This document discusses strategies for medical device manufacturers to generate demand for their products in hospitals. It recommends manufacturers:
1) Drive acceptance of their product's messaging through "inertia" following hospital committee approval to promote widespread adoption.
2) Effectively communicate the product's value and tailor messaging to address key questions and objections from different hospital stakeholders.
3) Identify and utilize "Key Opinion Leaders" (KOLs) like physicians and nurses to promote the product throughout the hospital.
The document also provides examples of accelerating user access through educational programs, in-servicing for staff, developing hospital protocols, and selling the product's value proposition to different healthcare providers.
Market Access 101: Connecting Access Challenges to Brand OpportunitiesOgilvy Health
Last week, our payer marketing team hosted their inaugural All Access Festival event in our NJ headquarters. This rock concert-inspired event gave our colleagues an inside look at fundamental elements of optimizing market access strategies. Take a look at the presentation chock-full of insights from this event.
New Pharma approach: from (e-)detailing to customer & patients excellence: a ...A.R.J. (Rob) Halkes
In the demand for a new business model for pharma, the roadmap from current promotion via detailing to a more engaging way to physicians and health care providers, may lead stepwise to improved servicing to physicians and may lead to collaboration to co-create patient care. Role of social media to pharma and multichannel approaches may so find its position in new pharma marketing.
SMi Group presents the 23rd annual industry leading summit on Pharmaceutical Pricing & Market Access, 11 – 12 Oct 2017, London, UK.
Pharmaceutical Pricing & Market Access 2017 will tackle industry challenges head on by preparing attendees to develop a successful market access strategy for the ever changing pharmaceutical and payer landscape. Join us this autumn for insight into how manufactures plan to limit further price increase; a progressive outlook into the future of pharmaceutical pricing & reimbursement (P&R); stakeholder collaboration; meaningful patient engagement opportunities; and discuss what can be done for the industry to achieve efficient reimbursement and for patients to gain access to affordable medication.
Highlights will include an exclusive opening keynote from the FDA and interactive training on Real World Evidence (RWE). Featured Speakers include: Lundbeck, FDA, Shire, Sobi, Teva, Grifols, Allergan, Sanofi and more!
Successful market / customer access is a primary objective in healthcare marketing. This presentation provides the insight to successfully position, price and promote your pharmaceutical, medical device or clinical service in leading healthcare market segments.
This presentation is from www.healthcaremedicalpharmaceuticaldirectory.com, no subscription is required. Please visit us to see more presentations about the latest marketing trends in the healthcare industry.
John Baresky Healthcare Marketing Leader, Pharmaceutical Marketing, Digital Marketing Strategy, Content Marketing Strategy, Market Access Strategy, Healthcare RPA Software Marketing Strategy
www.healthcaremedicalpharmaceuticaldirectory.com
John G. Baresky
https://www.linkedin.com/in/johngbaresky
#baresky
Five Steps to Find your 'Beyond the Pill' Strategyexecutiveinsight
A short window of opportunity exists for pharmaceutical companies to establish indispensable beyond the pill services, which may even help them 'own' particular disease areas.
Overview of aspects of pharma's value added services and its primary aspects to deliver them.
Learn what others do and reflect how it's an opportunity for your pharma company..
Market Access 101: Connecting Access Challenges to Brand OpportunitiesOgilvy Health
Last week, our payer marketing team hosted their inaugural All Access Festival event in our NJ headquarters. This rock concert-inspired event gave our colleagues an inside look at fundamental elements of optimizing market access strategies. Take a look at the presentation chock-full of insights from this event.
New Pharma approach: from (e-)detailing to customer & patients excellence: a ...A.R.J. (Rob) Halkes
In the demand for a new business model for pharma, the roadmap from current promotion via detailing to a more engaging way to physicians and health care providers, may lead stepwise to improved servicing to physicians and may lead to collaboration to co-create patient care. Role of social media to pharma and multichannel approaches may so find its position in new pharma marketing.
SMi Group presents the 23rd annual industry leading summit on Pharmaceutical Pricing & Market Access, 11 – 12 Oct 2017, London, UK.
Pharmaceutical Pricing & Market Access 2017 will tackle industry challenges head on by preparing attendees to develop a successful market access strategy for the ever changing pharmaceutical and payer landscape. Join us this autumn for insight into how manufactures plan to limit further price increase; a progressive outlook into the future of pharmaceutical pricing & reimbursement (P&R); stakeholder collaboration; meaningful patient engagement opportunities; and discuss what can be done for the industry to achieve efficient reimbursement and for patients to gain access to affordable medication.
Highlights will include an exclusive opening keynote from the FDA and interactive training on Real World Evidence (RWE). Featured Speakers include: Lundbeck, FDA, Shire, Sobi, Teva, Grifols, Allergan, Sanofi and more!
Successful market / customer access is a primary objective in healthcare marketing. This presentation provides the insight to successfully position, price and promote your pharmaceutical, medical device or clinical service in leading healthcare market segments.
This presentation is from www.healthcaremedicalpharmaceuticaldirectory.com, no subscription is required. Please visit us to see more presentations about the latest marketing trends in the healthcare industry.
John Baresky Healthcare Marketing Leader, Pharmaceutical Marketing, Digital Marketing Strategy, Content Marketing Strategy, Market Access Strategy, Healthcare RPA Software Marketing Strategy
www.healthcaremedicalpharmaceuticaldirectory.com
John G. Baresky
https://www.linkedin.com/in/johngbaresky
#baresky
Five Steps to Find your 'Beyond the Pill' Strategyexecutiveinsight
A short window of opportunity exists for pharmaceutical companies to establish indispensable beyond the pill services, which may even help them 'own' particular disease areas.
Overview of aspects of pharma's value added services and its primary aspects to deliver them.
Learn what others do and reflect how it's an opportunity for your pharma company..
Analysis of what patient services proposed by pharma companies should be. This document explains: 1. why patient centricity is essential? - 2. how to craft a patient-centric strategy? - 3. How to implement patient-centric initiatives?
