Introduction
In today’s healthcare ecosystem, there are few things more impactful to your rural hospital’s financial success than its service portfolio. Infusion services for example, many rural systems lose reimbursements, which makes this service an overall expense. Service directors may struggle to fix mistakes citing lack of resources as the primary need. Making partnering with a specialized partner important in your goal to generate profits. The typical rural hospital already does infusion services, but on an ad-hoc or emergency need basis.
Rural hospitals provide crucial care to communities that might otherwise be left behind. With limited resources and shrinking budgets, they've had to shut down lower performing service lines. In some ways this exacerbates the financial issues, and leaves patients having to travel to obtain services.
While rural hospital executives face having to be profitable, demographic shifts, reimbursement rate discrepancies, staffing challenges, and the high costs of technological advancement are other prevalent issues. Each of which has its own financial caveat. Addressing this multifaceted challenge requires a holistic approach, incorporating policy interventions, community engagement, and innovative management strategies. Imagine trying to pour over hours and hours of data to find the exact services your rural hospital needs, then trying to make a run at being successful while maintaining the current level of staff and adding priorities. Seem difficult? That’s because it is like trying to find the needle in the proverbial haystack.
Infusion services involve the administration of medications through injections or intravenous (IV) lines. Drugs administered through infusion are diverse, encompassing a broad range of therapeutic categories. These services require space, nursing staff, and proper billing to function properly. Scheduling of infusion services can be challenging if your rural hospital is short staffed and set up to only do infusions when spare time exists. In a rural hospital, spare time rarely exists and where it does revenue disappears. Inspecting these services may show data that suggests that you aren’t billing properly, nor are you serving the overall needs of your local community.
As healthcare continues to evolve, infusion services have moved from being exclusively in-hospital to outpatient settings, and in a growing number managed by 3rd party providers, broadening their accessibility. Outsourcing part, or all, of the infusion therapy services is not a new trend, but a growing one due to the complexity of medical billing. The complexity is partly caused by Medicare and programs like 340(b) that make expensive drugs more affordable for low-income populations. While billing seems to take the brunt of the blame for the failure of these programs, hospitals sometimes overlook billing, scheduling, and pre-authorizations, causing deeper issues.
With the right approach, rural hospitals can transform their infusion services into profit-generating service lines, while treating a wider population of patients. While there is no magic formula, hospitals that use data to understand their populations can see where services exist and where expansion of services can be utilized to treat more patients. Couple this by adding proper billing procedures and pre-authorizations, revenue streams can suddenly come back to life. Rural communities are changing in that they are skewing more towards the elderly, making having a wider breadth of care and knowing how to best bill for that care extremely important to the bottom line.
A combination of effective management, utilization of available resources, and partnerships can lead to a sustainable profit model for infusion services in rural settings. While maintaining the utilization of resources the hospital system already has in place, outsourcing a partner can be winning strategy for some rural hospitals. Take the two most time-consuming tasks out of the equation for your local staff and then add back missing revenue, and you get a recipe for success.
Companies like Community Infusion Solutions (CIS) can give healthcare professionals the needed power to support this transformation. By leveraging the expertise of a partner like CIS, rural hospitals can maximize the profitability of their infusion service offerings. There are large companies offering this service as an in-home service, which works for patients provided everything shows up on time and the traveling nurse has experience in this type of treatment. Moving this service or sending patients sometimes hours away doesn’t bode well. There are several implementations of this type of partnership that CIS has documented, specifically in the form of case studies and testimonials. What makes it work is the dedication to outcomes by both the hospital and the partner. Register here, to get the latest case study of Hillsdale Hospital and how they turned a twice failed infusion suite into a profitable center in their hospital.
By turning costs into profits, rural hospitals can bolster their financial standing, enabling them to offer more services and cater to more patients. In some cases, 25% or greater revenue from infusion services can be sustained over long periods of time, and since the partnership utilizes services already in place as a base of operations, it doesn’t take long to start generating the added revenue.
Improved Patient Care
Profit-centric models often lead to improved services, meaning patients receive top-tier care without the associated high costs. In rural hospitals, nursing staff often do more than just patient care even when nursing staff is already short, so when a partner can come in and take some of the non-care load from a nursing staff better care will often develop.
Rural communities benefit from the enhanced healthcare offerings and local economic growth stimulated by a profitable hospital. Hospital systems that generate profitable care often can provide patient care grants, and other local donations, further assisting their populations.
While the transition promises numerous benefits, rural hospitals will face challenges such as initial setup costs, training, and other potential hiccups along the way. Addressing these head-on with clear strategies is crucial. Community Infusion Solutions has a continuous improvement system in place, and dedicated staff that will do what it takes to rectify any issues that become known. Its that type of commitment that can make the difference between a program that continues to fail and one that becomes profitable. The transparency of the communications between the patient and scheduling is one area that CIS excels. This avoids patients having to reschedule treatments due to no staff or no medications.
With the ongoing shift towards value-based care and patient-centric models, the infusion service line in rural hospitals holds immense potential. Hospitals can keep or expand their service offering and footprint at the same time provided they can navigate the complexities without further extending their nursing and billing staff. Outsourcing makes sense because the partner is more advanced in their specific capability. Many times we’ve heard from program directors that they have tried to focus on infusion services but failed each time. In the future, this will become more common simply because of the complexity of innovation in all areas of the rural hospital and how that interacts with care.
Conclusion
The new age of rural hospital infusion services is one of transformation, innovation, and profitability. By using experts in areas of complexity, some are turning costs into profits. These rural hospitals can not only ensure their sustainability but also significantly enhance the quality of care they provide. At the end of the day, nothing is getting less complicated for rural hospital executives, which makes finding critical partnerships so valuable.
Request a level 1 meeting today, this will help us both figure out if Community Infusion Solutions is a fit for your system. If so, a level 2 meeting will be required to define more appropriately what partnering might look like.