Despite its importance as the gateway to your hospital, the emergency department is often fraught with challenges — declining reimbursement, staffing shortages and often a lack of strong medical director leadership. In response to these growing challenges, and the uncertainty surrounding how healthcare reform will impact the ED, many hospitals have made the strategic decision to outsource their ED to a staffing and management organization. But not all ED groups are the same, and without a clear plan, you run the risk of selecting a group that isn’t the right fit for your hospital.
Whether you are new to outsourcing or have been through the process many times before, you should consider the following tips to increase your odds of making a successful decision for your hospital.
1. Assemble your team. One of the first decisions you need to make is who from your leadership team needs to be involved in the selection process. Given the importance of the decision, it is imperative that the CEO spearheads the process. Many hospitals also include the COO, CFO, chief medical officer/chief of staff, chief nursing officer, and vice present of patient care services.
2. Identify your goals. What are you hoping to achieve by outsourcing your ED? Do you want to improve patient satisfaction scores? Reduce wait times? Be sure to solicit feedback from all individuals on the selection committee to ensure that expectations are captured on the front end.
3. Define your process. Will you use an informal approach or a more prescriptive process for selecting a partner? How many candidates will you review? Will you develop a formal “request for proposal”? It is important to delineate the process on the front end and ensure all parties are in agreement.
4. Identify qualified candidates. Who will you invite to participate in the review process? If you are part of a system, do you have the authority to explore a variety of options? Many hospitals solicit ED group suggestions from colleagues, healthcare consulting firms or their state hospital association.
5. Write the RFP. Make sure your RFP questions are tied to the goals the team identified in Tip #2 above. Also, be sure to include background information on your hospital and the ED, including your current staffing arrangement, volume information, operational metrics and outcomes you hope to achieve.
6. Make yourself available. Some ED groups, particularly those with more experience, may ask for more detailed information throughout the process. While it may seem time consuming, the more information you share, the better the chance you’ll get a response that meets your needs.
7. Evaluate responses. While it may seem like a daunting task, it is important to thoroughly review the responses to your RFP. Many hospitals create an evaluation template that provides a vehicle for each member of the selection committee to rate the candidates on a number of criteria. This can provide an objective measure for evaluation by multiple individuals and can be used later if necessary to justify the final decision.
8. Look beneath the surface. Don’t make a hasty decision based on a single factor, such as price. For example, physician compensation makes up the majority of a group’s costs. If your candidates vary widely in their pricing, ask detailed questions about the assumptions underlying the pricing model. In order to be competitive in the bidding process, some groups may underestimate physician compensation, only to find that later they are unable to recruit at those rates. This leaves your hospital understaffed and most likely facing a request for a subsidy increase from the group once the contract has started.
9. Check references. Ask for references in your RFP and be prepared to dedicate the resources to thoroughly check them. How long have they contracted with the group? How well did the group handle the transition? Did they develop a strategic action plan to ensure the hospital’s goals were met? Was the support team experienced and responsive?
10. Finalize the transition. Once you have selected the group you wish to partner with, you’ll want to make arrangements for a formal transition. An experienced group should have a formal transition plan they can share with you to ensure minimal disruption. This may include timelines for recruiting (if required), communication to key constituents, and transition of billing operations.
While certainly not exhaustive, this list can be used as a starting point when considering to outsource your ED. By selecting the right group for your hospital, you significantly increase your chances of success.
Tracy Young is a vice president at TeamHealth. Learn more about TeamHealth.
Whether you are new to outsourcing or have been through the process many times before, you should consider the following tips to increase your odds of making a successful decision for your hospital.
1. Assemble your team. One of the first decisions you need to make is who from your leadership team needs to be involved in the selection process. Given the importance of the decision, it is imperative that the CEO spearheads the process. Many hospitals also include the COO, CFO, chief medical officer/chief of staff, chief nursing officer, and vice present of patient care services.
2. Identify your goals. What are you hoping to achieve by outsourcing your ED? Do you want to improve patient satisfaction scores? Reduce wait times? Be sure to solicit feedback from all individuals on the selection committee to ensure that expectations are captured on the front end.
3. Define your process. Will you use an informal approach or a more prescriptive process for selecting a partner? How many candidates will you review? Will you develop a formal “request for proposal”? It is important to delineate the process on the front end and ensure all parties are in agreement.
4. Identify qualified candidates. Who will you invite to participate in the review process? If you are part of a system, do you have the authority to explore a variety of options? Many hospitals solicit ED group suggestions from colleagues, healthcare consulting firms or their state hospital association.
5. Write the RFP. Make sure your RFP questions are tied to the goals the team identified in Tip #2 above. Also, be sure to include background information on your hospital and the ED, including your current staffing arrangement, volume information, operational metrics and outcomes you hope to achieve.
6. Make yourself available. Some ED groups, particularly those with more experience, may ask for more detailed information throughout the process. While it may seem time consuming, the more information you share, the better the chance you’ll get a response that meets your needs.
7. Evaluate responses. While it may seem like a daunting task, it is important to thoroughly review the responses to your RFP. Many hospitals create an evaluation template that provides a vehicle for each member of the selection committee to rate the candidates on a number of criteria. This can provide an objective measure for evaluation by multiple individuals and can be used later if necessary to justify the final decision.
8. Look beneath the surface. Don’t make a hasty decision based on a single factor, such as price. For example, physician compensation makes up the majority of a group’s costs. If your candidates vary widely in their pricing, ask detailed questions about the assumptions underlying the pricing model. In order to be competitive in the bidding process, some groups may underestimate physician compensation, only to find that later they are unable to recruit at those rates. This leaves your hospital understaffed and most likely facing a request for a subsidy increase from the group once the contract has started.
9. Check references. Ask for references in your RFP and be prepared to dedicate the resources to thoroughly check them. How long have they contracted with the group? How well did the group handle the transition? Did they develop a strategic action plan to ensure the hospital’s goals were met? Was the support team experienced and responsive?
10. Finalize the transition. Once you have selected the group you wish to partner with, you’ll want to make arrangements for a formal transition. An experienced group should have a formal transition plan they can share with you to ensure minimal disruption. This may include timelines for recruiting (if required), communication to key constituents, and transition of billing operations.
While certainly not exhaustive, this list can be used as a starting point when considering to outsource your ED. By selecting the right group for your hospital, you significantly increase your chances of success.
Tracy Young is a vice president at TeamHealth. Learn more about TeamHealth.