.
1. Outline a physician adviser's top priorities. Most on-site physician advisers are hired and told, "Go out and do good," said Dr. Wuebker. However, hospitals need to define what "good" means. "If everything is a priority, nothing is," he said. "Pick two or three items you want the physician to focus on. If you don't give them guidance, it'll be a mess."
2. Think through who the adviser will report to. Hospitals often assume physician advisers should report to the hospital's CMO or case manager, but Dr. Wuebker said physicians should give this more thought. Who advisers report to will affect their mentality and what they focus on, he said.
3. Discuss the Two-Midnight Rule. As the Two-Midnight Rule can be interpreted many ways, Dr. Wuebker said it is important a hospital's compliance or clinical team sits down with their physician adviser to discuss the regulations and establish what protocols they need to ensure compliance. Many hospitals believe a length of stay of less than two midnights is the biggest audit risk, but the larger risk area is inpatient lengths of stay ranging from two to three days, according to Dr. Wuebker.
"If you're striving for zero one-midnight inpatient cases, I think you're missing out on a lot of dollars," he said.
More articles on finance:
What Utah man's $80k out-of-state ER bill reveals about negotiating hospital charges