3 Things to evaluate to ensure a successful Infusion Center

What makes a successful infusion center?  Clients often ask me how can we grow or develop this business to be a center of excellence for my community, and program that is financially sustainable and maybe even profitable.    Obviously having a good payer mix is helpful, having patients with insurance is good and a good revenue cycle process is important.  But, perhaps the most important component to a highly successful infusion center is ownership.  No, I’m not talking about equity stakeholders but rather 1) Ownership of the Problems 2) The Processes and 3) most of all, ownership of the Patients.

Sometimes it is difficult to see if an organization’s staff has real ownership.  If processes are moving swiftly without issue you might assume that there is ownership, but there is now guarantee.   Sometimes it is easier to identify organizations that have staff that do not have good ownership.  Have you ever been told “I don’t know”, or “It’s not my job”, “I’m sure somebody could tell you, just not me” Compare that to “I don’t know, but I’ll make sure I find out for you” – it really comes down to providing not just good but great customer service.

Medical practices are complex organizations, hospitals are even more complex.  Just because an organization is complex does not mean that it cannot provide high quality service and high quality customer service.   I work complex hospitals and practices all the time.  It does not take much observation to find out if staff is taking ownership.

The Problems:  Let’s face it, in complex systems there will inevitably be problems some of them very challenging.  In infusion medicines problems can range from not having the correct authorization for a medication to not having the right supplies.  Most of the time, there is a way around the problem that will still allow for the patient to receive the medication they need in a timely manner.  The solutions often are with the nurse or medical assistant that has the “can do attitude” that makes the delivery of the drug a reality.

The Processes: The process of infusion medication often starts with a complex verification and authorization of insurance information.  The process of treating the patient likely was started long before the patient arrived.  Practices routinely review charts in advance of the patient, they anticipate the medication they will use and prepare the tube sets and other devices and supplies they need for their work.  If the process of scheduling is not developed to specific drugs that are being infused there will be problems.  Process problems are usually worked out by evaluating the work flow on paper – identifying the gaps in the program and reworking the process.  Systems consulting can help you and your team with process evaluation.

The Patient:  The patient as everyone knows is realistically where things can go wrong most frequently.  For example, the veins are challenging, or the concerned nurse notices that an error from the pharmacy indicates that there may be a potential medication error.  Quality staff is trained to know what to do, when to ask for help and when to “red flag” a process are critical.  When you have staff that understands the patient and takes ownership of their problems healthcare becomes individualized. 

Put yourself in the patients’ position, it will not be long before you assess your team and if they have ownership!  Ultimately, that is why most of us are in healthcare?

If you or your team needs Infusion Center Expertise - call our team we can help with workflow, profitability, program development (Maybe you just need a "check-up"  please call us today for a free 30 minute consult today 1 866 222 4488

3 Most Common Types of Infusion Centers

Many people follow the growth of the pharmaceutical industry and see that there are many new biologic drugs on the horizon. Naturally, where there is an opportunity for growth the assumption of profit draws in a greater audience. 3 of the most common locations for providing infusion therapy are as follows..1. Hospital Outpatient Department (HOPD) This is the traditional location that drugs have been infused, and are often comingled with chemotherapy, blood transfusions, biologics and fluids for rehydration.2) Physician Specialist / Sub-specialist practice infusion centers. As monoclonal antibodies appeared in the market, certain segments such as Rheumatologist or Gastroenterologist infused biologic drugs such as Remicade3) As more biologic drugs are infused the development of free standing ambulatory infusion centers are growing. These centers essentially operate as a physician office, yet are actually delivering care / services on behalf of their referring physician customers.The "Place of Service" defines how a practice or hospital will bill for these services. We can help you navigate through this complex process. Want to learn how you can learn more about developing an ambulatory infusion center, improve your hospital outpatient department or extend the growth of your practice infusion center? Call us today to learn how we can help your organization grow in this exciting market. We offer a free 30 minute telephone consultation 1-866-222-4488 or review our website http://www.huizenga-consulting.com/infusion-center-consulting-turn-around/

3 Strategies to Increase Efficiency at your Infusion Center

Infusion centers today are challenged by many issues today from ASP + 6 pricing, increased costs, and more insurance rejections - it just seems like margins are getting "thinner". Here are 3 ideas to enhance your bottom line. Remember, to increase your profits you can either increase revenue or decrease expenses - typically there are opportunities for improvement on both the revenue and expense side.

1. Know your customer – in health care we are often challenged by the question “who is my customer”? Unfortunately it is often not clear. A nurse will almost always see the patient as the customer; the administrator identifies the insurance company as the gatekeeper of the money and therefore the customer. Traditionally the employer has carried the greatest burden of the cost so they can be a customer as well, but let’s dig deeper. If you’re running an infusion center and trying to garner additional patients often times the customer is a bit more tangential. Think of the case manager at the health plan that may recommend your center, what about the referral coordinator at the referring doctor’s office, or a sub-specialty physician who identifies your venue as a more appropriate place of service? As you can see, there are many customers, and it is important to make sure that they know they are important, that they receive the information they need to do their job (such as communication on the status of the patient, any change in meds etc). The insurance companies measure lots of things, but if you conduct survey’s or studies they might be interested in learning how you operate and in the long run refer more patients to you.

2. Develop a process to manage and maintain the eligibility of patients, and verify that insurance before each visit. Many of the drugs infused at your facility are extremely costly many biologic pharmaceuticals or orphan drugs can cost several thousand dollars. We try to encourage front desk staff to remember a) Verification – that they have insurance and b) Eligibility – are they eligible to receive this product. Insurance companies have developed protocols to save the plan, the patient and the employer money – unfortunately, that does not always fit with your treatment plan. So, even if a patient is eligible, develop a strategy to ensure that each patient is eligible for the treatment before you begin the infusion. It may not feel like you’ve developed a model of efficiency, but in the long run your revenue cycle (the amount of time it takes to treat, bill and collect) will improve.

3. Create a Charge Master a.k.a. fee schedule that will help you identify if you will have a profit margin on the drugs you infuse. With the volatility of the reimbursement of drugs and the ever changing prices of pharmaceuticals you owe it to the organization to develop a charge master. First, identify 80% of the payers, likely that will be four or five insurance carriers. Next, compile a list of drugs and procedures that you perform in your facility. You can do this on paper, but due to the dynamics of this business we always recommend you have an Excel spreadsheet charge master (need help to configure this? Just send us an e-mail we’ll send you a free spreadsheet template with the formulas already built). Finally, you’ve got to find out what the carriers pay for their products and what your acquisition costs are. Of course you have to manage this whenever there are changes in reimbursement or acquisition costs, you need to update the spreadsheet. You will be surprised, once the spreadsheet is designed, the maintenance will really enhance the revenue at your infusion center.

Do you additional ideas to improve your infusion center? Call us today for a FREE 30 minute telephone consult to learn how we can help you 1-866-222-4488, or review our website http://www.huizenga-consulting.com/infusion-center-consulting-turn-around/ .
Mark Huizenga