Access to customers is necessary for healthcare marketing and sales initiatives to succeed. Pharmaceutical and medical device manufacturers can optimally position, price and promote their products through strategic assessment of healthcare market segments!
www.healthcaremedicalpharmaceuticaldirectory.com
John G. Baresky
https://www.linkedin.com/in/johngbaresky
John Baresky Healthcare Marketing Leader, Pharmaceutical Marketing, Digital Marketing Strategy, Content Marketing Strategy, Market Access Strategy, Healthcare RPA Software Marketing Strategy
Pre-Launch Planning: Priming Your Pharma Brand For Profit And Success (mini)Eularis
In today’s environment, Pharmaceutical companies find themselves in a bind. Until recently, if drugs made over $500 Million in annual revenue within 3 to 5 years of launch, they were considered hugely successful. They were a support to an extensive company portfolio and a component of greater company profit.
However, things have changed. The standards for a successful drug have become much higher and much more dangerous. With so many revenue-producing drugs going off patent, companies are facing large holes in their balance sheets and sales that are increasingly slow.
Plus, with the stakes high and available funds low, pipelines are drying up. Add to this the closer scrutiny of safety issues, the rise of Generics, slower physician acceptance and adoption of new therapies, and the Pharma Industry is in trouble.
More and more, companies are expecting marketers to be instrumental at the key moment of launch, and marketers are under extreme pressure. To deliver on the high hopes of Pharmaceutical brand launch, companies must engage in comprehensive pre-launch planning.
In this report we analyze why launch is increasingly important, the issues involved in pre-launch planning, including key organizational strategies, marketing tactics, regulatory considerations, global issues, and methods for ensuring the most effective plans.
This position paper answer the following questions: Why is creativity so important? - How to craft a creative strategy? - How to build a creativity-driven organization?
Description of the "KAM Expert Wheel" which is a method to structure the activities of Key Account Managers and help them cope with the complexity of their task
Beyond-the-pill: how to move from selling pills to value-added solutionsexecutiveinsight
New shores: The shift from selling pills to developing value-added services has only just begun!
Biopharma companies are discovering that compelling and aligned services underpinned by a core strategy are providing them with distinctive competitive advantages.
This is my Keynote presentation to Pharma Forum Russia, St. Petersburg, May 23rd, 2013.
It gives an outline of crucial elements in building a new market approach to different markets.
6th Alex Marketing Club (Product Launch Difficulties) by Dr.Ahmed ShamaaMahmoud Bahgat
#Mahmoud_Bahgat
#Marketing_Club
Join us by WhatsApp to me 00966568654916
*اشترك في صفحة ال Marketing Club* عالفيسبوك
https://www.facebook.com/MarketingTipsPAGE/
*اشترك في جروب ال Marketing Club* عالفيسبوك
https://www.facebook.com/groups/837318003074869/
*Marketing Club Middle East*
25 Meetings in 6 Cities in 1 year & 2 months
Since October 2015
*We have 6 groups whatsapp*
*for almost 600 marketers*
From all middle east
*since 5 years*
& now 10 more groups
For Marketing Club Lovers as future Marketers
أهم حاجة الشروط
*Only marketers*
From all Industries
No students
*No sales*
*No hotels Reps*
*No restaurants Reps*
*No Travel Agents*
*No Advertising Agencies*
*Many have asked to Attend the Club*
((We Wish All can Attend,But Cant..))
*Criteria of Marketing Club Members*
•••••••••••••••••••••••••••••••••••••
For Better Harmony & Mind set.
*Must be only Marketer*
*Also Previous Marketing experience*
●Business Managers
●Country Manager,GM
●Directors, CEO
Are most welcomed to add Value to us.
■■■■■■■■■■■■■■■■
《 *Unmatched Criteria*》
Not Med Rep,
Not Key Account,
Not Product Specialist,
Not Sales Supervisor,
Not Sales Manager,
●●●●●●●●●●●●●●●●●●
But till you become a marketer
you can join other What'sApp group
*Marketing Lover Future Club Group*
■■■■■■■■■■■■■■■■
《 *Unmatched Criteria*》
For Conflict of Intrest
*Also Can't attend*
If Working in
*Marketing Services Provider*
=not *Hotel* Marketers
=not *Restaurant* Marketers
=not *Advertising* Marketer
=not *Event Manager*
=not *Market Researcher*.
■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■
*this Club for Only Marketers*
Very Soon we will have
*Business Leaders Club*
For Sales Managers & Directors
Will be Not for Markters
●●●●●●●●●●●●●●●●●●●●
■ *Only Marketers* ■
*& EPS Marketing Diploma*
●●●●●●●●●●●●●●●●●●●●
Confirm coming by Pvt WhatsApp
*To know the new Location*
*#Mahmoud_Bahgat*
00966568654916
*#Marketing_Club*
http://goo.gl/forms/RfskGzDslP
*اشترك بصفحة جمعية الصيادلة المصريين* عالفيسبوك
https://lnkd.in/fucnv_5
■ *Bahgat Facbook Page*
https://lnkd.in/fVAdubA
■ *Bahgat Linkedin*
https://lnkd.in/fvDQXuG
■ *Bahgat Twitter*
https://lnkd.in/fmNC72T
■ *Bahgat YouTube Channel*
https://www.Youtube.com /mahmoud bahgat
■ *Bahgat Instagram*
https://lnkd.in/fmWPXrY
■ *Bahgat SnapChat*
https://lnkd.in/f6GR-mR
*#Mahmoud_Bahgat*
*#Legendary_ADLAND*
www.TheLegendary.info
Enabling Patient Centricity for Pfizer through AWS Cloud (LFS301-S-i) - AWS r...Amazon Web Services
Pfizer needed the ability to perform rapid analysis on its set of real-world evidence (RWE) data to improve patient outcomes, but its existing platform could not scale and meet its objectives. Pfizer collaborated with Deloitte to transform its real-world data and analytics capabilities that maximize insights and avoid duplicative investments by migrating their existing RWE data and analytics environment to the AWS Cloud. Learn how these strategies for planning, executing, and validating the success of these capabilities helped position Pfizer to use the AWS Cloud environment as the cornerstone of its patient-centric analytics to expand and incorporate new AI/ML capabilities, such as Amazon SageMaker. This session is brought to you by AWS partner, Deloitte Consulting LLP.
