Skills in DemandWith the consistent upward trend in the healthcare Industry there is huge demand for specialist doctors and experienced Nurses in the respective specialties. Survey respondents were allowed multiple answers.Average hiring for a single hospital per year is around 50 from the different departments and specialties.When asked which overall category was experiencing the most growth within their Hospitals, the top reply was Gynecology, with 23% of the response. Cardiology followed at 15% and Pediatrician was third, with 13% of the response.Hiring MethodologyA usual trend in the healthcare industry was considered to be through personal references and through newspapers, but surprisingly the demand for right personnel has forced the healthcare industry to bank on electronic media like job sites and emails.The highest attrition is for Nurse and Duty doctors who are also high in demand. The finding of the report is startling and reveals the correlation between the hiring and attrition rate in organizations.With the scarcity of healthcare personnel, even hospitals are finding it difficult to hire fresh candidates.Unlike other Industries, there is no specific hiring period and almost all the healthcare organizations hire round the year.Keeping these trends in mind and going further will maximize your potential towards the healthcare niche.Regional Outlook
HR Managers in the West North South states forecast the strongest hiring activity. 78% of executives expect to add staff and only 2% anticipate personnel cutbacks.Survey Methodology
The national poll includes responses from more than 400 HR Managers from a stratified random sample of Hospitals and Healthcare firms with 50 or more beds.
Full Episodes Worth 11 Times More Than LUPA EpisodesAmong the most costly groups of Medicare patients are those subject to LUPA. Using the most recently available national claims database, Healthcare Market Resources’ research shows that a full episode patient is worth 11 times more than a LUPA episode patient. Furthermore, the indirect costs in servicing a patient – including intake, medical records, billing and quality review – are practically the same regardless of whether it is a LUPA or full episode. The average labor cost per visit is also higher for a LUPA episode, since the added effort of the initial and discharge visits are balanced by fewer “regular” visits. LUPA episodes are financially unattractive and, therefore, every effort should be made to minimize their frequency.Understanding Why LUPAs Occur Can Help Minimize Them in the FutureThere are three types of LUPA episode patients based on the reason for the adjustment: Inevitable episodes, intake episodes and operational episodes. By understanding why an adjustment is made, an agency can take steps to minimize the occurrence of LUPA episodes in the future:1. Inevitable LUPA EpisodesThese types of LUPA episodes are very difficult to prevent. They can happen if a patient is readmitted to the hospital or transferred to hospice before a treatment plan is completed. Another example of an inevitable LUPA episode is a patient service who requires a re-certification period, but achieves the treatment plan goals before completion of the full episode visit level. Other than making sure that the transfer to hospice occurs after the fifth visit, there is little that your agency can do to prevent these inevitable LUPAs.2. Intake LUPA EpisodesAs you can see in the Metrics Matters section of this newsletter, patients with certain primary diagnoses are more likely to generate LUPAs than others. The prime offenders – diagnoses that generate the most “intake” LUPA episodes – include:Mental health
B12 shots (Blood)
Once your agency has decided to admit a patient with one of these diagnoses, there is little that you can do to avoid the LUPA. If your agency has programs that serve these patient populations while your competitors do not, you’ll likely end up with a disproportionate number of LUPA cases. Several of Healthcare Market Resources’ Market Profile Reports can help your agency determine if it’s bearing the burden of LUPA diagnoses for your community.Certain referral sources, such as ambulatory surgery centers, may also generate a disproportionate number of LUPAs because of the limited needs of their patients. Only an agency that is built around a per-visit model rather than an episode model may have the cost structure to serve these patients. As the impact of the reimbursement cuts begin to affect the survivability of home care agencies – especially local visiting nurse associations (VNAs) – tough decisions may have to be made as to whether an agency can afford to continue to serve these patient populations, particularly if the long-term survivability of the agency is at stake.3. Operational LUPA EpisodesFrequently caused by patients missing visits, this type of LUPA is the most preventable. Monitoring these “absences” on a real-time basis and holding staff accountable for rescheduling the visit is essential. Also, your agency can contact projected LUPA patients between visits to see if their condition has changed. If a patient’s condition has changed, your agency can respond by contacting the physician to get an assessment visit authorized. In