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SHM Annual Meeting 2008

Value of a Hospitalist Program. SHM Annual Meeting 2008. Michael Wagner, MD FACP Chief General Medicine, Tufts-NEMC Steve Houff, MD CEO, Hospitalist Management Group Robert Bessler, MD CEO and President, Sound Inpatient Physicians. Outline of Discussion. Drivers of hospitalist medicine

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SHM Annual Meeting 2008

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  1. Value of a Hospitalist Program SHM Annual Meeting 2008 Michael Wagner, MD FACP Chief General Medicine, Tufts-NEMC Steve Houff, MD CEO, Hospitalist Management Group Robert Bessler, MD CEO and President, Sound Inpatient Physicians

  2. Outline of Discussion • Drivers of hospitalist medicine • Customers • Assumptions • Value proposition • Quality and cost • Benefits of a hospitalist program 2

  3. Drivers for Hospitalist Medicine • Hospital drivers • Utilization Management • LOS, cost per case, denials • Quality Management • Core measures • Customer service • Patient satisfaction • PCP satisfaction • Specialist satisfaction • Nursing satisfaction • Medical staff drivers • Uncovered unassigned call • House duties • PCP recruitment • Specialist re-focusing on specialty care • Workforce • Ready made training programs • Recent graduates lifestyle oriented

  4. Hospitalist Customers Patient and Family Nursing and CM Primary Care Physician Hospital admin Specialist Physician Hospitalist Ancillary services Emergency Medicine Rehab/LT care facility Program Coordinator Third Party Payers 4

  5. Assumptions (what the world expects) • Physician core competence • Hospitalist have basic knowledge and skill to care for hospitalized patients • Physicians are team players • Work as team (sign in/out) • Complete medical records and hospital related paperwork • Practice management infrastructure • Documentation • Coding, billing, compliance • Malpractice • Recruitment, scheduling, payroll • Enrollment and credentialing

  6. The Value Proposition Value = Quality / Cost 6

  7. Domains of Quality • Clinical outcomes • Mortality • Readmission • Absence of bad outcomes • Quality management • JCAHO core measures • Pathway adherence • Peer review • Customer service (satisfaction) • Press-Ganey, Gallup, etc. • Site specific surveys • Reputation

  8. Domains of Cost • Cost of direct patient care • LOS • Cost per case • Utilization • Cost of support • Subsidy • Indirect costs • Reputation • Negative reputation

  9. Benefits of a Hospitalist Program • Medical leadership • Improve medical record documentation • Compliment orphaned services • Nursing support and education • Halo effect to other medical staff • Support the emergency department • Increase referrals from non-aligned or distant physicians

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