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Not even health care is immune to current economic conditions. 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, reduces productivity and hurts morale-critical to patient satisfaction scores. So what else can be done? Below are 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.
3. Verify that Medicare's "3-day rule" is being implemented correctly by your automated billing rules. Typically, any services performed on a Medicare patient three days pre- and post-admission are rolled into the inpatient stay and bundled with the patient's DRG payment. However, Medicare rules state that services unrelated to the inpatient admission do not apply and may be billed separately, thereby increasing revenue. The trick is proper documentation and proper billing processes.
4. Reduce infections, complications and fall rates. Any health care analyst knows these things are costly. But more payers are implementing strategies to avoid paying for these cases altogether. Analyze financial, clinical and operational data to determine root causes, don't just assume you know the answer. Often root causes are hidden beneath many symptoms.
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 analyzes. 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.
