Program Analysis
This service is recommended to those institutions that are contemplating the introduction of hyperbaric medicine and wish to fully ascertain all of its clinical and financial implications. A detailed on-site review of selected patient medical records, determination of medical staff interest and needs, and an appreciation of regional health care complexities will generate important clinical data.
A component financial analysis will detail capitalization costs, space requirements, staffing recommendations, and operating budgets for each type of hyperbaric delivery system. A case by case patient insurance determination will furnish exacting program reimbursement expectations.
Breakdown of Key Components:
- An institutionally based analysis of specific disease states and procedure codes.
National Baromedical Services personnel will visit the client hospital's Medical Records Department to conduct a detailed chart-by-chart review. This approach represents the most accurate assessment of actual clinical potential.
- Determination of annualized patient referral potential; acceptance for therapy volumes, and treatment frequency per disease state.
Every effort is made to determine those patients, within a given disease category, that are likely candidates. For each such patient, a precise disease-related treatment course can be determined.
- Impact and influence of potential patient transfers and other non-traditional/new referral sources.
Hyperbaric medicine often represents a tertiary clinical service even in an otherwise non-tertiary hospital setting. The financial impact of this component will be addressed.
- A survey of Medical Staff members regarding previous experience, potential
utilization, credentialing interest and general comments; (pro and con).
Hyperbaric medicine is a physician referral service. It is critical to the clinical and financial success of the service that key specialty physicians appreciate the therapeutic mechanisms and indications involved, and have confidence in the consulting physician team. Criticisms need to be aired and addressed. Those interested in being credentialed must be given the opportunity to make their interest known.
- Determination of reimbursement potential, by payer class.
The chart review process allows exacting categorization of each potential patient referral. This is a critical process, given the adverse influence of DRG-based reimbursement, per diem contracts and emerging capitation.
- Comparison of capitalization for each of the standard hyperbaric delivery
systems.
The hyperbaric provider has a choice of three distinct chamber types: multiplace, duoplace and monoplace. Advantages and disadvantages of each system are provided, as are space requirements and optimal staffing patterns.
- A three year operating analysis, in spreadsheet form.
Hyperbaric and ancillary service revenue, anticipated reimbursement, capitalization, fixed and variable costs form the matrix of this financial pro forma.
- A narrative overview of the role of hyperbaric oxygen therapy in modern
medical practice.
This will serve to educate administration personnel, and update medical staff members. Particular emphasis is placed upon the recent clinical validation of several common referral indications, and the supportive roles of the NCI, the NIH and the ADA.