Maximizing Revenue

Rural hospitals across the country continue to see declining revenues, and although there are many areas of a hospital that contribute to this decline, the decline in inpatients generally results in the largest revenue erosion. This decline in revenue is having a significant impact on rural hospitals ability to remain financially viable, and no one understands this better than HospitalMD. Why? Because HospitalMD was created by our owner to reverse this revenue decline after managing community hospitals for years.

He witnessed these declining revenues himself and realized that if something wasn’t done soon, rural hospitals would not survive. The traditional model utilized at the time that saw ED staffing group staff the ED while depending on the local primary care physicians (PCPs) to manage inpatients wasn’t working. ED staffing groups saw declining revenues as a hospital problem and the PCPs often acknowledged their lack of eagerness to continue to care for inpatients. PCPs communicated their desire to support the hospital if the hospital was able to provide a Hospitalist service. Unfortunately, a Hospitalist service was not a financially viable option.

Recognizing that rural hospitals needed much more than what the traditional model had to offer at that time, HospitalMD’s Hybrid medicine model was created.

Recognizing that rural hospitals needed much more than what the traditional model had to offer at that time, HospitalMD’s Hybrid medicine model was created.  The Hybrid model gave rural hospitals the ability to provide a 24-hr Hospitalist service without the traditional cost. Through this service, PCPs now had the Hospitalist service they needed to continue to admit their patients to the hospital, resulting in increased revenue for the hospital. HospitalMD has become a dedicated partner that focuses on solving rural hospitals unique needs. By integrating the business of medicine with clinical expertise, HospitalMD has helped rural hospitals regain the revenue from the ED and inpatient service that they so desperately need.

HospitalMD has identified a number of areas that are routinely given too little attention by traditional staffing models that can help rural hospitals maximize revenue. Whether it’s capturing patient out-migration from an inpatient perspective, increasing ER volumes, increasing patient satisfaction, controlling costs by analyzing the appropriateness of diagnostic exams as it relates to medical decision making, utilization management techniques to ensure medical necessity, clinical documentation training and monitoring to maximize reimbursements, or support for Hospital’s ICD-10 processes, they all have one thing in common: the physician. ED staffing groups do not dedicate the time or resources necessary to address these areas in detail, but a Hybrid Management group, HospitalMD does!

Clinical Knowledge + No Financial Knowledge = Knowledge “Gap”

Every clinical decision has a financial consequence for which physicians have received little, if any, training.

Physicians receive extraordinary training in the science of medicine. This training enables them to assess a patient’s condition and symptoms and quickly make critical clinical decisions. But every clinical decision has a financial consequence for which physicians have received little, if any, training. And although physicians hear the criticisms that patient care costs too much, they order too many diagnostic exams, they over treat patients and they under document, they generally don’t know what to do about it. Because is not provided for them to understand the financial impact of their medical decisions, the result is a significant knowledge “gap” between their medical decision and the financial ramifications of those decisions.

This “gap” can cause a perfect storm for unintended and adverse medical and financial outcomes for the patient, hospital, and payer. Only physicians with complete medical and financial knowledge can make decisions that truly achieve a balance of business and medicine. Otherwise, the physician puts the hospital at financial risk. That is why HospitalMD has created an extensive training program to provide our physicians with the knowledge and support they need to bridge this “gap”.

They learn the revenue, cost, and regulatory implications of their decisions.

We teach our physicians to make clinical and financial decisions that consider the patient’s medical needs within and beyond the ED. They learn the revenue, cost, and regulatory implications of their decisions as well as the importance of working with case management and utilization review. We provide direct on site and technology-based support. This focus leads to more effective patient assessment and diagnostic decisions that balance cost in light of patient disposition, an understanding of “medical necessity” as the only standard for acute admission and not a “cookbook” reference, and clinical documentation that assures you that you will maximize your revenue for the services provided.

Teaching and coaching our physicians in this arena is only the start. Measuring the effectiveness of the training program and communicating the results with the physicians and hospital in a consistent manner helps us maintain and adjust our training methods over time. The result is continuous management of our physician practice that focuses on maximizing the revenue for our client!

So, when you choose HospitalMD as your dedicated partner to integrate the business of medicine with clinical expertise, you can be assured that the hospital’s financial health will receive the same amount of attention as the health of your patients.

Contact us today to learn more!