Hospitalists looking to demonstrate the value of their program should always keep one eye on the bottom line and the other on satisfying stakeholders.
Hospitalist leaders who are looking to demonstrate the value of their program should always keep one eye on the bottom line and the other on satisfying the program’s myriad stakeholders and customers.
By Ken Simone, DO
As a consultant, I frequently am engaged to evaluate hospitalist programs that are operating in the red. When I deal with programs that are owned or heavily subsidized by the sponsoring hospital, the administrators will inevitably tell me some variation of the following: “We’re not sure the program’s affordable or worth the amount of money we’re sinking into it… We don’t know why the program isn’t more successful.” These statements immediately raise a red flag; they signal that the financier is questioning the fiscal viability of the program, as well as its value!
The scenario described above may be a symptom of a number of problems. Perhaps an in-depth feasibility study was not performed prior to program start-up. This is the time when finances should be assessed with an eye to both the demand for and cost of providing hospitalist services. It is also the time when program leaders should educate, collaborate, and build common vision with all of the key program stakeholders.
When an administration questions the value of its hospitalist program, it may also be indicative of a leadership void. It is the responsibility of the hospitalist leaders to advocate for their program and demonstrate its value for the subsidizing entity.
Customer service is key
Hospitalist leaders have many tools and strategies they can employ to improve ROI. First, program leaders must create short- and long-term plans that address the program’s financial, operational, and clinical performance; the focus should be on improving the bottom line. The key to success is customer service and satisfaction. In the hospitalist venue, the “customer” represents many stakeholders, including patients and their families, referring providers, nursing and medical staff, the sponsoring hospital administration, and the emergency department. Programs should make a concerted effort to educate and market to these targeted groups. This can take many forms, such as creating patient education pamphlets, developing a practice website, and creating user groups. This effort should also involve holding focused educational meetings, developing collaborative (interdisciplinary) initiatives, and visiting every referring provider’s office to meet with the clinicians and front office staff.
Hospitalist leaders must evaluate their program’s resources in an effort to fulfill unmet needs. Let’s examine three examples of how a hospitalist program can expand its service line. Consider a medical community that is having difficulty recruiting a general surgeon or medical subspecialist. The hospitalist program can help meet this need by offering co-management services. A hospitalist practice in a hospital that is experiencing unexpected readmissions in its elderly (Medicare) population can create a palliative care service allowing for the appropriate long-term planning and disposition of patients with chronic debilitating illnesses. In the final example, a community hospital may be losing market share to a competing institution because it can’t provide a full complement of intensive care services. A hospitalist program in this case may selectively recruit for intensivists and/or procedurists to provide these services and prevent “leakage.”
Looking beyond the bottom line
There are many ways to provide value and positively impact the bottom line of a hospitalist program and/or the sponsoring hospital. Through proper planning, attentive collaboration, and the embrace of a common vision, any program can expand its services toward profitability while meeting community need.
Ken Simone, DO, FHM, is a board-certified family physician and the founder and president of Hospitalist and Practice Solutions, a consulting company that develops, restructures, and redesigns hospitalist programs.