PHASE 1 | Assess

We begin by collecting information about the existing or potential new practice. For a new practice, this includes the hospital’s payer mix, patient volumes by physician and existing arrangements for unassigned-patient call coverage. We’ll also ask to see minutes from meetings in which hospitalist practice was discussed. We’ll then determine the key drivers for program development, examining goals from the perspective of each stakeholder.

For existing practices, we collect descriptive information about the practice and the hospital(s) it works in, as well as data about existing volumes and workload, scope of services, staffing levels (both providers and support staff), schedules, employment contracts, operating systems and processes, financial and billing information and other pertinent details about the practice. We use this information to begin understanding the context in which the practice functions, and how it operates.

PHASE 2 | Visit

Our site visits with clients typically last two days. During this time, we:

  • Interview stakeholders, including PCPs, ER doctors, medical and surgical sub-specialists, hospital administrators, discharge planners, case managers and financial experts. In existing practices, we spend a significant amount of time meeting with the hospitalists themselves, ideally as a group.
  • Refine our understanding of program goals and expectations from the perspective of each stakeholder.
  • Discuss options for how the program might operate  For new practices this includes who will employ the doctors, what will be the scope of services, what staffing and scheduling options are feasible and what support resources are required. For existing practices these discussions focus on what changes might be made to improve the practice and its service to the sponsoring organization.
  • Dispel misconceptions about hospitalist practice and set appropriate expectations among stakeholders.
  • Facilitate perspective shifts among the hospitalists themselves, where appropriate, with the goal of engaging them around building a culture of ownership.
  • Provide immediate feedback regarding our preliminary findings, conclusions and recommendations prior to our departure.

PHASE 3 | Recommend

After the site visit, we continue to analyze the information we’ve collected, and consolidate our observations and conclusions into specific recommendations for the new or existing practice.

For new programs, we project future referral patterns, total patient volume, payor mix and anticipated professional fee collections. From this data, we create a financial pro forma and program implementation plan which are reviewed with key stakeholders by phone and e-mail to gain consensus regarding assumptions and approach.

For existing programs, we assess productivity and compensation, project required staffing levels and develop recommendations covering a wide variety of strategic, operational and financial issues.

We then provide an electronic copy of our report, and confer with you by phone to discuss and clarify.  We make any needed corrections or amplifications, and then provide a final report in electronic and/or hard copy format at your direction.

Our final report is a detailed and comprehensive business and implementation plan addressing all aspects of the practice, including:

  • scope of services
  • workload and staffing needs
  • operating policies, procedures and protocols
  • financial performance
  • political concerns that may arise

PHASE 4 | Support

For six months following submission of the final report, we’re available to field questions and offer suggestions for implementing our recommendations — at no additional charge.

An extra fee is incurred for return site visits to present and discuss report findings, or for more extensive assistance implementing our recommendations.