any case, this practice is good customer relations. Additionally, agencies should conduct periodic chart reviews to determine how many LUPAs were preventable.LUPA Rates Vary Among Different MarketsLUPA rates also vary significantly from market to market. Healthcare Market Resources demonstrated LUPA levels vary dramatically by state, for example, in a previous newsletter article, “Metrics Matters: What Percentage of Your Home Care Patient Episodes Are Subject to LUPA?” In fact, we found a negative.65 correlation, which is statistically significant, between recert rates and LUPA levels. That means the higher the recert rate, the lower the LUPA levels. This strong correlation indicates that LUPAs are less likely to occur if agencies serve a highly chronic population.Each market has its own LUPA level, caused by:The types of patients referred to home health
At what point in the disease process patients are referred
How long agencies are “allowed” to keep patients.Managing your agency’s percentage of LUPA patients can have a significant impact on your financial results.
While reading some online content the other day, I happened across a paragraph that gave me pause. The article was addressing the work of primary care providers. Nothing earth shaking in what I read until I saw a sentence that said we should ask the patient how they define health. WOW!!! This is a major point that we often overlook. Taking notice of this one item can explain a great deal about our patient’s health behavior.Those of us who have chosen an occupation in the health and wellness field have been well educated in the classic definition of health. We study normal lab values, charts, tables and a plethora of other items that we use to define good health. Variations to these normal values are usually indicative of some disease process. When a healthcare provider sees a value outside of the normal, we have this deep, burning desire to manage and correct the process that produced the offending value. We will often consult fellow practitioners to get their consul on how to best address the problem that we have found. Then we use a variety of medications and procedures to try and bring all of the values we measure back to the physiologic normal. At that point we pronounce the patient healthy.According to the Centers for Disease Control and Prevention, there are approximately 12 million workers in the healthcare sector. That seems like a lot of people until you consider the population of the entire United States, slightly more than 300 million people. Thus, only about 4% of the population looks at health the way that a nurse, pharmacist, physician or other healthcare worker does. The other 96% probably define good health or wellness in ways that we find difficult to comprehend.When a healthcare worker sees a patient who is diabetic, they will usually pronounce their management as being good when associated with either a fasting blood sugar between 70 to 120 mg/dl or a hemoglobin A1c of 6 or 7%. We have all read studies, viewed slides and listened to lectures that tell us that these values are indicative of good health. But what about the patient? How do they define good health in their own mind? The variety of answers will truly astound many people, but it will explain a lot of unhealthy behavior.Most people usually seek medical care for one of two reasons. Either they are in pain or they are leaking a red, warm, sticky fluid from their body. Otherwise, they will pronounce themselves healthy. It is easy to see how this applies to those who have not been sick previously. But many people, even in the face of a diagnosed chronic disease, will consider themselves healthy if they subjectively feel good. Never mind the dire warning of future consequences if they don’t take their prescribed medication. They feel good right now, so they must be ok. Unfortunately, this is when the patient decides to abandon their medication or other treatment. You see, by their definition, they are now well again.It is important for us to determine how the patient defines good health. In order to gain their compliance in helping with their treatment plan, we need to know how the patient views what we are doing for them. Some people are inquisitive and will seek out knowledge about their disease process from us or other healthcare sources. Others are not interested in our dire predictions about increased risk of stroke, heart attack or other serious event if they don’t take their medication. They are living in the here and now. Tomorrow is another day that will be addressed when it arrives. Once we determine the patient’s definition of good health, we now have some insight into how we need to approach them. It may mean that this patient will benefit from a support group or more frequent follow up visits. It may mean that they will actually read and utilize the patient education pamphlets we give them.Whatever the situation is, we must take the time to get the patient’s idea of good health. If we ignore this critical point, we may constantly wonder why the patient is not getting any better in spite of all of the advice and medication we may dispense. Working towards a common goal with a common definition will probably make life better for everyone.
