Multiple sclerosis (MS) clinics by themselves seldom generate profits or break even without significant outside funding. Even when programs work to limit costs and maximize volumes—such as sharing space and employing mid-level providers, respectively—most still operate at a deficit.
However, evaluating the benefits of an MS clinic requires more complicated financial calculus. MS programs typically attract patients that use hospital and ambulatory services at a much higher frequency than average patients. While there is potential for significance downstream revenue, it is important for organizations to consider whether these units of services would have been captured by the organization without a formal MS clinic.
More difficult to quantify—but still important to consider—is the revenue that hospitals may save by preventing unnecessary emergency department (ED) visits. Organizations pursuing population management business models may generate additional benefit from offering a destination site of care to transform care management for a complex patient group.
Read more »
In addition to launching our national meeting series at the end of April, we’re also offering a series of webconferences across the coming months. These webconferences will focus on the outlook for key service lines, providing an overview of key trends in volumes and examining strategies that hospitals can use to continue to transform and grow particular service lines.
The series begins with orthopedics on March 20—we encourage Marketing and Planning Leadership Council members to register today. We’ve included more details, including links to the webconferences, below.
Read more »
Despite the proliferation of Joint Commission-certified primary stroke centers, there is still ample room for improvement in the medical management of stroke—only a small percentage of stroke patients receive treatment within the “golden hour” time window. Among the 800 certified stroke centers, only a handful have the resources to provide advanced neurointerventional services and be considered, unofficially, a “comprehensive” stroke program.
The Joint Commission has recently proposed more stringent requirements for comprehensive status that would formalize the designation that current “comprehensive” stroke programs have claimed.
As previously featured in Technology Insights' blog, The Pipeline, the new criteria would specify the infrastructure, technology, staffing, and services needed to receive designation as a “comprehensive stroke center.” Under the proposal, comprehensive stroke centers would no longer be defined at the procedural level, but rather by their ability to manage stroke care longitudinally, leaving many organizations out of the running for designation given the higher barrier to entry.
Read more »
Although neuroscience volumes have been one of the best areas of recent growth for hospitals, high growth for some procedures may not be sustained in future years. In fact, volumes for some neuroscience procedures are even predicted to decline in the hospital setting.
Across some services, the drop will result from a shift in site of service, migrating out of hospital settings. For example, the advent of portable sleep monitoring is pushing many hospital-based sleep services to the patient home. Even though total sleep study volumes are projected to increase 66% by 2020, hospital outpatient department (HOPD) volumes will decline by an estimated 12%.
Read more »
While many neuroscience programs have robust direct-to-patient marketing programs for stroke and spine, traditional consumer marketing methods may not have the same return on investment for all subspecialty services, such as epilepsy or Parkinson’s disease. Many of these programs may have existing capacity issues due to high demand and/or a limited number of specialists.
Patients also tend to come from specific demographics, and self-referrals are often less common than for other neuroscience areas, such as spine. Given these characteristics, it is unlikely that expensive, mass marketing techniques will result in large returns for these services.
Determine whether to market subspecialty services
Some programs may not need to market their subspecialty services at all. When deciding whether to market services, programs must consider internal capacity, competition, and profitability. Programs experiencing capacity issues and long wait times may derive little benefit from marketing their subspecialty offerings and may better use resources for other services.
Read more »
Although spine procedures are considered to be a bread and butter service of hospital business units, there are a number of challenges that will affect the pace at which these procedures are poised to grow in the future. The traditional growth drivers of the past, such as demographics and advances in technology, may actually temper growth in coming years. The utilization of certain spine procedures, spinal fusion in particular, may begin to slow as baby boomers continue to age—the utilization of spine surgery peaks between ages 45 and 64.
Advances in technology and treatment techniques may also reduce inpatient volumes by pushing procedures to outpatient settings (see the Marketing and Planning Leadership Council’s Service Line Forecast Compendium for inpatient and outpatient forecasts).
Commercial payers and government agencies are also increasing their scrutiny of spine surgery utilization, putting additional pressure on growth prospects. For example, CMS recently announced (and then postponed) plans to launch a demonstration in 11 states evaluating the appropriateness of high-end procedures, including common spine procedures, by conducting prepayment reviews to ensure medical necessity before providers are reimbursed. Such efforts, along with news coverage putting “unnecessary” utilization of spine procedures in the spotlight, are likely to push providers to offer more conservative therapies as penalties and denied payments increase.
Read more »
Developing a multidisciplinary stroke service is an emerging imperative for institutions looking to drive outcome improvements and extend patient care coordination across the broader continuum. Multidisciplinary care consists of the following components:
1) Interdisciplinary team structure: The ideal model includes:
- Medical director
- Clinical stroke coordinator
- Vascular neurologists
- Neuroscience nurses
- Rehabilitation specialists
- Operations coordinator
The collaborative nature of this type of stroke services allows the clinicians to develop a robust and individualized, nuanced treatment plan for each patient. Previous research has shown that such models result in incremental improvement in both outcomes and patient satisfaction by facilitating streamlined decision making and standardization of processes and goals.
Read more »
Neurosciences, while a high priority at most hospitals, is still a relatively new service line. For many neuroscience administrators, resources supporting their wide range of responsibilities have often been difficult to find in a single, centralized place.
One of our members recently alerted us to a new resource geared toward neuroscience administrators, and it we've deemed it useful enough to share. To better meet the needs of this burgeoning group of service line leaders, the American Academy of Medical Administrators is developing the “American College of Neuroscience Administrators.”
The American College of Neuroscience Administrators (ACNA) will provide opportunities for networking and professional development to service line administrators focused on “neurosurgery and neurology, involving stroke, PMR (including acute rehab), sleep medicine, ortho (spine), rheumatology, neuro-oncology, epilepsy, Parkinson’s, neuro-psychiatry, EEG-EMG, otolaryngology and related concerns.” As the group builds its membership, it may eventually begin offering credentialing and advancement opportunities. Ultimately, the group’s proposed mission is “to advance excellence in neuroscience leadership through individual relationships, multi-disciplinary interaction, ongoing education and active engagement.” For many neuroscience service line administrators, this may be a welcome resource to provide support for leading one of the fastest-growing service lines.
Read more »