Tips for staying afloat with less reimbursement

Here are some other suggestions on how to keep afloat in the changing reimbursement environment:

· Start working with your hospital's finance staff to determine what it really costs you to do business. Cost accounting is a difficult process and you need professional help to do it right.

· Determine the resources you actually use to provide care for patients. Include human resources and supply resources, pharmacy and laboratory services, supplies, and equipment - anything used to care for patients in a particular category.

· Once you know what the resources are, determine the cost of the resources needed for each unit of care for each diagnosis and each level of acuity.

· Be creative in the way you deliver services. Because you're likely to get a lower price for your services, you have to increase your volume and deliver an increased volume of services at a lower cost, points out Nancy Beckley, MS, MBA, president of Bloomingdale Consulting Group in Valrico, FL.

Some providers have cut costs by conducting therapy in a group setting, increasing the use of nonlicensed staff, and reducing paperwork and meeting time.

· Eliminate staff overcapacity by looking at ways to flex your staff. Since patient care is labor-intensive, the majority of costs are for staff time.

Hospitals have a flexible nursing schedule for times when beds aren't filled, Beckley says.

"If you're going to get reimbursed only so much, why pay staff more than you are going to get back? " she says.

· Take a look at the professional and nonprofessional costs to deliver treatment and see what you can cut out.

· Learn from the physicians who have been forced to deal with huge cuts in reimbursement and see what they have done.

"If the volume of money is 30% less, the smart doctors aren't running their offices the way they used to. We hear providers saying they can't do it any other way but some people are doing quite well and they are the ones who are going to survive," Beckley says.

· When negotiating managed care contracts, you must determine the market price of your services and base your price on what the competition would charge. This means you may have to redefine how you are delivering services, Beckley says. n