Basic areas to include in the first layer of a hospitalist program ROI analysis are net program cost, efficiency and utilization improvements, and more accurate documentation of severity of illness. The second layer of ROI analysis delves deeper than the first. This layer of analysis examines areas such as nursing labor costs, tracking avoidable days and reducing 30-day readmission rates. Quality and satisfaction metrics are also important to track and now have financial penalties attached to poor performance.
“Hospitalist programs can measurably improve quality, satisfaction and financial performance of inpatient healthcare delivery,” said Dr. Bessler. “The goal of any hospitalist program is to improve the quality and reduce the cost of healthcare for patients and hospitals.” With a smoothly run program, hospitals can avoid unnecessary bed days and improve utilization metrics, such as pharmacy cost per case, while improving quality and satisfaction.
A high-performing hospitalist program will focus on performance management, which starts with a thorough assessment of current performance. Areas to analyze include quality, readmissions, mortality, efficiency, and satisfaction of the patients, staff and physicians. After analysis of the program, hospitalist groups must implement customized workflows, tools and processes to drive results.
Hospitalist programs continue to grow in their scope and deliver more value, so it is important in larger programs to have administrative time for the chief hospitalist, utilize hospitalist RNs and other administrative support, and use midlevel providers where appropriate.
As hospitals shift from being providers to payers, hospitalists can deliver value to the system by helping to avoid unnecessary admissions and ensuring patients receive care in the most appropriate setting. Through a focus on performance management, a strong hospitalist program can deliver a substantial ROI for hospitals and the overall healthcare system.
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