The transition to rehab facility under HealthSouth allows Drake to accept more patients than under the previous long-term acute care hospital license, notes Hinds. "It was a good chance for us to sustain and grow our rehabilitation services at our site and serve the needs of our community better," he says. The decision was supported by the clinicians.
The performance improvement initiative—a system-wide examination of all hospitals, departments, clinical practices, inpatient and outpatient services—identified $15 million in savings opportunities. Additionally, revenue opportunities totaling nearly $15 million were identified by improving access, management of specific diseases such as chest pain, reduction in days in AR, LOS/discharge planning, bed utilization, and improvements in throughput. Physician preference item initiatives, spine, orthopedics, and cardiology, in fiscal year 2012, realized audited savings of greater than $6 million.
When it comes to reducing physician preference without alienating doctors, Hinds believes that what's often missing in the typical not-for-profit setting is the willingness by the hospital administration to collaborate and allow physicians to develop strong leadership and governance roles. "The physician tends to end up feeling like an employee, and that breaks down the alignment structure," he explains.
Though UC Health welcomed physicians into the governance and leadership of the organization, Hinds recognizes that "It's a difficult change for a lot of hospitals. But in the long term, physician collaboration is going to be a key to success. Yes, hospitals can get reimbursed without good physician alignment, but in the long run those organizations [without good alignment] will struggle to get the sustainable cost reductions they're after," he concludes.