Finally, when negotiating contractual agreements, health organizations should carefully consider the contracts of the rescue service. For example, managers must ensure that their organization is not at risk of violating OIG regulations. Executives should also avoid committing Medicare/Medicaid fraud by accepting a discounted price or agreement with the entrepreneur that could be considered a bribe or volume inducement. A hospital or system must consider a number of factors when deciding whether to build or contract ambulance services: the demographics of its community, the local competitive emergency department landscape, and the importance of direct control over the quality of care and patient experience. Other factors include the investments needed to develop an ambulance fleet, the model of the region`s ambulance system, and how emergency services can influence market dynamics. Many hospitals and systems choose to create their own ambulance services to have more control over patient care and transportation and reduce costs. However, deciding to own and manage an ambulance service or contract with an external organization is more complicated than many healthcare executives realize – and can have a downstream impact on outcomes and costs. In addition to capital expenditures, operating an ambulance service requires other investments. More than ever, regulators are focused on emergency services` compliance with billing rules and data protection laws. Education, quality management and logistics also require resources.
A hospital system must balance these costs with the potential benefits of direct control over these services, which it believes reduces the liability or risk of being involved in a compliance issue due to the negligence of an external organization. At the same time, hospital staff in billing, compliance and quality services may not be aware of rescue and clinical care requirements, and may require additional training. Savvik Purchasing Group: With contracts pending with reputable suppliers, Savvik leverages the purchasing power of its entire group to get the best possible deals on commodities to offer our members greater discounts. Buy exactly what you need and save money by consolidating your purchases with your colleagues nationwide. All this at no extra cost to you. More and more patient care is taking place outside of the hospital, and patient navigation and logistics are becoming increasingly important as healthcare providers prepare for the widespread adoption of value-based payment models. Hospitals and health systems must objectively analyze whether the organization`s ambulance services, whether internal or contractual, are helping to achieve hospital or system objectives efficiently and effectively. Nationally, a number of forward-thinking ambulance services are adopting new and innovative models, including community paramedic programs and alternative transportation to destination, to help hospitals and systems achieve their patient care goals. These models often provide paramedic-managed home care and chronic disease management. For hospitals, these new models of care can help avoid 30-day readmissions and increase patient satisfaction.
Example 2: A large multi-hospital system in an urban centre on the East Coast used contract ambulance services to transfer patients between its hospitals. The system relied on a sophisticated control center to monitor bed availability and distribute ambulances accordingly. With caution and determination, leaders can order services that help their organization achieve a triple goal and succeed according to value-based payment models – or, if it serves their organization better, create an internal ambulance service to achieve those goals. Does your Supplier Guide sheet need to be updated? Use this form to submit updated information. When hospital and health system leaders decide that a third-party ambulatory services agreement is best suited to achieve their goals, they should include six elements in the contract: The following case studies show how hospital systems have deployed ambulance services in the way that would best meet the system`s objectives: Example 1: A growing health system in the Southeast recently decided to: bid on ambulance services and use a system-wide provider. The hospital system had provided ambulance services and special transportation to one of its locations. In addition to these transportation services, the hospital system also had contracts with other emergency services, including agreements for air transportation. In an effort to control quality and save money, system management considered operating emergency services in-house. Leaders conducted an independent study on emergency services, which created a model for best practices in use and deployment.
However, as a result of the analysis, the leaders made the decision to renegotiate their contract with the ambulance provider instead of developing their own internal transport service. As part of the contract negotiations and to improve conditions, managers added specific performance indicators and additional safeguards for the organization. These safeguards allow for intervention rights for vehicles and equipment to help contracted emergency services better meet system requirements. However, the hospital system found that timely service was an issue for its multi-contract ambulances, which also served other hospitals and communities. Ambulances could not quickly get patients out of hospitals and into their homes or care facilities in rural areas, which became a flow problem for hospitals. Hospital officials realized that they still had to transfer patients from remote facilities to the anchor hospital and, after a review, found that using a single transportation provider made more sense. AAA affiliate members have demonstrated their commitment to our industry by supporting our association. Visit a category below for easy access to the products and services they can offer you.
Christine Zalar, B.S.N, M.A., is a founding partner at Fitch & Associates in Platte City, Mo. Jay Fitch, Ph.D., is President and Founding Partner of Fitch & Associates. As healthcare evolves rapidly, hospital and health system leaders are increasingly focusing on how to customize existing service lines to achieve better patient outcomes at a lower cost. .
