How to Make Productivity Gains Possible and Profitable
Staff cuts are not always the answer.
Cary understands what it takes to make, “Better American Hospitals.” In addition to being a seasoned consultant, Cary has worked as interim hospital CMO in three different organizations, as well as served as medical director for two multi-specialty medical groups and several HMOs. Cary has a solid history of leading medical staff through improvements in utilization management, changes in peer review practices, and corrective action procedures. As President and Chief Operating Officer, Cary is armed with a diverse background in hospital, medical group, and managed care settings, and has immersed himself in developing the strong knowledge base and extraordinary skill set needed to successfully improve today’s hospitals. While serving as a member of the American College of Physician Executives, Cary has used his deep knowledge of the complex structures of the healthcare field and applied it toward implementing quality improvement initiatives and developing governance structures, strong compensation plans, productivity reporting models, and effective physician management training programs. Prior to joining Compass Group, Cary provided a number of successful consultant services resulting in projects that included the effective merging of medical staff of two hospitals, reducing the length of stay at hospitals, decreasing inpatient utilization for managed care organizations in several markets, the successful turnaround of the financial performance of a Medicare PHO with full capitation, mentoring Chief Medical Officers, evaluating medical group capability for managing capitation, and improving operating room utilization. Cary continues to use his compelling interpersonal skills to maintain a strong focus on improving clinical operations, developing medical staff leadership, and strengthening physician relationships. While Cary served on active duty in the U.S. Navy, he was Head of the Quality Assurance Department of the Navy Medical Command, National Capital Region, in Bethesda, Maryland. Cary is board certified and completed a laboratory medicine residency and an immunohematology fellowship at Washington University in St. Louis. In addition to his numerous national speaking engagements, he has authored a number of publications including, Hospital Service Recovery, Journal of Hospital Marketing and Public Relations.
Staff cuts are not always the answer.
Proactive hospitals need to prepare for the future – today.
Will the new CMS Acute Care Episode Demonstration Project address the patient’s concern that their interests are being subordinated to the physician’s or the hospital’s financial interests?
There is an elephant in the room that is not being discussed – personal responsibility for health. For years, studies have shown that up to 70% of disease is influenced by …
By Cary D. Gutbezahl, MD, President, Compass Clinical Consulting. Although many factors may contribute to an avoidable injury, investigations often reveal that the policy and procedures were in place, the staff was trained on and understood the policy and procedures, staffing was adequate to do the work, but people didn’t follow the policy.
By Cary Gutbezahl, MD, President, Compass Clinical Consulting: Our experience says that while hospitals sometimes overlook indications of problems, more often, CEOs and boards tolerate a series of ineffective attempts at fixing the problem.
It’s difficult to predict the specifics of what health care reform will bring, but it is clear that it won’t be business as usual. We believe that three things will be certain results of the current public debate. First, reimbursement changes are going to increase the importance of managing the cost of delivering services. Second, coordinating care will become more important. Third, increased accountability for patient safety and treatment plans consistent with best practices and evidence-based medicine will require cultural change.
In our experience in case management, both in hospitals and in managed care organizations, we have found many reasons why patients are readmitted to hospitals.
The Reconciliation Process can do nothing but shut off oppositional thinking before the best possible healthcare reform is designed and implemented. Cognitive conflict can yield stronger programs that assure hospitals and doctors are in a position to provide quality care for patients. I hope they don’t repeal “First, do no harm”.
Diversions are when ambulances are sent to another ER because the nearest ER is too busy and does not believe they can safely provide care. I thought it might be useful to understand that the hospital goes on diversion because it has determined that patient safety might be at risk if more critical patients were added to those already at the hospital. Adding more work beyond the capacity of the ER not only jeopardizes the new patient but puts all the other patients at risk.
By Cary Gutbezahl, MD: The issue is the misuse of research findings and extending conclusions beyond the conditions of the research. That this research is publicized is evidence of the failure of our educational system! It’s time to stand up and scream “Foul!”
The number of medical school graduates going into primary care practice falling into chasm. A graph tells a thousand words. In 1991 about 15% of medical school grads went into primary care. Then came a surge of PCPs from 1997 to 2000 when 35 to 40% of graduates set off on primary care careers. Today [...]
The primary rule of medicine is “first, do no harm”. Why can’t health care policy makers adopt the same principle? Otherwise, in the not too distant future, we’ll be scrambling to replace the next broken healthcare system. Will we be the butt of the old joke?
A recent study in the New England Journal of Medicine implies that because 50% of re-admitted patients had no outpatient physician visits their care was sub-optimal and that somehow hospitals are responsible and should be financially punished for high rates of re-admitted patients. This logic is flawed.
The president’s budget calls for $26 billion in savings from patient re-admissions over 10 years, which includes lowering payments to hospitals with high numbers of patients who are re-admitted. Such a kneejerk reaction simply penalizes hospitals for following the rules — get patients out of the hospital according to DRG rules.
We all need to make sure that unintended consequences of reform do not tear down what is still – with all its room for improvement – the best healthcare system in the world. Hospitals, like all businesses, are in a race to become much more efficient, accomplishing more with the same, or even fewer resources. Stagnant or declining hospital revenue increases motivation to eliminate activities that bring little value, or even undermine quality outcomes, delivery and service.
These three articles will help you gauge where healthcare reform is headed and how it might impact your hospital. Includes a copy of the 11-page letter used by Senator Grassley that can strike fear into any hospital CEO getting this letter in the mail.
Sharon Begley, senior editor of Newsweek, sees doctors as having long resisted using science to guide their practice, thus leading to a chronic pattern of overtreatment and using more expensive techniques than necessary.