By the time this article reaches your screen the national political scenario may have been resolved. Healthcare leaders across the country have already positioned their organizations to survive with sequentially less reimbursement. To continue to provide high quality care in our communities, healthcare must deploy a global transaction strategy (GTS). This strategy unifies the cost of care inputs with the best practice revenue management process. Let’s review the principal components of this strategy.
- Cost inputs as expressed in Materials Management and the Pharmacy must be sourced and paid for using the best possible contracts, with expert understanding of tier pricing and other discount strategies. The item master and formulary cannot have any missing descriptions or prices and quantities must be managed at both the acquisition and distribution levels.
- There needs to be one-to-one relationships between the charge description master (CDM) and the item master/formulary. These links must be mirrored in the charge selection process.
- The business rules that translate item cost into the charge should be managed using business rules. These rules need to be automatically applied every time there is a change in the item cost. Too many organizations leave this important step to an annual review or across-the-board price increase. This always leads to reduced reimbursement.
- Traditional decision support systems often report information that is four to seven weeks old. They also have cumbersome structures when requesting new reports. Future requirements will necessitate that report cycle time be daily; also, healthcare care executives will be able to create new reports without IT or analyst support using their smart phone, tablet or laptop computer. Decisions impacting specific patient treatment strategies will need to be reviewed in real time.
Currently, CentraMed supports one of the largest repositories of materials management databases in the industry, with over 500,000 unique items related to healthcare materials manufacturers and distributors. We have created tools that will electronically enhance an item master to the required expert level. Linked item master to CDM files are currently being deployed to hospitals’ and business rules are being inserted to manage daily price maintenance. This quarter will see the introduction of real-time decision support to handheld devices.
If your organization has not yet deployed a contemporary strategy to manage these keys processes, contact CentraMed to discuss how SaaS-based analytic tools can help preserve the best possible reimbursement results.By Jack Duffy
Executive Vice President