US President Obama has just recently passed the divisive shifts to the nation’s healthcare policies. The bill allows for the health insurance coverage of around thirty million citizens not benefiting from the deficiency in proper medical care. Historically, Obama is the first American president to have comprehensively renewed the country’s healthcare system. The clinical and pharmacy businesses, in turn, will have to do big adjustments in line with the nation’s healthcare policies, which are following the model of European nations like the UK. Over 16 million citizens will be included in Medicaid’s policies. This covers low- to middle-income-earning citizens. Private insurance companies are banned from refusing medical care for pre-existing conditions such as heart or bone problems.The reform has been anticipated to have an overall uplifting change on the pharmacy businesses. The bill grants complete insurance plans to an added number of US citizens. In terms of pharmacy industry matters, the bill gives pharmacist-provided medication therapy management (MTM) services. It also has a loan forgiveness agenda. On the downside, the Medicare reimbursement to pharmacies is still unclear. It will take several years for businesses to smoothen out these details.Since the US is using Europe’s healthcare model, American pharmacies will have to change their buying systems as well. The demand to change their market will majorly influence the companies involved in driving the national medical economy. With the greater insurance plan, pharmacies will benefit from more customers hitting their stores to buy medicines. They’re no longer restricted by the unemployment or the severity of their condition. The challenge for pharmacies will arise from the deficiency in major choice makers, according to Chris Weight, co-author of the book “Drivers of Change to Pharmaceutical Commercial Models.” They’ll have to advertise their medicines to a larger organizations: Medicaid and Medicare. Pharmacy ratings will ultimately depend on these government payers. In the United Kingdom, pharmaceutical executives market their items to public healthcare payers instead of an individual and specific market. Instead of marketing the medicines at a profitable value, the drugs are sold at the lowest possible price. This will be a major shift for many community drug stores, which supply both generic and branded medications. it’s important for local American pharmacies to consult with European companies about their buying and marketing methods.Pharmacy benefit managers will be boosted from the extended drug coverage given by Medicare, due to this policy. Expect additional medicine benefits part of your company’s medical insurance coverage. Your plan, though, can only be directed by where you work. Anticipate some limitations and added advantages together.Online pharmacies will have fewer adjustments as compared to local drug stores. They presently sell at low and practical costs to customers under a tight and tiny budget. Most online pharmacies supply generics as an alternative to the more expensive brand name medicines. These businesses need to be careful as the bill provides a 75 percent discount to generic and brand name. Nevertheless, because these online pharmacies supply a private market, they’ll have to redirect marketing to public health payers and suppliers. It is obviously a total change for an Internet business. Nonetheless, pharmaceutical websites can continue to profit from persons who favor to obtain their drugs from private suppliers. Online pharmacies continue to be a convenience for individuals who stay in far off areas or require large amounts of drugs. Individuals who’ll be enjoying the prolonged clinical plan should talk about their options with their local or online pharmacy. Buyers loyal to online pharmacies can save more cash by using the insurance plan.