Turacoz Skill Development Program tells you about the medico-marketing, its objectives, ethics followed, and the unethical marketing practices in the healthcare industry.
Business Development & Licensing concepts, methods and tools. From theory to practice.
Application to the pharmaceutical sector. Guidelines and recommendations
In this assignment, you will demonstrate your mastery of the followi.docxwiddowsonerica
In this assignment, you will demonstrate your mastery of the following course outcomes:
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements Analyze organizational strategies for negotiating healthcare contracts with managed care organizations Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives
Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There are several ways to accomplish this. Choose one of the following:
If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses. Conduct research through articles or get information from professional organizations.
Below is an example of how to begin framing your analysis.
A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what happens in an emergency area. The patient could be asked to change into a hospital gown (think about the costs of the gown and other supplies provided). If the patient is displaying signs of vomiting, plastic bags will be provided and possibly antinausea medication. Lab work and possibly x-rays would be done. The patient could be sent to surgery, sent home, or admitted as an inpatient. If he or she is admitted as an inpatient, meals will be provided and more tests will be ordered by the physician—again, more costs and charges for the patient bill. Throughout the course, you will be gathering additional information th.
Analysis of what patient services proposed by pharma companies should be. This document explains: 1. why patient centricity is essential? - 2. how to craft a patient-centric strategy? - 3. How to implement patient-centric initiatives?
Access to customers is necessary for healthcare marketing and sales initiatives to succeed. Pharmaceutical and medical device manufacturers can optimally position, price and promote their products through strategic assessment of healthcare market segments!
www.healthcaremedicalpharmaceuticaldirectory.com
John G. Baresky
https://www.linkedin.com/in/johngbaresky
John Baresky Healthcare Marketing Leader, Pharmaceutical Marketing, Digital Marketing Strategy, Content Marketing Strategy, Market Access Strategy, Healthcare RPA Software Marketing Strategy
Pre-Launch Planning: Priming Your Pharma Brand For Profit And Success (mini)Eularis
In today’s environment, Pharmaceutical companies find themselves in a bind. Until recently, if drugs made over $500 Million in annual revenue within 3 to 5 years of launch, they were considered hugely successful. They were a support to an extensive company portfolio and a component of greater company profit.
However, things have changed. The standards for a successful drug have become much higher and much more dangerous. With so many revenue-producing drugs going off patent, companies are facing large holes in their balance sheets and sales that are increasingly slow.
Plus, with the stakes high and available funds low, pipelines are drying up. Add to this the closer scrutiny of safety issues, the rise of Generics, slower physician acceptance and adoption of new therapies, and the Pharma Industry is in trouble.
More and more, companies are expecting marketers to be instrumental at the key moment of launch, and marketers are under extreme pressure. To deliver on the high hopes of Pharmaceutical brand launch, companies must engage in comprehensive pre-launch planning.
In this report we analyze why launch is increasingly important, the issues involved in pre-launch planning, including key organizational strategies, marketing tactics, regulatory considerations, global issues, and methods for ensuring the most effective plans.
This position paper answer the following questions: Why is creativity so important? - How to craft a creative strategy? - How to build a creativity-driven organization?
Description of the "KAM Expert Wheel" which is a method to structure the activities of Key Account Managers and help them cope with the complexity of their task
Beyond-the-pill: how to move from selling pills to value-added solutionsexecutiveinsight
New shores: The shift from selling pills to developing value-added services has only just begun!
Biopharma companies are discovering that compelling and aligned services underpinned by a core strategy are providing them with distinctive competitive advantages.
This is my Keynote presentation to Pharma Forum Russia, St. Petersburg, May 23rd, 2013.
It gives an outline of crucial elements in building a new market approach to different markets.
6th Alex Marketing Club (Product Launch Difficulties) by Dr.Ahmed ShamaaMahmoud Bahgat
#Mahmoud_Bahgat
#Marketing_Club
Join us by WhatsApp to me 00966568654916
*اشترك في صفحة ال Marketing Club* عالفيسبوك
https://www.facebook.com/MarketingTipsPAGE/
*اشترك في جروب ال Marketing Club* عالفيسبوك
https://www.facebook.com/groups/837318003074869/
*Marketing Club Middle East*
25 Meetings in 6 Cities in 1 year & 2 months
Since October 2015
*We have 6 groups whatsapp*
*for almost 600 marketers*
From all middle east
*since 5 years*
& now 10 more groups
For Marketing Club Lovers as future Marketers
أهم حاجة الشروط
*Only marketers*
From all Industries
No students
*No sales*
*No hotels Reps*
*No restaurants Reps*
*No Travel Agents*
*No Advertising Agencies*
*Many have asked to Attend the Club*
((We Wish All can Attend,But Cant..))
*Criteria of Marketing Club Members*
•••••••••••••••••••••••••••••••••••••
For Better Harmony & Mind set.
*Must be only Marketer*
*Also Previous Marketing experience*
●Business Managers
●Country Manager,GM
●Directors, CEO
Are most welcomed to add Value to us.
■■■■■■■■■■■■■■■■
《 *Unmatched Criteria*》
Not Med Rep,
Not Key Account,
Not Product Specialist,
Not Sales Supervisor,
Not Sales Manager,
●●●●●●●●●●●●●●●●●●
But till you become a marketer
you can join other What'sApp group
*Marketing Lover Future Club Group*
■■■■■■■■■■■■■■■■
《 *Unmatched Criteria*》
For Conflict of Intrest
*Also Can't attend*
If Working in
*Marketing Services Provider*
=not *Hotel* Marketers
=not *Restaurant* Marketers
=not *Advertising* Marketer
=not *Event Manager*
=not *Market Researcher*.
