"These are tumultuous times for our industry as a whole," said Arthur E. Casey, CASC, senior vice president of business development of Outpatient Healthcare Strategies, a management consulting services firm, during a webinar hosted by SpineMark, a global spine service company for the development of spine centers of excellence and spine research organizations. "But every time you can be more efficient and more effective, looking at costs, leveraging relationships …you can only improve your bottom line."
The May 1 webinar focused on both the obstacles and opportunities presented by a changing landscape of the spine industry, with panelists Mr. Casey, Danielle Koelbl, president of MedRev Solutions, a revenue cycle management company, and Marcy T. Rogers, president of SpineMark.
During her opening presentation, Ms. Rogers gave an overview of the obstacles, such as declining reimbursements for spine procedures, and opportunities, such as medical tourism and a new payor mix, facing providers today. The panelists then offered several strategies for how providers can increase revenue — or avoid losses — during this time of change in the industry.
1. Determine actual cost per case. Before considering expansion to increase revenues, Ms. Koelbl recommended assessing per-case and per-service-line profitability on the current volume of patients. Providers should consider all factors, including overhead, staffing costs and implant costs, to determine if the current situation is profitable before growing. Then, they can look for ways to grow incremental revenue on the current case mix, including recouping lost revenue, to create a solid foundation for any future growth plans.
2. Discover trends in lost revenue, and create an audit strategy. Ms. Koelbl suggested providers make a spreadsheet to examine current reimbursement and payment patterns to discover payment variances. They also must watch for payment denials due to incorrect authorizations, patients with high-deductable plans who are unable to fulfill their responsibility, an unbalanced payor mix and payors with stringent 60-day appeal limits, which she said are "notorious for claims denials."
3. Maximize staff and room resources. Mr. Casey highlighted the importance of maximizing resources, including staff and operating rooms, to curb costs. He suggested hospitals and other providers monitor turnover times in ORs between cases, adjusting start times to keep rooms at capacity and allowing patients to fill out pre-admittance paperwork online to save time spent with clinical staff.
4. Leverage relationships with physicians. Mr. Casey also recommends organizations work with physicians to lower costs and schedule rooms appropriately to increase efficiency in the OR. He also said the vast majority of physicians are not aware of the high cost of implants and other supplies. Open communication and collaboration with physicians can lead to solutions that reduce cost without compromising care.
5. Leverage relationships with suppliers. To help reduce the often high cost of implants, Mr. Casey suggests providers analyze supplier relationships to see if new agreements can be reached. Consolidating suppliers and ordering standardized or generic implants can help defray costs, and he also recommends buying on consignment when possible.
To view a recording of the webinar, visit SpineMark's website by clicking here.
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