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November 27, 2008 | Leave a Comment
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InEconomics
November 4, 2008 | Leave a Comment
REALIZING REVENUE FROM A WOUND CLINIC
Sometimes wound care professionals don’t have to travel far from home to view the impact of their profession.
Leah Amir, MS, MHA
While waiting in line to pick up a prescription from a local pharmacy, the man in front of this author was taking a long time asking the pharmacist for a large bandage and an ointment to take care of what he said was a “large cut” on his leg. Every suggestion the pharmacist made was met with resistance from the gentleman. He had tried them all. He told the pharmacist, “I have had this for more than 6 months and it only keeps getting bigger.” Upon lifting his trouser leg he exposed a Stage III venous leg ulcer—with “all of the trimmings.” Everyone in line gave the obligatory gasp, and the pharmacist grimaced, “I think you had better see your doctor.” The man replied, “I have followed my doctor’s orders, there must be something else that I can do.”
After verifying the gentleman’s insurance this author provided him with the name and number of a local wound clinic staffed by a physician Board Certified in Vascular Surgery specifically trained in wound care. The gentleman’s physician had never referred him to a specialist to manage the growing venous leg ulcer. As the gentleman lumbered away, it was apparent he would finally receive appropriate medical care.
Trained to Recognize the
Big Picture
Being a healthcare economist, this author realized the revenue opportunity heading to the wound clinic. Given the brief assessment due to the open disclosure of his medical history, the gentleman may require a comprehensive history and physical due to his age, obesity, arthritic joints, and family history of diabetes. Treatment may include debridement, assessment of adequacy of venous and arterial supply, compression bandaging, follow up visits; possibly negative pressure wound therapy, and perhaps placement of a skin substitute. His diagnostic findings may result in vascular repair, cardiac catheterization, and perhaps assessment of his renal
function. Appropriate medical care provided by staff at the wound clinic, delivered with respect and dedication has been shown to result in developing patient loyalty. Loyal patients tend to refer others. In this case he is likely to inform his internal medicine physician, other family members and friends. This one patient properly managed is worth more to the wound clinic and hospital than any advertising campaign. The referral of the wound clinic to the patient was provided based upon the skill, knowledge, evidence of clinical success, and overall reputation of the wound clinic’s ability to manage patients with acute and chronic wounds in their outpatient and inpatient settings. While growing patient volume in an outpatient wound clinic is an overarching goal, proper processes need to be implemented to sustain revenue flow. Charges do not reflect revenue.
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Summer InBusiness
November 4, 2008 | Leave a Comment
FOCUS ON THE PRACTICE MANAGEMENT PROCESS
Like Focusing On The Clinical Process
Kathleen D. Schaum, MS
Not a day goes by that this author doesn’t receive a phone call or e-mail from a concerned wound care professional working in a hospital-owned wound clinic. The number of questions about the practice management process gives the perception that wound care professionals may not be given adequate orientation, education, and mentoring necessary to manage wound care practices. To verify this perception that wound care professionals may need to increase their knowledge about the ‘business of wound care,’ the author contacted a sampling of several different types of wound management companies and interviewed them about this topic. See Table I for the top 10 practice management issues that these wound management companies encounter. If any of these issues exist within the wound care clinic, be sure to request guidance and assistance from the administrator.
When some of the wound management companies were asked to identify the reasons that hospitals seek practice management assistance, the following reasons were given:
• Fear of failure
• Lack of knowledge/experience in wound care operations process; wound care is a specialty that requires a concentrated focus that includes evidence-based clinical guidelines, reimbursement, initial and ongoing education
• Lack of time and resources of a team dedicated to developing the operations side of the business
• Worried about billing correctly
• Minimize start-up costs
• Need assistance to bring physicians and hospital together
• Lack of marketing expertise
With these issues in mind, hospitals that are starting a wound care program from scratch, upgrading to a physician-driven clinic, or attempting to revamp a failing wound care clinic must focus on the practice management processes just like they focus on the clinical practice processes. Some hospitals can accomplish this work without any outside assistance. Other hospitals may need several days/weeks/months of assistance from one or more outside consultants to assist their staff in identifying and/or implementing steps to improve their practice management process. Still, other hospitals may prefer to transfer the entire burden of developing and/or managing the wound care clinic to an outside consulting firm. Regardless of who manages your outpatient wound clinic, certain steps can lead to success. See Table II
for the main steps to practice
management success.
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November 4, 2008 | Leave a Comment
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