The healthcare industry has turned into a highly competitive territory. In such a scenario implementing ERP or Enterprise Resource Planning can go a long way in improving services. ERP development can help streamlining services offered by different departments of an institution. The healthcare industry is focused on improving the quality of healthcare and operational efficiency while reducing costs and optimizing back-end operations.Worried how to implement that perfect ERP to provide high quality service to your patients? Get it done by experts, hire the services of ERP consultants from an offshore development center and get the best model implemented for your institution. Contrary to popular myths, ERP implementation isn’t a highly expensive affair. You can outsource it to development firms in countries like India and get a system which will help you reduce operational cost substantially in the future.Objectives of ERP in Healthcare· Better Patient Care- Health care is no longer about treating a patient. It is a complete treatment-to-recovery process. With the increasing number of healthcare institutions patients have lot to choose from. One deciding factor to choose between hospitals is the technology involved. This helps in making every aspect of the institution like admission, treatment, recovery, billing etc. smoother, much to the benefit of the patients.· Service-On-Demand- A good ERP solution automates many daily activities in your hospital. Patients can book appointments with the doctors or for some clinical tests through an online system. The system intimates the patients on the availability of doctors and other services prior to their booking.· Improved Recordkeeping – One of the primary tasks in any hospital is to maintain records and fetch them when required. Enterprise Resource Planning helps in logical storage of patent and other data in a hospital and allows their easy fetching when needed. So you can do always with stacks of files and folders in your facility!· Reduce Operational Costs – It is helping hospitals reduce their overhead cost with the simple adoption of technology. Different departments like Administration, Finance, Healthcare, Public Relations and Promotions can be centralized with lesser headcount and even lesser human activity to run the operations.· Decision Support System – An ERP solution will provide with real-time data to any authorized person in an institution. This helps individuals manning different departments of a hospital take important decisions relating to patient care. This does away with the communication gap between different departments.A custom ERP solution can go a long way in creating a competitive advantage over your rivals in the industry. It’s no longer a luxury for your business but sheer necessity. So why let patients slip away from your institutions just for the mere lack of technology? Remember in today’s market scenario it is the patients who have the power to choose and not you!
If you’re a claims manager or adjuster workers comp, auto, health or disability insurance, one of the scarcest resources you have is your time. When you have complex and costly cases, your time gets eaten up adjudicating claims and consulting others for opinions. If you find yourself in positions where you’re stretched too thin, a great way to extend your capabilities and to move your most difficult cases through your organization is to use the services of an Independent Review Organization. Independent Review Organizations are dedicated to providing medical decision support to claims payers of all types on healthcare benefits or on medical benefits related to specific treatments. An Independent Review Organization provides an external, objective medical review service for insurance carriers, Third Party Administrators, and other types of payers. Independent Review Organizations help them allocate their resources effectively and provide decisions about the approval and denial of treatments.Independent Review Organizations are typically accredited by a URAC (at least the good ones are). They provide a panel of external peer physicians in all specialties and sub-specialties who are capable of providing standard or expedited reviews of health care cases by determining their medical necessity, standard of care, whether they are experimental or investigational, whether they indicate an appropriate length of stay in hospitals and other types of questions that a doctor must review.The Independent Review Organization always matches the case with a specialist having the same background as the referring specialist. Independent Review Organization specialists are always board certified, licensed and in active practice. This insures is that you will be able to use the same expert knowledge to make your claims decision as was originally applied to the treatment being considered. It allows you to speed up your claims decision making, eliminate unnecessary medical treatment, reduce premium costs for disability and workers comp and ensure that your claims resources are being allocated to members who deserve the care, and not those who don’t.So if you’re a claims manager and you’re not using an Independent Review Organization today to evaluate claims inside your organization, consider one.
