Clinic Management Models: Participating in the Large Management Company’s Approach to Care & Business

As with any business, there are multiple types of philosophies when it comes to wound management companies — just as there are pros, cons, and tradeoffs to any form of business model. However, the one constant among all management companies that govern outpatient wound clinics is the desire, drive, and responsibility to ensure their clinicians are providing the highest possible level of care to those living with chronic wounds.

This article will explore the approach and strategies taken by large management companies, as well as the clinics they operate, by focusing on benefits that include: an ability to leverage a large network of clinics and providers; investment in and access to various technology and tools that offer a wealth of data, information, and training; and a robust corporate infrastructure that allows for regional provider networking and support.

Assessing Benefits of The Large Network

One of the initial benefits to joining a large management company is the opportunity to become part of a large network of highly trained wound care professionals. Management companies also offer stability, history perspective, and the distinct advantage of a large integrated wound care network. Relationships with other professionals throughout the network allows for sharing of best practices and collaboration. A large footprint of wound clinics across the country can help patients receive consistent care wherever they may be. This is especially important in areas of the United States that have a larger number of seasonal residents. Often, patients will seek treatment in a clinic near their vacation home and continue care near their primary residence when returning home. With a large number of clinics spread across various geographies, providers within a large care network can coordinate their care to ensure patients get the same advanced treatments whether they are at home or elsewhere. The ability for outpatient clinics and providers to coordinate care to and from other care venues is another benefit of being part of a large network. Through a physician-led model, the large management company can coordinate care from the hospital inpatient setting to the outpatient clinic and into a skilled nursing facility, if necessary. This community-based approach to wound care is instrumental in providing consistent, high-quality care to patients across the healthcare continuum.

Benefit of Information Sharing

A key advantage of being part of a larger management company is the organization’s ability to invest in enabling technology and tools that positively impact the clinical, operational, and financial aspects of the wound clinic. Tools such as wound care-specific electronic health records (EHRs) help optimize patient flow and documentation. Today’s EHRs feature sophisticated programs that transmit assistive programs such as “treatment logic” and medical alerts to help guide providers as they strive for quality patient care in an environment that’s shifting away from a volume-based approach. These alerts are built into the EHR and are based on clinical algorithms shown to enable optimal patient care. As physicians are entering information into the EHR, prompts appear that ask the physician if specific, appropriate tests have been performed on the patient. The alerts help the physician look at the entire plan of care and assist in real-time clinical decisions. Advanced financial analysis tools that take into consideration debridement rates, billing, and collection data also give insight into areas of opportunity or improvement. The information garnered from these tools can help identify both clinical and billing inconsistencies. For example, if a center is billing largely for selective debridements and less frequently for surgical debridements, this could signal either clinical and/or billing problems. This information can then be used to determine the root cause of the problem and plans can be put in place to correct. Large management companies may also provide software to help maximize the effectiveness of referral development. The availability of customer relationship management (CRM) tools that communicate with a clinical database help clinic managers effectively plan and execute impactful referral development campaigns that educate referring physicians to send appropriate patients to the clinic. The management company has the ability to assess referral activities based on wound type and referral sources. This information is then taken into consideration when developing referral development campaigns. For example, if the management company notices a lack of referrals for a certain wound type, it can develop a campaign focusing on that wound type and give clinic managers direction, through the CRM, about who to visit during the campaign. This type of targeted referral development helps clinic managers better identify potential referral sources and provides specific messaging for more effective referral development activities. Investments in scheduling tools also help clinic providers accommodate more patients and maximize center efficiency while continually providing high-quality care. The management company implements a case management model within its centers to help improve center efficiency and promote better clinical outcomes. Great care is taken when scheduling patients and slots are assigned based on acuity and whether or not a patient is new to the center. Through effective case management and scheduling, providers are able to streamline care to patients while helping to coordinate patient care beyond the walls of the wound clinic.

Communicating one another’s successes in developing best-practice standards is also encouraged throughout the large management company approach.

