Frequently Asked Questions
My facility is a
critical access hospital (CAH).
How do you structure programs for such small facilities?
No hospital is too small to benefit from a hospitalist
program. Hospital Care Consultants primarily works with small rural
hospitals with programs tailored specifically around your needs.
Some of our programs are done in concert with Emergency
Department physicians – using them as hospitalists during their
slower time.
Critical access hospitals have a maximum of 25 acute beds.
Hospital Care Consultants has created a special CAH
hospitalist program specifically designed to meet the needs of such
hospitals. We understand
the regulations governing CAH operations, and we work with local
physicians to maximize the return to the hospital.
Hospitalist programs
are too expensive. How
can I afford it?
HCC’s programs produce an
average return on
investment of 3.5 to 1. Hospital Care Consultants will review your
hospital’s specific information and show you how your hospital could
improve profitability, patient care and operating efficiency with
the right hospitalist program.
Patient care and patient satisfaction have a very positive
impact on facilities with quality hospitalist programs.
Hospital Care Consultants will review your admissions,
interview your physicians, and analyze your admission patterns.
Generally, rural hospitals see a significant reduction in
patient admissions Thursday – Sunday of each week.
Local primary care physicians generally choose to not admit
patients that they will have to round on during the weekend.
Each patient not admitted means your hospital does not
receive the $4000 - $5000 such admissions generate. This may also
result in less-than-optimum care for the patient.
How do I convince my
Medical Staff to accept a Hospitalist program when they are against
it?
Hospital Care Consultants will not start a program in a
facility where we have not met with the medical staff.
Our educational presentation does a very good job of
explaining to your physicians how hospitalist programs work.
Once your physicians understand that our programs are
completely voluntary, that we will accept any unassigned patients if
your physicians wish, that we will take
over as either attending or perform consultations
at any time and return them to the primary care physician at any
time, physicians begin to realize that the right hospitalist program
is an enhancement to the hospital, and can be a valuable tool for
them to use.
Why do I need a
hospitalist program if my physicians discharge patients on time?
Even if your physicians are discharging patients in the
timeframe that Medicare says is reasonable, hospitalists generally
discharge patients sooner.
On average, hospitalists have a length of stay of 0.7 days
less than primary care physicians.
On average, hospitalists have a reduction in cost per case of
11% versus primary care physicians.
On average, hospitalists have a readmission rate 82% lower
than primary care physicians. Hospital Care Consultants physicians
are resident at your hospital 24 hours a day.
This allows them to be very responsive to patient, family,
and nursing needs.
Reduction in average length of stay is only one component of quality
hospitalist programs.
Why do I need a
hospitalist program if my physicians admit all appropriate patients?
Although hospitals like to think that their medical staff
admits every patient that is appropriate for inpatient care at your
facility, physicians usually admit that there are instances where
they choose not to admit a patient.
HCC has found such circumstances are quite common in smaller
communities where primary care physicians have busy office
practices. Some patients
are sent home and told to follow-up in a couple of days; some
patients are sent to a facility out-of-town because the primary care
physician does not have time or expertise to manage the care.
Some primary care physicians direct the Emergency Department
to transfer care to another hospital on patients they are not
willing to manage. Each
such case represents a lost $4000 - $5000 opportunity.
Why do I need a
hospitalist program if I don’t have many transfers to other
facilities?
HCC
has found that in many rural hospitals, there are few specialists on
staff who are willing to manage complex patient care needs.
Since Hospital Care Consultants physicians are in-house 24
hours a day, they are readily available to manage the complex cases.
Typically, the number one reason for patient transfers is
chest pain and the need to rule-out cardiac events.
Statistics show that over 80% of all chest pain cases are
non-cardiac. Local
physicians are generally not comfortable managing cardiac cases, and
thus most of these patients get transferred, resulting in a
significant lost opportunity for your hospital.
What size hospitals are
best for a hospitalist program?
Hospital Care Consultants has found that virtually every
hospital can justify a quality hospitalist program.
Critical access hospitals find that hybrid programs are very
successful – using Emergency Department physicians as hospitalists.
Hospital Care Consultants has a formal training program for
these physicians.
Hospital Care Consultants provides physician care that is
on-site 24 hours per day.
Generally, one physician is in-house is sufficient for the
needs of facilities with less than 100 acute beds.
Hospital Care Consultants will typically utilize 3 – 4
physicians to provide this level of coverage.
In larger hospitals, Hospital Care Consultants will partner
with the hospital on providing a cost-effective program of physician
staffing, clinical and operational staffing, and management
oversight. Hospital Care
Consultants also provides consulting services to these larger
facilities to help revamp existing first or second generation
programs bringing them up to current standards.
No program is too small or too large for Hospital Care
Consultants’ involvement.
How do
hospitalist programs work?
Hospital Care Consultants recruits, credentials and provides
Board Certified physicians to its client hospitals for managing
inpatient care of your patients 24 hours a day, 365 days a year.
Our physicians manage the care of any and all patients
assigned to them – either unassigned patients from the Emergency
Department, or accepted to the hospitalist service from a local
physician.
Hospitalists round multiple times per day on each patient.
They are available, generally, at any time to help the
nursing staff with a question or problem with one of the
hospitalist’s patients.
They are capable of managing ICU and CCU patients, as well as acute
patients, skilled nursing and cardiac rehabilitation care.
Hospital Care Consultants charges its client hospitals an
hourly stipend for staffing the facility.
It also receives the professional billing fees for its
services. Hospital Care
Consultants provides the physicians we provide with malpractice
insurance coverage.
Generally, hospitals will achieve a breakeven on the cost of a
quality hospitalist program with 12 – 13 new admissions per month.
In most of HCC’s programs, we find our hospitalists are
admitting 1 new patient per day – or 30 per month.
Coupled with a reduction in the average cost per case and the
reduction in length of stay, most hospitals achieve a return on
their investment of better than 3 to 1.
