Business Briefs: Focus on the Practice Management Process

  Not a day goes by that this author doesn’t receive a phone call or e-mail from a concerned wound care professional working in a hospital-owned wound clinic. The number of questions about the practice management process gives the perception that wound care professionals may not be given adequate orientation, education, and mentoring necessary to manage wound care practices. To verify this perception that wound care professionals may need to increase their knowledge about the ‘business of wound care,’ the author contacted a sampling of several different types of wound management companies and interviewed them about this topic. See Table I for the top 10 practice management issues that these wound management companies encounter. If any of these issues exist within the wound care clinic, be sure to request guidance and assistance from the administrator.

  When some of the wound management companies were asked to identify the reasons that hospitals seek practice management assistance, the following reasons were given:
    • Fear of failure
    • Lack of knowledge/experience in wound care operations process; wound care is a specialty that requires a concentrated focus that includes evidence-based clinical guidelines, reimbursement, initial and ongoing education
    • Lack of time and resources of a team dedicated to developing the operations side of the business
    • Worried about billing correctly
    • Minimize start-up costs
    • Need assistance to bring physicians and hospital together
    • Lack of marketing expertise

  With these issues in mind, hospitals that are starting a wound care program from scratch, upgrading to a physician-driven clinic, or attempting to revamp a failing wound care clinic must focus on the practice management processes just like they focus on the clinical practice processes. Some hospitals can accomplish this work without any outside assistance. Other hospitals may need several days/weeks/months of assistance from one or more outside consultants to assist their staff in identifying and/or implementing steps to improve their practice management process. Still, other hospitals may prefer to transfer the entire burden of developing and/or managing the wound care clinic to an outside consulting firm. Regardless of who manages your outpatient wound clinic, certain steps can lead to success. See Table II for the main steps to practice management success.

  Keep in mind that there are outside forces beyond control, constantly causing revamping of the wound care practice management process. The major outside forces that should be monitored are:
    • Coding changes (for procedures, products, clinic visits, etc.)
    • Coverage changes (including accepted indications, utilization guidelines, and documentation requirements)
    • Payment system changes (for facility, physicians, non-physician practitioners, etc.); this includes changes in coinsurance for patients.

  When any of these changes occur, clinic managers must carefully integrate them into their wound care practice management processes. This should include providing education to the wound care professionals; they must understand their responsibility in implementing these required practice management changes into their clinical practice.

  To summarize, hospitals must allocate time and resources to orient, educate, and mentor clinic directors and medical directors in practice management issues pertinent to wound care clinics. During the interviews, the wound management representatives offered practice management advice for readers to utilize. See Table III (See Table III on page 12) for their valuable advice and their contact information.

  Kathleen D. Schaum, MS, is President of Kathleen D. Schaum & Associates, Inc., Lake Worth, Fla. Schaum can be reached for questions and consultations by calling (561) 964-2470 or at kathleendschaum@bellsouth.net.

  Information regarding coding, coverage, and payment is provided as a service to our readers. Every effort has been made to ensure the accuracy of the information. However, HMP Communications and the author do not represent, guarantee, or warranty that the coding, coverage, and payment information is error-free and/or that payment will be received. The ultimate responsibility for verifying coding, coverage, and payment information accuracy lies with the reader.