■■■■■■■■■■■■■■■■
■■■■■■■■■■■■■■■■
*this Club for Only Marketers*
Very Soon we will have
*Business Leaders Club*
For Sales Managers & Directors
Will be Not for Markters
●●●●●●●●●●●●●●●●●●●●
■ *Only Marketers* ■
*& EPS Marketing Diploma*
●●●●●●●●●●●●●●●●●●●●
Confirm coming by Pvt WhatsApp
*To know the new Location*
*#Mahmoud_Bahgat*
00966568654916
*#Marketing_Club*
http://goo.gl/forms/RfskGzDslP
*اشترك بصفحة جمعية الصيادلة المصريين* عالفيسبوك
https://lnkd.in/fucnv_5
■ *Bahgat Facbook Page*
https://lnkd.in/fVAdubA
■ *Bahgat Linkedin*
https://lnkd.in/fvDQXuG
■ *Bahgat Twitter*
https://lnkd.in/fmNC72T
■ *Bahgat YouTube Channel*
https://www.Youtube.com /mahmoud bahgat
■ *Bahgat Instagram*
https://lnkd.in/fmWPXrY
■ *Bahgat SnapChat*
https://lnkd.in/f6GR-mR
*#Mahmoud_Bahgat*
*#Legendary_ADLAND*
www.TheLegendary.info
Enabling Patient Centricity for Pfizer through AWS Cloud (LFS301-S-i) - AWS r...Amazon Web Services
Pfizer needed the ability to perform rapid analysis on its set of real-world evidence (RWE) data to improve patient outcomes, but its existing platform could not scale and meet its objectives. Pfizer collaborated with Deloitte to transform its real-world data and analytics capabilities that maximize insights and avoid duplicative investments by migrating their existing RWE data and analytics environment to the AWS Cloud. Learn how these strategies for planning, executing, and validating the success of these capabilities helped position Pfizer to use the AWS Cloud environment as the cornerstone of its patient-centric analytics to expand and incorporate new AI/ML capabilities, such as Amazon SageMaker. This session is brought to you by AWS partner, Deloitte Consulting LLP.
Turacoz Skill Development Program tells you about the medico-marketing, its objectives, ethics followed, and the unethical marketing practices in the healthcare industry.
Business Development & Licensing concepts, methods and tools. From theory to practice.
Application to the pharmaceutical sector. Guidelines and recommendations
In this assignment, you will demonstrate your mastery of the followi.docxwiddowsonerica
In this assignment, you will demonstrate your mastery of the following course outcomes:
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements Analyze organizational strategies for negotiating healthcare contracts with managed care organizations Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on pay for performance incentives
Prompt You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus. Becker’s Hospital Review has an excellent list of things to know about the hospital industry. Once you have determined the hospital, you will need to think about the way a patient visit works at the hospital you chose so you can review the processes and departments involved. There are several ways to accomplish this. Choose one of the following:
If you have been a patient in a hospital or if you know someone who has, you can use that experience as the basis for your responses. Conduct research through articles or get information from professional organizations.
Below is an example of how to begin framing your analysis.
A patient comes in through the emergency department. In this case, the patient would be triaged and seen in the emergency department. Think about what happens in an emergency area. The patient could be asked to change into a hospital gown (think about the costs of the gown and other supplies provided). If the patient is displaying signs of vomiting, plastic bags will be provided and possibly antinausea medication. Lab work and possibly x-rays would be done. The patient could be sent to surgery, sent home, or admitted as an inpatient. If he or she is admitted as an inpatient, meals will be provided and more tests will be ordered by the physician—again, more costs and charges for the patient bill. Throughout the course, you will be gathering additional information th.
I need the follwoing assignmentThe project is the creation of a w.docxnatishahaen
I need the follwoing assignment:
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals vary in size, location, and focus.
Becker’s Hospital Review
has an excellent .
Common challenges faced by Physicians and Practitioners with Medical Billingjennyvergeese
Medical billing refers to the process of filing and following up on claims with health insurance companies / providers in order to receive payments for the healthcare services rendered to patients by the practices / physicians. Medical billing serves as an effective channel between medical service providers and insurance companies.
Industry Insights Healthcare Information Technology - October 2016Duff & Phelps
This issue of Healthcare IT Services Insights details the impact credentialing, privileging and enrollment has on the revenue cycle, providers and patients. Practitioner credentialing, used broadly here to include privileging and enrollment, is an often overlooked but increasingly critical process at the front end of revenue cycle management.
Understanding Orthopedic Medical Billing.pdfCosentus
There are many branches of the healthcare sector. While there are many budding branches of the same, one such branch is orthopedics. In this ever-evolving sector, now, orthopedic practices stand at the forefront of ensuring the mobility and well-being of patients.
Healthcare transition in GCC: Current Painful Realities & Proposed Strategic ...STELIOS PIGADIOTIS
Goals of research effort
1. Hands on analysis of GCC and specifically UAE healthcare market.
2. Proposed 2016 strategies for CEOs in GCC healthcare ecosystem
Mastering Pharmacy Medical Billing + Claims Submissionkendall100
Claim your free access to invaluable pharmacy billing guides and streamline your processes with confidence. Pharmacy billing encompasses submitting claims to insurance payers for reimbursement for pharmacy services. These services range from dispensing medications to providing medication therapy management (MTM) and other clinical interventions you can bill for!
Hello, I need assistance with the following I need assistance.docxisaachwrensch
Hello, I need assistance with the following:
I need assistance with the following, would you be able to assist?
The project is the creation of a white paper.
Much of what happens in healthcare is about understanding the expectations of the many departments and personnel within the organization. Reimbursement drives the financial operations of healthcare organizations; each department affects the reimbursement process regarding timelines and the amount of money put into and taken out of the system. However, if departments do not follow the guidelines put into place or do not capture the necessary information, it can be detrimental to the reimbursement system.
An important role for patient financial services (PFS) personnel is to monitor the reimbursement process, analyze the reimbursement process, and suggest changes to help maximize the reimbursement. One way to make this process more efficient is by ensuring that the various departments and personnel are exposed to the necessary knowledge.
For your final project, you will assume the role of a supervisor within a PFS department and develop a white paper in which the necessary healthcare reimbursement knowledge is outlined.
The project is divided into three milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final submissions. These milestones will be submitted in Modules One, Three, and Five.