Technological investments that support collaboration through access to an intranet tailored to specific job needs also allow for real-time sharing of news updates, blog posts, training resources, and comprehensive reporting. The reports function relates to the clinical, operational, and financial “health” of the center. These reports help the clinic and regional managers better monitor and manage the business.

Benefit of Sophisticated Training Modules

Another significant area of investment for the large management company is in the training provided to all staff members. The large management company has the ability to deliver online and in-person training that’s tailored to each position (clinical and administrative) within the clinic. It is important to note that training within the large management company environment is not a singular event, but part of an ongoing curriculum to continuously develop physicians, clinical staff, and operations employees. Great care is taken to ensure education is delivered in the most effective and impactful way possible.

Typically, training begins with pre-learning through online modules assigned to each role, including clinical staff, front-office staff, center management, and physicians. The pre-learning prepares the staff for live training that occurs at the corporate headquarters for physicians, nurses, program directors, and hyperbaric oxygen therapy (HBOT) techs. Front-office staff members receive in-person training at the wound clinic. The emphasis on continuous improvement and education is evident throughout the organization. Physicians receive continuous training through preceptorships, conference calls, monthly webinars, and an annual meeting. The emphasis on training prepares all clinic staff to provide efficient, high-quality patient care.

Benefit of Data

With likely years’ worth of wound care outcomes available from data related to millions of treated wounds in their clinics, large management companies have the advantage of a wealth of statistical evidence about care rendered. A rich database of wound outcomes can assist clinical management in a variety of ways. First, the availability of data brings with it the ability to continuously analyze results and to discover potential gaps in treatment protocols. Company data can be compared to the latest in wound research in an attempt to guide modifications to clinical practice guidelines as appropriate. Such a database can also ensure providers are being educated on current treatment procedures to help optimize patient healing. Extensive data may also be utilized by clinic management through benchmarking. Larger companies can examine data from all existing centers under management and set standards related to clinical, operational, and financial data in order to establish clear goals for each clinic. This provides clinical and operational staff guidance related to how clinics are performing against other network clinics and promotes a culture of continuous improvement as well as clinical excellence. Data are also leveraged down to the specific wound clinic level. Typical data points that are reported include weekly patient visits scheduled, patients who’ve missed appointments, HBOT metrics, and other clinical key performance indicators to clinic staff. Weekly reports can be shared with clinic staff members to help them remain prepared as well track patients who need appointment reminders and encouragement to remain compliant. Various types of reports available in a larger network typically contain information that can be useful when reporting to hospital partners about the overall value an outpatient wound clinic brings to the hospital and its community. Other examples of data that can be reported on a regular basis include Joint Commission reporting and effectiveness of referral development.

Benefit of Provider Networking & Support

Perhaps one of the greatest benefits to joining a large management company is the level of supportive resources available. Support starts in the field with area managers who are assigned to each clinic. These managers include reimbursement specialists, clinical operations directors, regional safety directors, and operational vice presidents. In addition to robust field management, large management companies offer a wealth of corporate resources to support field operations. Areas of expertise include clinical care and quality, billing and coding, marketing and public relations, referral development, human resources, financial planning and analysis, information services, legal and compliance guidance, learning-and-development programs, accounting, and more. Having such a variety of experts available offers clinical staff comprehensive insight into wound care trends and development, including assistance in remaining at the forefront of governmental affairs. Significant time is spent observing trends by liaisons who work for the company as well as outside resources related to healthcare reform that may positively or negatively affect wound care reimbursement and communicating with key opinion leaders in the wound care industry to ensure the business is prepared for any material changes that may occur. The depth of specialized knowledge, training, and support available to members of the large management company adds value to the relationship with hospital partners. Clinic managers and staff are able to leverage these resources to ensure clinics operate with optimal clinical and financial outcomes. 

Christopher Morrison is executive medical director for Healogics Specialty Physicians, Healogics Inc., Jacksonville, FL. Jessica Taft is director of marketing and corporate communications for Healogics Inc.