1. Decide how order sets will be implemented. After determining a process for developing the sets, organizations should decide how they will implement them. Organizations should consider whether or not they will make use of the sets voluntary or mandatory and if they will use paper or electronic implementation with computerized physician order entry.
"If organizations are focused on achieving meaningful use, they will need to show a certain percent of order sets are being done in the CPOE system," says Linda Peitzman, MD, chief medical officer for Wolters Kluwer Health, which includes ProVation, and former medical director for HealthSystem Minnesota/Park Nicollet Clinic in St. Louis Park, Minn.
If an organization chooses to enter the order sets into the CPOE system, it should set goals of how many sets it will enter by a certain time frame and develop a process for entering the sets, says Dr. Peitzman. Some tools for order set management allow order sets to be integrated automatically, but if organizations manually maintain order sets in other ways, such as in an Excel spreadsheet, they need to assign resources to this process.
2. Make sure all assets are recorded. Hospitals sometimes have equipment that isn't on the books, which is a cause for concern when the hospital is audited, says Michael Staunton of Principle Valuation. While staff members at the hospital often have a good cataloging process for acquiring equipment, often they overlook equipment acquired by unusual means. For instance, if the hospital leases an item and then purchases it when the contract is over, that asset may not be recorded properly. Making regular inventory checks is important for catching these types of updates.
3. Move collections to the front end. The best way to ensure that patients pay their out-of-pocket expenses for a procedure is to require payment before the procedure. Lisa Rock, president and CEO of National Medical Billing Services, agrees with the policy of asking patients to pay in full on the date of service for out of pocket costs. "Upfront collections are definitely preferable. However, we must have professional courtesy with front-end collections," she says. "We have to remember why it is we're doing these procedures."
Everyone interviewed for this article agreed that patient care should never be compromised due to financial circumstances or a patient's ability to pay.
If patients have a large deductible that they cannot pay upfront, the facility will require them to pay half upfront or work with them to set up payment plans before the procedure. Occasionally, a patient may be charged more on the day of service than what the patient actually owes due to lag-time in billing clearance. If there are accounts with overestimated patient responsibilities, the facilities can refund any overpayments made by the patient immediately.
4. Move from growth plan strategies to effectiveness strategies. When devising strategic plans, hospitals should now focus more on effectiveness strategies than growth strategies, says Luke Peterson, a National Director of Kurt Salmon's Healthcare Strategy Group. "What we are seeing in the market is that effectiveness is critically important, along with growth," he says. "We anticipate some push-back to this change of focus, but we believe this is where the market is heading."
While growth plans are predominantly about external markets and volumes, effectiveness plans require the organization to look at its internal processes and value equations says Mr. Peterson. "It is no-longer simply about growing the top line," he says. "Finding ways to fundamentally change the care processes to improve quality, service and reduce costs require different approaches and information."