In this assignment, you will demonstrate your mastery of the following course outcomes:
†
Analyze the impacts of various healthcare departments and their interrelationships on the revenue cycle
†
Compare third-party payer policies through analysis of reimbursement guidelines for achieving timely and maximum reimbursements
†
Analyze organizational strategies for negotiating healthcare contracts with managed care organizations
†
Critique legal and ethical standards and policies in healthcare coding and billing for ensuring compliance with rules and regulations
†
Evaluate the use of reimbursement data for its purpose in case and utilization management and healthcare quality improvement as well as its impact on
pay for performance incentives
Prompt
You are now a supervisor within the patient financial services (PFS) department of a healthcare system. It has been assigned to you to write a white paper to educate other department managers about reimbursement. This includes how each specific department impacts reimbursement for services, which in turn impacts the healthcare organization as a whole. The healthcare system may include hospitals, clinics, long-term care facilities, and more. For now, your boss has asked you to develop a draft of this paper for the hospital personnel only; in the future, there may be the potential to expand this for other facilities.
In order to complete the white paper, you will need to choose a hospital. You can choose one that you are familiar with or create an imaginary one. Hospitals var.
MMLP3.2InstructionsIn LP01.1, LP02.1, and LP03.1 you were aske.docxraju957290
MMLP3.2Instructions
In LP01.1, LP02.1, and LP03.1 you were asked to prepare milestones for a business plan. An executive summary, while written last, is the first part of a business plan. This document is what the executives will read to determine if the business plan has merit and may determine whether or not they will read the entire business plan. The executive summary covers all the key points of the business plan and should be 650-1,000 words. Must use 3 scholarly sources and cite APA.
Here are some helpful sources that discuss what to include in your Executive Summary:
· Chron
· SBA
REFERENCE ONLY: Below is the LP1.1 information
Description of the Business
Wickham Hospital is a rural hospital that provides quality healthcare services to the local community. Our mission is to engage in the promotion of healthier lives by providing quality healthcare services. This is to be executed in a fiscally responsible way that promotes the social, physical, spiritual and psychological wellbeing of the community and patients it serves. Further, the hospital aims at serving all members of the community regardless of their gender, religion, race or age.
Among the services provided by the hospital include outpatient and inpatient services, emergency services, primary care, skilled nursing care, center for rehabilitation medicine, a lung cancer center and surgical services. Our main competitors are some hospitals established within the same community. Among these are Greenview Hospital, Jordan Memorial Hospital and Sloan Hospital. These hospitals offer outpatient and inpatient services as well as other services such as primary stroke services, rehabilitation for pediatric polio patients.
Recommendations to Stand out of the Competition
To stay on top of the competition, Wickham Hospital needs to invest and adapt to the most recent technology to ensure efficient delivery of quality medical services. Further, all healthcare personnel needs to undergo further training through platforms such as seminars and online educational forums. This will promote safe and efficient delivery of services to patients as they promote the quality of life within the community. Besides this, management needs to be keener with the appropriate allocation and deployment of resources to ensure that all areas are sufficiently covered (Enthoven, 2014).
How to Accommodate a Global Business Environment
The hospital currently serves the adjacent community and a few consumers from the outskirts. To broaden into the global business environment, a few strides should be taken. For instance, a website should be created describing the business and services offered. This way, international consumers will seek the business even when they come visiting within the local community. Further, the organization could seek for international investors whose partnership or involvement would attract international healthcare consumers towards the organization (Lunt & Mannion, 2014). The business ...
Provides an overview of the current revenue cycle management and its processes and offers a point-of-view on today’s RCM trends and areas of transformation.
Why Should Healthcare Providers Consider Outsource Medical Billing ServicesMatthew Clark
Medical billing has become increasingly challenging for healthcare providers in today's complex healthcare landscape. The complex coding requirements, evolving regulations, and the need for efficient revenue cycle management can place a significant burden on healthcare organizations.
Ultimately, by bringing into sharper focus the emotional and rational drivers that influence customers’ perceptions and usage of a particular product, it helps to get a clearer perspective on what opportunities can be gained by this unique intelligence.
The saying is somewhat valid that you only
have “1 shot” at launching a new product but
that would stand the reasoning that 100% of
product launches are successful…and we all
know that’s NOT accurate. In this presentation
I will attempt to provide ways you can
revitalize your brand if indeed…your launch
wasn’t stellar.
The purpose of this presentation is to introduce you to the varied issues and structures that influence the way pharmaceutical products are priced in today’s complex health care market.
Awareness of the different mechanisms behind the costs of prescription drugs and medical services will help you determine the pricing strategy of your product/services to be competitive in today’s challenging/evolving health care environment.
As a professional, your ability to influence and negotiate both corporately and externally is critical to your business success. These skills are natural to some and more difficult for others. But like many soft skills, influence and negotiation takes time to master and requires continuous learning, implementation, and refinement by anyone who has customers.
“…The Sales Director is perhaps themost important role
in the company. Arguably no single management
person can generate the immediate and sustainable
profit impact that the Sales Director can.”
AndréHarrell
To help the participant remove apprehension and gain confidence and sense of self that will help not only the ability to speak in front of an audience…but the assuredness that her/his presence in any situation has impact.
I’m asked frequently on how do you build a “functional business development plan” that’s versatile and can be implemented in any industry. The following presentation are basic steps and nomenclature you can use to build your biz dev team plan. This presentation is also from a workshop implemented by AH2 Management, contact me if interested in having a rollout introduction of this program.
The following workshop activities are unbranded and designed to demonstrate AH2 Management capability to tailor selling skill workshops that meet your needs. Our organization prides itself on its ability to be flexible and nimble to your specified needs. The listed activities are just examples and again can be constructed to meet your organization and industry needs.
LEADERSHIP MANAGEMENT DEVELOPMENT CURRICULUMAndré Harrell
All information in this Leadership Management Development Curriculum is based on fictitious assumptions. This plan is designed to demonstrate AH2 Management capabilities to construct an effective LMDC that meets your centers of excellence needs.
Note: All information in this global commercial training strategic plan is based on fictitious assumptions. This plan is designed to demonstrate AH2 Management capabilities to construct an effective commercial operations department that meets your centers of excellence needs.
LEADERSHIP EXCELLENCE (Accountable & Personal Leadership)André Harrell
The content in this presentation discusses key principles centered on “ACCOUNTABLE LEADERSHIP” the responsibility of leading others, and “PERSONAL LEADERSHIP ”one's ability to lead themselves. I believe that there are good learnings from this presentation that can enhance your life—both professionally and personally.
