By Stephen W. Earnhart, MS
Earnhart & Associates
In USA Today, there was an article on a recent survey of 1,400 CEOs from around the world. They were asked what they perceived as key threats to business. The no. 1 threat (79%) was “over-regulation.” We in healthcare understand. Another interesting result was that 72% listed lack of “key skills.” Tried to hire any quality, experienced staff lately?
It made me wonder what we, as healthcare providers and workers, can do to reduce meaningless, bureaucratic, paper-shuffling, just-burden-them-with-useless-waste-of-time-busywork so we can eliminate some of the mind-numbing nightmare of taking care of our patients. Much of this work is passed down to us from above, but that doesn’t necessarily make it right. I work with some of those people at the top, and most are clueless as to how to deal with it, so they just keep shuffling it down the tube to us to make sure it is properly dealt with.
Let’s see if we can’t make a difference. Send me an email and let me know what you think is the biggest waste of time we deal with in our surgical departments, and let’s try to eliminate it. I will research it and get back to everyone with a potential solution!
QUESTION ON IOL COSTS
Someone asked me last month what is the ideal supply cost per case for cataract extraction with an intraocular lens (IOL) implant. Great question.
I did some research and found, what I think, is among the lowest in the country. Depending upon the CMS wage index for your part of the country, Medicare reimbursement is about $980 for the procedure, which includes the patient co-payment of $196 (collect it before surgery!) and the cost of the IOL. Ugh! Can you make a profit anymore? Yes, but you have to work hard for it. The key to success resides in your supply cost and a high number of cases.
Surgeons can choose the lens that they think is right for their patients (of course), and they have several vendors to choose from: Abbott Medical Optics, Alcon, Bausch + Lomb, and perhaps others. The prices also vary enormously among these vendors. Good luck trying to get your doc to choose the lowest price lens — it just makes them mad, I know — but at least you can anonymously slip the price of each lens into their lockers. It helped me once.
What price should you strive for? If you are not around $200 per case — yes, that includes the IOL — you are missing an opportunity to improve your bottom line. It can and is being accomplished!
Now, many facilities doing cataracts have several surgeons doing them. In one facility, we have seen some docs supply cost around $200 and others around $500. Why? Old habits. That, and the fact that there is not enough physician education going on at your hospital or ASC on cost control.
Most staff members, except possibly your docs, are willing to be educated on lowering their supply cost; they just have not been willing to learn new ways and techniques. Peer pressure always works best, so try doc on doc first. A facility doing 3,000 cataracts per year that can save $150 per case in supplies adds up to $450,000. It’s worth the effort.
Speaking of “effort,” do send me your paperwork pet peeve. Let’s see what we can do! [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates, 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. Email: firstname.lastname@example.org. Web: www.earnhart.com.]