Whether your office is large and busy or small and growing, making use of RFID tracking and the latest healthcare software can improve your office manager’s ability to track assets, ensure patient safety and control access to patient records. Overall, your office will run more efficiently and your patients will be better satisfied. As time goes by, the cost of implementing these systems is recouped numerous times through increased profits.Security and inventory tracking are big issues for all kinds of companies these days. Most companies are making use of standard UPC bar codes and other electronic devices. RFID tags may never fully replace bar codes, but the amount of information that can be stored in them, as well as the distance from which they can be read is superior to any other kind of tracking device.The pharmaceutical industry is currently making use of the technology. If you store drugs, medical equipment or similar items in your office, and you have the right programs installed in your office PCs, you or your employees can find out what pharmaceuticals you currently have on hand, without even opening a storage closet.Accurate tagging and the latest healthcare software programs make inventories a breeze. In a matter of minutes, an inventory can be verified, printed and placed on your desk.Studies indicate that this kind of tracking reduces problems with low inventory. You can be sure that the items you need are close at hand when you need them. RFID reduces loss and helps to prevent theft, as well. Your employees’ nametags can be equipped with a tag that allows them access to or prevents them from entering stockrooms. This practically eliminates drug theft.If you have a busy clinic, incoming patients can be fitted with wristbands that include chips containing their medical history. The histories can be read with portable readers. In hospitals, the use of these wristbands has reduced the number of errors, which improves patient satisfaction and safety.The latest healthcare software can be used for staffing, payroll, accounts receivable and accounts payable. Programs are available that help doctors treat patients and educate patients about caring for their own health. RFID tags are being used to keep track of home health care devices. With the right tools, doctors can ensure that drugs and medical equipment are going to the right patients and staying with them.In short, healthcare software and RFID tagging is improving the medical industry at all levels and making it easier for you to do your job.
If you are a hospital or health insurance payer today, there are a myriad of workflow applications available to help improve efficiency and reduce cost in your organization. Everything from inscription software, to case management systems to finance and accounting software has been specialized for clinical practices. Those are just some of the examples of the way organizations can use software to perfect their business processes, reduce their costs and improve the overall viability of their organizations and its competitiveness.A good example of workflow software in the healthcare arena is the use of Web applications for conducting reviews. Whether it is a independent medical review for health plans or hospital peer review, today there are new cutting-edge applications that support the Independent Review Organization review process and allow for the exchange of critical, confidential patient information (PHI) in a secure, Web based work flow.We’re developing a Web-based application at Allmed called PeerPoint. This software will allow us to transact with our business partners, clients and specialist doctors across the country securely and greatly enhance our ability to efficiently track and manage cases as they move through the medical review process. We’re excited about this software and the benefits that it’s going to offer to you, our clients. You will have the ability to check the status of cases online. We will benefit from internal cost reduction and improve the scalability of our company.If your company is considering deploying Web applications in a healthcare environment, in particular if you’re thinking about deploying a custom Web application, we can give you some advice and ideas, because we’ve spent the last year developing experience and perspective by building ours.
With the development of patient simulators, the use of simulation is now rapidly increasing for healthcare professionals, particularly in anaesthesia, surgery and critical care environments. High Fidelity Patient Simulator development has been driven by the need to train technical skills, but the value of advanced patient simulation in the training of human factors skills, known in healthcare as Team Resource Management, is now also being recognised.To date, clinician assessment has largely focused upon an individual’s technical abilities, but it has failed to examine significant human factors, such as situational awareness, decision making and workload management.Healthcare, like the aviation industry is a technically complex, dynamic and high risk environment. It is an interdependent process carried out by teams of individuals, who have varying roles and responsibilities.Research suggests that a majority of incidents and accidents in healthcare are not due to deficient technical ability of clinicians, but the result of failures in areas such as communication and decision making. These are areas that have been addressed in aviation training since the 90s. Essentially, the application of lessons learned in aviation Crew Resource Management training, could save lives in healthcare.Instructors from the aviation and healthcare industries are now working alongside each other to develop techniques in teaching and assessing non-technical skills in the simulation environment.Joint training allows for shared learning and the opportunity to explore the perspective of human factors in another professional setting. The focus of these courses often presents healthcare practitioners with new perspectives on how influences such as organisational culture can impact upon human performance and safety.Human Factors training has been prevalent in the aviation industry since the 1980’s, however the current developments outlined above will demonstrate how the application of aviation derived training techniques to other high risk industries could reduce adverse incidents and accidents. Transferring these approaches in to healthcare will revolutionise existing protocols, improving safety and ultimately save patients lives.