Coming in as Chief Commercial Officer, I was asked to first assess the commercial functions of the organization. This presentation walks you through the process and findings.
BOARD DEVELOPMENT from a CHAIRMAN'S point of viewAndré Harrell
Inside look at “The Board” …from a Board Chair perspective
“A board is comprised of a group of exceptional leaders from all backgrounds and experiences whose responsibility and accountability is tied to its shareholders, corporate organization and community it ultimately serves”
André Harrell
DEVELOPING AS AN EFFECTIVE LEADER/FOUNDER IN A GLOBALLY DYNAMIC MARKETPLACE
I've had the good fortune of mentoring some of the most talented global leaders in today's business world, and the one thing I've learned from each and every one of them.......HUMILITY.
DM me if you'd like to learn more about something I absolutely enjoy doing.
COVID VACCINE DELIVERY IN NIGERIA (EXCELLENCE)André Harrell
INNOVATION & DISTRIBUTION EXCELLENCE of the vaccine to Nigeria…partnership made in heaven
KareBoks & Dovizia Pharma Services are teaming up to provide significant value to the supply chain once Nigeria gets the vaccine. The combination of refrigeration innovation and centers of excellence distribution/logistics position these 2 organizations to address the significant needs Nigeria will have once the vaccines enter the marketplace.
If you are interested in getting more information and/or interested in investing in our project, please DM me (Thanks!). I can also provide our investment deck.
ZOOM PITCHING INVESTORS USING P.E.A.K.SAndré Harrell
Okay, I’ve had enough…not seeing “Centers of Excellence” founder zoom pitches.
Yes, I understand we are in a global pandemic so “Live Pitches” to investors are not happening. So, we’re all left to zoom pitching investors…is that really an excuse for the HORRIBLE zoom pitches I’ve witnessed. C’mon man!!!
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
2. INTRODUCTION
This presentation will discuss the business issues surrounding
technology and capital equipment, and the role of specialized patient
care units and non-acute patient care facilities as part of the healthcare
business environment.
Subjects in this presentation will include:
q Describing the process of how technology & capital equipment is
purchased.
q Explain several types of care that are delivered through specialized
institutional units.
q Explain how institutions use for-profit subsidiaries to strengthen their
business model.
q Describe ways in which some institutions are growing their business and
how you as suppliers can work with them to maximize yours.
3. BACKGROUND
q The purchase of “Medical Capital Equipment” is a multilayered
process, involving several institution departments, and the
authorization of department executives. In addition, capital
equipment needs to be managed and maintained after
purchasing.
q Institutional units are often specialized, in order to care for
specific medical needs. These specialized units will have unique
equipment, training needs, and pharmaceutical use.
q Most institutions have developed for profit outpatient services
that serve the purpose of attracting patients to the
hospital/clinic managing health care needs more efficiently and
increasing the institution's profit margin.
q Healthcare institutions need to compete for patients within a
given geographical area. Specialized inpatient services, which
can be marketed to patients and physicians can help grow the
business of the institution.
4. TECHNOLOGY
& CAPITAL
EQUIMENT
q Technology has relieved in part, some of the burden of patient care in
the institution.
q Monitors and pumps that regulate the delivery of medication are
examples of technology that has advanced care and improved
efficiencies.
q Hardware, software, computerized drug delivery and drug inventory
make it possible for larger institutions to operate more efficiently as
such agencies like teaching hospital costs continue to increase.
q Innovative electronic procurement, ordering, billing and meeting
purchasing thresholds have allowed progressive hospitals to remain
profitable.
5. Purchasing
Capital
Equipment
Key Elements in Purchasing Capital Equipment
q Legal purchase order forms
q Authorization to make the capital purchase
q A clearly defined requisition process
q A list of approved suppliers
q An established procedure for obtaining competitive bids from
suppliers
q A method of tracking and expediting open purchase orders
q Ensuring proper credit is issued for returned goods
q A method of monitoring and documenting supplier performance
q A method of monitoring timeliness and effectiveness of the
performance of the purchasing department
6. Purchasing
Capital
Equipment
cont.
q Purchasing capital equipment is a top-down process.
q Expensive equipment purchases, such as intravenous
pumps, electronic monitors, and respirators are carefully
considered by multiple departments and stakeholders in
the institution.
q Such capital expenditures frequently require the approval
of the CEO of the institution, finance committee and the
board of directors.
q Competitive bidding is a standard procedure used for the
hospital to get the most favorable price on capital
equipment.
q Requests for bids are sent out to preferred vendors and
evaluations of those bids are made.
7. Specialized
Institution
Units
q The development of specialized units leads to greater
efficiency and quality of care for several reasons.
q Patients with similar diagnoses typically require similar
equipment, medications, procedures and staff with
experience in a special group of disease states or medical
conditions.
q For example, grouping all patients with cardiac conditions
on a cardiac nursing floor will allow the institution to have
the correct equipment (cardiac monitors, defibrillators) and
specially trained staff placed in the most useful location.
q The nurses who are trained to work on such a unit will
develop a great level of expertise in the use of the required
equipment, and in administering the array of medications
that cardiac patients will need.
8. Non-Acute
For-Profit
Subsidiaries
Home Health Care Services Ambulatory Surgical Units
Urgent Care Centers Ambulance Services
Home Infusion Services Outpatient Therapy Centers
Diagnostic Imaging Facilities Specialty Clinics
Institutions (e.g., Hospitals) often offer a variety of services:
q Offering a variety of outpatient services to the public provides
advantages including meeting the healthcare needs of the
community and generating additional revenue.
q Many institutions strategically market their services to the
socioeconomic area they serve, such as meeting special
language or cultural needs of patients within a community.
q Finally, many institutions (e.g., hospitals) find that these
complimentary outpatient services offer a higher profit
margin than inpatient hospital care.
9. Opportunities
for Device
Manufactures
Institutions like hospital health systems have several methods of growing their
business. Inpatient and outpatient services can be marketing tools to generate
additional interest in the specific system and increase inpatient hospital revenue.
Hospitals for example compete with one another using breadth of services and
accessibility to meet the needs of the community and attract physicians and their
patients.
