| Michigan Healthcare Improvement, LLC. |
| The health care improvement specialists |
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Trying Times for Hospital Bottom Lines
Not even health care is immune to current economic conditions and cost reductions.
Hospitals are reducing staff to control their increasing loses.
But is this the best strategy?
Sure it’s a good time to reassess staffing levels but reducing staff costs money and
hurts morale— critical to patient satisfaction scores. So what else can be done?
Some ideas that can save at least a few FTEs:
1. Make sure Medicare is not unnecessarily penalizing you with transfer DRG
payment reductions. For example CABG patients sent home too early and with
homecare will not earn full payment. Be mindful of Medicare’s expected lengths of
stay.
Not even health care is immune to current economic conditions and cost reductions.
Hospitals are reducing staff to control their increasing loses.
But is this the best strategy?
Sure it’s a good time to reassess staffing levels but reducing staff costs money and
hurts morale— critical to patient satisfaction scores. So what else can be done?
Some ideas that can save at least a few FTEs:
1. Make sure Medicare is not unnecessarily penalizing you with transfer DRG
payment reductions. For example CABG patients sent home too early and with
homecare will not earn full payment. Be mindful of Medicare’s expected lengths of
stay.
2. Take steps to ensure proper documentation of critical criteria for DRG assignment and avoid DRG downgrading.
For example with PTCA patients, documenting the use of drug eluting stents or the presence of major cardiovascular
diagnoses is imperative to the correct DRG assignment. Consider modifying the physician operative note to include
reminders or create a new document that will trigger proper documentation.example with PTCA patients, documenting
the use of drug eluting stents or the presence of major cardiovascular diagnoses is imperative to the correct DRG
assignment (severity adjustment).
3. Verify that Medicare’s “3-day rule” is being implemented correctly by your automated billing rules. Services
unrelated to the inpatient admission do not apply and may be billed separately, thereby increasing revenue.
4. Reduce infections, complications and fall rates (see Falls article, this issue) Don’t like these tips? There are plenty
of other options. You can find new ways to improve profitability by performing methodical and thorough data
analyses. Start by assessing the profits and losses on each of your service lines, drilling down to the DRG, physician
and even patient levels while looking for patterns.
For example with PTCA patients, documenting the use of drug eluting stents or the presence of major cardiovascular
diagnoses is imperative to the correct DRG assignment. Consider modifying the physician operative note to include
reminders or create a new document that will trigger proper documentation.example with PTCA patients, documenting
the use of drug eluting stents or the presence of major cardiovascular diagnoses is imperative to the correct DRG
assignment (severity adjustment).
3. Verify that Medicare’s “3-day rule” is being implemented correctly by your automated billing rules. Services
unrelated to the inpatient admission do not apply and may be billed separately, thereby increasing revenue.
4. Reduce infections, complications and fall rates (see Falls article, this issue) Don’t like these tips? There are plenty
of other options. You can find new ways to improve profitability by performing methodical and thorough data
analyses. Start by assessing the profits and losses on each of your service lines, drilling down to the DRG, physician
and even patient levels while looking for patterns.
