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Lisa, is there much prevalence of urgent care facilities w extended hours? Perhaps the issue is more w uncertainty about how to navigate the system or the hours of access? Do EDs offer a fast track arm? Is there any opportunity without violating EMTALA to provide a navigational point, a sort of triage before ED triage, that can direct patients to adjoining urgent care facilities for lower acuity issues? It’s not the same as shunting them to primary care access channels but the immediate access of the ED may be too stark a contrast to our traditional primary care access channels to be able to successfully redirect without lowering the threshold to entry.
There are always those more influential and respected members in any group of providers – it would be useful if at all possible to engage those providers in this initiative and pursue it as a pilot of sorts. It may be difficult if not impossible to convince anyone to completely relinquish their existing model when they have no burning platform and there would be uncertainty about the gains, unless really it can be structured as all upside–access to additional services and supports without impinging on existing practices. Even then a potential change in locale would be a difficult sale, but I wonder if it can get off the ground by providing a part-time or rotational model?
Well, Internet died and lost my response which was surely the answer to all your problems. =). Anyway, I’m unclear whether the problem is that the software is unable to handle the differing charges or if the goal is more one of management, trying to reduce variation for the purposes of managing operations and planning. Unclear what is behind the payer denials or if it is arbitrary?
It would seem that would need revenue steering committee w representation across the hospitals focusing on one group of CPTs/bundles at a time to try and gain alignment and then bring in payer representation, though w so many private payers that will prove to be a slow and challenging road..
Acknowledge directly the challenges org is facing rather than normalizing. Take ownership for lighting a path forward by example, accepting my role in healing and setting example. Work to inspire belief that can be part of something better and that input is valued, foster shared pride in what can achieve that will benefit us all.