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ROYAL HOBART HOSPITAL

M aximising Hospital Revenue with Efficient N on-inpatient services Presenter: Pam McGrath Royal Hobart Hospital. ROYAL HOBART HOSPITAL. KEY PROBLEMS. Poor revenue performance: Missed billing opportunities – revenue targets not reach. Inefficient billing processes and systems

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ROYAL HOBART HOSPITAL

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  1. Maximising Hospital Revenue with Efficient Non-inpatient servicesPresenter: Pam McGrath Royal Hobart Hospital ROYAL HOBART HOSPITAL

  2. KEY PROBLEMS • Poor revenue performance: • Missed billing opportunities – revenue targets not reach. • Inefficient billing processes and systems • Low profile of the Private Patient Scheme (PPS) Hospital Wide • Major risk to the PPS

  3. INNOVATIONS IMPLEMENTED Revenue innovations : 1. Review of the Staff Specialists’ Private Practice Agreement 2. Privately Referred Outpatient Billing Scheme/Systems 3. Private Inpatient Incentive Scheme

  4. HOW WE DID IT Innovation – “Implementation of the Privately Referred Outpatient Billing Scheme”. • Commenced April 2000 • Sponsored by CEO - Working party • GP Input – communications • HIC approval/rules/endorsement • Marketing the scheme • Recruiting the Specialists • VMO Participation • Indemnity • Implementing effective billing procedures/ processes

  5. OUTCOMES – BULK BILLING

  6. Clinics – Systems/processes Referrals –control and management • Named • Recording - central data base • Valid - updates Scheduling and booking systems Phone traffic rooms GP feedback Staff recognition - revenue

  7. ORP services vs public • 55% of total OOS in outpatient clinics are BB as Privately Referred Out- Patients • 50% of same day procedures (e.g. endoscopies/dialysis ) are BB as Privately Referred Out-Patients

  8. HOW WE DID IT Innovation - “Review of the Staff Specialist PPS” OLD MODEL (prior to 2000) • Not sensible/logical or fair • Paid as you bill • High Earners reach 35% first • No incentive to keep billing • Static revenue –

  9. HOW WE DID IT Innovation - “Review of the Staff Specialist PPS” NEW MODEL (post 2000): -Create an incentive to bill • Simultaneous distribution of the 35% • Hospital share • 50-:50 Phase • Complies with Tax Legislation

  10. STAFF SPECIALISTS PPS • FEES RAISED UNDER NEW AGREEMENT

  11. STAFF SPECIALIST S’ PPS

  12. VMO FEES RAISED

  13. HOW WE DID IT Innovation No 3 – “Private Inpatient Incentive Scheme:- • Education of Staff Hospital Wide • 3% bed single bed revenue to Wards • No out of pocket expenses for Patient • Free TV • Simplified Billing System

  14. OUTCOMES – Private Inpatients

  15. OUTCOMES – PPS ACTIVITY

  16. CURRENT PROJECTS • Improved systems to allow timely and accurately billing of services provided by Medical Officers to chargeable inpatients; • Appointment of Inpatient Billing Clerk; • DEM Admissions; • Bulk billing – Ante-natal clinics;

  17. LESSONS LEARNT • Create incentives for Doctors to participate in revenue generation • Make it easy to bill • Give good feedback • Establish open communications with the HIC

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