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BUSINESS OF
MEDICINE

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Another solution offers a specific method that physicians use to Employers are moving to the bundled-pricing model to control
increase their volume of patients and improve their bottom line: cost and increase quality. Each stakeholder gains something in this
• Review all the surgeries you perform scenario:
• Choose the 10 you perform most and presumably enjoy perform- • Surgeons have a quality facility to work in, with a steady stream
ing the most. of available patients
• Track metrics (you might already have this information) • Patients have access to a quality facility with known quality met-
o success rates, rics and proven outcomes
o cases performed, • Employers have a known entity held to specific standards of care
o complication rates and any other necessary information with a known cost
• The Hospital has a steady stream of patients whose bills are paid
A solution may be found by contacting a service that connects promptly.
surgeons directly to patients; register and provide the information
they request. Once registered, you will begin to receive a request for Outcome-based care was a solution discussed at the Healthcare
proposals for only the surgeries you want to perform. The result Financial Management Association (HFMA) conference in Las
can be a new and consistent flow of surgeries that you can choose Vegas this June. Because margins are already squeezed on all sides
to perform and determine the cost. Payment terms between the and C-Suite executives – of an individual practice or a large facility
payer of care and the surgeon are agreed upon up front and there – there is a lot of trepidation about how to move to this model. The
are no insurance issues to deal with. general consensus at the HFMA conference is that bundled pricing
Bundled prices for outcome-based care are also a solution. The and direct contracting are coming; let’s figure out how to make it
administrative side is clean and simple which enables the physician work for us.
to spend more time with the patient and doing work that he or she In summary, every market is unique, and the solutions need to be
loves… rather than paperwork! local. Access to care and social determinants are huge issues in San
This allows employers hungry for solutions to offer best in class Antonio. Moving to a more outcome-based approach, that works
care at a more reasonable cost. for patients, payers (mostly employers) as well as providers can help
Hospitals may use bundled pricing and direct contracting to im- us address many of the issues we face here – Diabetes, Kidney Dis-
prove their already solid market position. Already recognized as a ease, Maternal Mortality, Infectious Disease, as well as many others.
location of choice for several surgical specialties, their goal is to con-
tinue to grow and make their facility the location of choice for sur- Allison De Paoli is the founder of De Paoli Professional Services. She can
geons of all specialties. be reached at acdepaoli@depaoliprofservices.com or by calling 210-857-4322.

42 San Antonio Medicine • March 2019