Advancing Operational Success with Hospital-Based Service Line Optimization

With increasing pressures on reimbursement, a shift in focus by payors to inpatient costs and outcomes, and consolidation in the physician market, health systems and hospitals face numerous demands in operating efficient and high-quality service lines. For many facilities, contracts for coverage of key service lines – anesthesiology, emergency medicine, intensive care units, hospitalist medicine, radiology, trauma centers, etc. – represent the single largest expense with outside physician vendors. What was previously a cost of doing business has become one of the primary drivers of a health system’s financial and operational success.

HealthCare Appraisers has consulted on thousands of hospital-based clinical coverage arrangements (“HBCCAs”) and has gained unmatched insight into the trends of HBCCAs. This knowledge has allowed our clients to remain competitive and financially healthy despite the ever increasing costs associated with HBCCAs.

Our team’s expertise extends to all areas of service line optimization, including service line assessments and Request for Proposal due diligence.

Service Line Assessment

Using our decades of experience and internal resources, our advisory services team offers thorough assessments of service lines to help our clients answer certain key questions regarding contract renegotiation or renewal, such as:

1. Benchmarking and staffing review, including:

a. Cash compensation and benefits;
b. Patient volume and work relative value units;
c. Other operating expenses, profit margins, and management fees; and
d. Professional collections;

2. Review of current contract, including:

a. Compensation structure; and
b. Quality Metric selection and compensation.

Request for Proposal (“RFP”) Due Diligence

Whether or not the decision to perform an RFP was made independently or as a result of guidance from our team of consultants, HealthCare Appraisers can help you navigate the sometimes daunting and complex RFP process. We can assist with reviewing each proposal, identifying strengths and weaknesses, and working with our clients to select a partner, not just another contractor. Our highlighted services include:

1. Assisting and creating the RFP questionnaire;
2. Coordinating responses and data provided by candidates;
3. Benchmarking and staffing review of each submission;
4. Summarizing and providing key recommendations on candidates;
5. Ensuring alignment with strategic goals; and (if requested)
6. Conducting a fair market value assessment of the selected RFP.

  Read Our Latest Hospital-Based Service Line Optimization FMVantage Point™