Maximizing Revenue

Hospitals across the country continue to see declining revenues from their Emergency Department (ED).  This decline in revenue is having a significant impact on a community hospitals ability to remain financially viable, and no one understands this better than HospitalMD.  Why?  Because our owner created HospitalMD after managing community hospitals for years. He witnessed these declining revenues himself, and realized that ED staffing groups saw declining revenues as a hospital problem.  He recognized that community hospitals needed much more than ED staffing groups at that time had to offer. Community hospitals needed a dedicated partner that integrates the business of medicine with clinical expertise, focused on helping them maximize their revenue at every turn.  That is the foundation of HospitalMD, and we take pride in being known as an ED “Management” group rather than staffing company.

HospitalMD has identified a number of areas that are routinely given too little attention by ED staffing groups that can help community 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 as an ED Management group, HospitalMD does!

Knowledge “Gap” or Clinical and Financial “Gap”

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 the same extensive training that physicians receive in the science of medicine 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”.

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, 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 continued 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!