Outpatient Services and clinics are a rapidly growing area that many
hospitals use to attract patients:
Opportunities for Device Manufactures:
q Manufactures should investigate the impact that their product may
have upon the use or need for capital equipment.
q Any product which simplifies, user friendly, efficient and reduces
institutional cost will be attractive to the administration.
q Offering “Best In Class” educational programs and insight into the most
efficient ways to handle the specific medical needs of these units.
q Manufactures can capitalize on the market value of their product if they
understand how that product will make the institution more attractive
to patients and the physicians who refer them.
11. Medicare &
Hospital
Reimbursement
• With today’s aging population, approximately 50% of a
hospital’s revenue may come directly from Medicare.
• Medicare Part A is "Hospital Insurance." It helps pay for
inpatient hospital care, inpatient care in a skilled nursing
facility, home health care and hospice.
• Medicare Part A is financed primarily through federal payroll
taxes (FICA taxes) paid into Social Security by employers and
employees.
• The current FICA tax is 7.65 percent on both employees and
employers (15.3% total). Of this, 1.45 percent (2.9% total)
goes to the Medicare Part A Trust Fund.
12. Medicare &
Hospital
Reimbursement
Medicare structure its reimbursement to hospitals by:
q Cost finding which is a process of determining the amount
and cost of services that each cost center in the hospital
(such as pharmacy, laboratory, waste management, laundry,
etc.) provides to, or receives from, other cost centers.
q Costs can be broken down into direct costs (costs of
providing patient care) and indirect costs (administration,
telephones, housekeeping, etc.).
q Reimbursement is no longer based on the cost finding
process, hospitals still use cost finding principles to
supplement their regular accounting procedures.
13. Medicare
Hospital
Payment
System
q In 1983, Medicare instituted a payment system designed to drive
efficiencies rather than paying for services based upon a collection of
costs.
q Prospective Payment System (PPS): is a system of using pre-
determined prices to reimburse hospitals for services.
q Diagnosis Related Groups (DRG): are the classification system that is
used as the basis to determine what payment will be made under
PPS.
Example Illustration:
127 Heart Failure & Shock 1.0135 6.0 $6,667
209 Major joint reattachment 2.0902 5.0 $8,572
148 Major complicated bowel 3.3417 12.3 $17,893
088 COPD 0.9314 5.1 $$3,873
DRG Description
DRG
Relative
Weight
Average
Length of
Stay
Average
Medicare
Payment
14. Medicaid &
Hospital
Reimbursement
q Medicaid operates as a vendor payment program, with
payments made directly to providers such as physicians,
hospitals, and pharmacies.
q Each state has relatively broad discretion in determining (within
federally-imposed upper limits and specific restrictions) the
reimbursement methodology and resulting rate for services,
with three exceptions:
1) For institutional services, payment may not exceed amounts.
that would be paid under Medicare payment rates.
2) For disproportionate share hospitals, different limits apply.
3) For hospice care.
15. Reimbursement
Methodologies
Device Manufactures: Should understand how their product will affect the various
cost centers in the hospital such as purchasing, materials management, CFO,
pharmacy, nursing, laboratory, engineering, PACU etc. Hospital administration will
be interested in products that can demonstrate savings or efficiencies in the overall
cost of providing patient care.
Reimbursement Methodologies
Types of Reimbursement Methods
► DRG
► Straight Charge (% discount)
► Per Diem
► Case Rates
16. Reimbursement
Methodologies
q Diagnosis Related Groups (DRGs) represents a fixed payment
to the hospital for a single admission for a single patient.
q Straight Charge Structures In this methodology, hospitals
control the mark up on each of the services (through the
charge master) and therefore control their profit margin.
q Per Diem Reimbursement a fixed payment is assigned per day
to cover all services provided during the hospitalization.
q Case Rates are a fixed reimbursement payment methodology
based upon specific procedures or diagnosis and have a strong
similarity to DRG reimbursement.
A device manufacture who can demonstrate that their product will increase
the efficiency of medical care delivery will get the attention of hospital
decision makers. Providing “PROOF” on how your product will affect the cost
and complexity of care, use of resources and length of stay will go a long way
in demonstrating how your product should be preferred over others.
18. The
“Hospital Story”
In order to survive as an organization, hospitals must
operate efficiently, balancing their revenue and costs
well enough to pay their employees, maintain their
facilities, and prepare for investing in the future. The
practices of Precertification, Preadmission Testing,
Retrospective Review, Disease Management,
Managing Length of Stay and Cost Shifting, as well as
decisions regarding the use of outpatient facilities,
and alternatives to acute care, all influence the
financial well-being of the hospital while meeting the
medical needs of the patient.
19. Cost Containment
Mechanisms
Precertification is the process of seeking approval from the 3rd
party payer for benefits and payment before any services or
admission to a hospital occur.
Preadmission Testing Centers are being recognized for their
efficiency and cost effectiveness and are being established by
many medical centers.
Length Of Stay is the number of days a patient stays at a
facility. An average LOS can be calculated for the entire facility
and can be a general indicator of utilization for the facility.
Cost Shifting refers to the need for a provider such as a
physician or hospital to bill some patients or payers at higher
rates to make up for reimbursement from patients or payers
that don’t pay or pay at greatly reduced rates.
20. Key Takeaways for
Device Manufactures
q Understanding patient mobility through the processing
steps will identify product placement and where to provide
value based on length of stay and appropriate care
guidelines.
q Products that can help a patient transition from hospital
care to home care can be important to the hospital’s cost
containment strategy.
q Manufactures should understand how such a product may
be useful in promoting alternative site care.
q Length of stay is an important variable in cost containment
strategies. Manufactures should understand how their
product can improve the efficiency of patient care and
how it can help shorten the overall length of stay.
22. Regulatory Environment
It is important for Device Manufactures to recognize that changes made to
the established system of care, including delivery systems, medical devices,
and medications, can impact the record keeping, monitoring requirements,
and other tasks of personnel in affected hospital departments under the
watchful eye of JCAHO standards.
q JCAHO quality improvement initiatives encourage
measurement to establish a quality baseline, assessment of
current practices, and evaluation of opportunities for
improvement.
q JCAHO has developed an indicator measurement system,
focusing on the outcomes of clinical care, rather than
standards of the process of care.
q JCAHO is so well respected for quality standards, that many
states accept JCAHO accreditation in lieu of performing state
surveys.
23. JCAHO Standards
EXAMPLE:
JCAHO has established standards related to pain management.
These standards:
q Recognize the right of patients to appropriate assessment and
management of pain.
q Record the results of the assessment in a way that facilitates
regular reassessment and follow-up.
q Establish policies and procedures that support the appropriate
prescribing or ordering of pain medications.
q Ensure that pain does not interfere with a patient’s participation
in rehabilitation.
q Educate patients and their families about the importance of
effective pain management.
24. Quality Assurance
q Risk Management refers to the hospital’s systems put in place in
order to minimize the risk of injury to individual patients.
q In most cases causes of medical device issues have been
demonstrated to be 85% systems failure, and 15% individual
failure.
q Thorough Risk Management Plans help to identify and
investigate adverse incidences and near misses.
q Risk Management is an important function of the hospital
administration, and may involve a risk management coordinator,
and a risk management team.
q The Risk Management Team is responsible for investigating
incidents, determining adverse events, evaluating exposure,
managing claims, supervising litigation, and structuring indemnity
payments.
25. Example (Risk Management)
Failure Modes and Effects Analysis (FMEA) is a systematic method of
proactively improving a process to prevent failures from occurring. FMEA
is frequently used in the hospital to manage high risk procedures such as
administering dangerous IV medications. JCAHO has requirements for
hospitals to perform FMEA on at least some procedures on a regular
basis. IV patient-controlled analgesia has been a common target for
FMEA.
An FMEA identifies the opportunities for failure, or "failure modes," in
each step of the process. A complicated process such as IV-PCA has many
processes such as compounding drug cartridges, programming the
pumps, and cleaning the equipment. Each process step or “failure mode”
can be assigned a numeric score that quantifies (1) how likely the failure
will occur, (2) how likely the failure can be identified, and (3) how serious
a problem the failure is likely to cause.
A complicated process such as IV-PCA will have much more risk involved
in it than other types of pain management, such as oral or IM analgesics.
Device Manufactures should keep in mind that the hospital is always trying to
manage patient care, cost and risk when making decisions about purchasing
medical technologies in the hospital.
26. Keys for Device Manufactures
q Device Manufactures should be aware of the impact that
their new device can have upon compliance with
accreditation standards and be able to discuss the
advantages that a product has in this regard.
q Device Manufactures need to know how their product affects
risk management issues for the hospital and for individual
patients.
q Device Manufactures need to know how their product will
help a hospital to comply with CMS standards for efficiency.
q Device Manufactures should understand the impact their
product will have upon the finances of DSH.
28. Generating
Demand
4 Objectives:
1. It’s critical that you generate some type of “Inertia” that
delivers your products core messaging to drive whole hospital
acceptance following hospital committee approval.
2. From our previous discussion ensure that you can effectively
tailor your product’s value and verbalize core messaging that
will get wide user acceptance in the hospital.
3. Expect and react appropriately to key questions/objections you
may receive regarding your product and develop a
communication plan to address responses swiftly.
4. IMPORTANTLY, identify, develop, and implement KOL’s (Key
Opinion Leaders) in targeted hospitals to help promote product
throughout hospital. Allies are critical.
29. Typical Review Process
Note: this process could vary hospital to hospital
Product Status Review
Device Approval Process
Hospital Forms Committee Review
Executive Committee Review Hospital Training process
Product Utilization Review Educational Program
Nursing Training (In-Service)
Director of Nursing
Hospital Medical Education Dept
Hospital Protocols
Standard Order Forms
Hospital Policy/Procedures
Nursing Flow Sheet
30. Accelerating
User Access:
Education,
Demand &
Protocols
Product Pull-Through
Education/In-servicing
q Nursing
q Pharmacy
q Anesthesia
q Surgery
q Members of the
q Anesthesia
Committee
Hospital Policy/Protocol
q Standard Order Forms
q Algorithms
q Nursing Flow Sheets
q Hospital Purchasing
q Narcotics Pharmacist
q Members of Anesthesia
q Committee
Generating Demand
q Sell the Value Proposition
q Sell the differences of the
q delivery method
q Sell every Health Care
Provider
q Involved with the utilization
of product
31. Accelerating
User Access:
Education/In
-Servicing
EXAMPLE:
• Medical Education Department
• 200 Trained KOL Speakers
(Surgeons, Anesthesiologists, Nurses and Pharmacists)
• 200 programs budgeted through fiscal year
• 800 programs budgeted through fiscal year
• Account Representative In-Servicing
• Key Health Care Providers
• Anesthesiologists, Surgeons, Nurses, Pharmacists,
Anesthesia Committee, Other
• Nurse In-servicing
• “Nurse Response Team”
• Resident/Fellow In-servicing
• “Inspiring Innovation Program”
32. Accelerating
User Access:
Generating
Demand
q Selling the device’s “Value Proposition”
q Selling the difference in “Delivery Method”
q Strategic targeting of “King-Pin” customers
q Selling every Health Care Provider involved as the end user of the
chosen product
33. Accelerating
User Access:
Policy/Protocol
• Device Manufactures will work with Health Care Providers
according to hospital policy and protocol.
• Heath Care Provider Training and Support
• Appropriate “Patient Selection” is critical
• Inappropriate use can lead to unsuccessful product experience
and dampen product uptake
• Numerous healthcare providers have a stake in appropriate use of
device
• Educational resources and materials reflect HCP needs
• Device Manufacture should be committed to a comprehensive Risk
Management Plan
34. Summary
q Before launching a new device/technology in the
institutional setting, thorough profiling and planning is
critical.
q Identifying and developing KOL’s/Key Customer Targets
will be important in “generating demand” throughout
the entire institution.
q Understanding and adhering to the institution’s
policy/protocol will help the new device transition
process and help the “education process”.
q Having a proven “value proposition” placed on the new
device will demonstrate the “economic value” of the
product to the institution.
q Developing a “pull-through” strategy once the product is
approved, proper utilization through a thorough “risk
management” and education process will ensure a
favorable initial experience.