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Market Data for Managed Care
Contract Negotiations

August 2013 
In This Issue
PDS Welcomes HCA
Are Your Case Rates a Risk or an Opportunity?
Moving Ahead and Leaving Behind
Stop Paying for Poor Service
PDS University
PDS Welcomes HCA     

We are excited to announce that Los Robles Regional Medical Center, Riverside Community Hospital, and West Hills Hospital and Medical Center, are now up and running with PDS. Welcome to our ever expanding network of hospitals. 

Are Your Case Rates a Risk or an Opportunity?     
Leslie Gold

Case rates represent an opportunity for a predictable revenue stream, if, and only if, your rates are high enough and your costs are predictable.   You may have used the PDS data to negotiate favorable case rates, but your entire profit margin for a service line can vanish if you don't effectively manage or prevent outliers. But how do you know if you have more outliers than most? How do you know if you have a significant opportunity to improve quality and lower costs by reducing variation? PDS can help.

 

Because we collect more than just the payments, we can run custom reports against our claims database to benchmark utilization, LOS, complications rates, and more. And, we can use this data to help you find opportunities to improve. For example, a recent study of LOS for DRG 470, hip and knee replacements, indicated that while some PDS hospitals discharged up to 80% of their commercial patients within 3 days, others achieved this goal only 20% of the time.

 

Even if all of the hospitals studied had negotiated the same case rate, those with the consistently shorter LOS are much more likely to generate income for this service, whereas those with the longer, less predictable LOS may see significant shifts in service line income from month to month and may even be losing money. Don't be one of those hospitals!

 

If you'd like to learn more about the custom reporting services available from PDS, please contact me at 213.283.8003 or lgold@hasc.org.

 

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Moving Ahead Means Knowing What to Leave BehindJim Barber
Last month we shared a valuable tool to help you make good decisions quickly.  This month's article, also by Nick Tasler in the Harvard Business Review, discusses how when we make a decision, we have to naturally leave something behind.  The Latin root of the word "decide" means "to cut or to kill".  If  we decide to do something new, without killing something old, we technically have not made a decision at all, but merely made an addition.  To lead is to decide, so good leaders cannot be afraid to end programs or procedures to make way for newer and better programs and procedures.  With the unique changes that hospital leaders face, if we are afraid to decide - to cut - we will find ourselves overwhelmed with trying to keep old and outdated programs going while taking on the addition of the newer requirements.  So go forward and boldly lead by boldly deciding. 

In continued partnership,

 

HASC logoJim Barber
Chairman & CEO, PDS
President & CEO, HASC

 
"Control your own destiny, or someone else will." -- Jack Welch   

Stop Paying for Poor Service
As hospitals are moving to value-based payments for the services they render, perhaps they should also move to value-based payments to the vendors who serve them; this is the compelling thought of Quint Studer, founder of Studer Group, in this article by Molly Gamble in Becker's Hospital Review.  "Mr. Studer says hospitals can improve quality and performance while cutting costs if they reexamine contracts with an eye toward incorporating performance-based metrics".   He goes on to suggest that hospitals put in place similar performance-based contracts with their employees, but notes they should be coupled with training and development opportunities.
PDS University -  
More Ways to Use PDS Data 
You know that PDS is the go-to place for contract negotiations, but did you know that there are many other ways you can benefit from our extensive database?  In this short webinar we will talk about ways you can harness the power of the PDS database through custom reports and snapshots, to tackle the many changes in healthcare.
Date:  August 29th
Time:  11:00 a.m. PDT, 1:00 p.m. CDT
Register: click here

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What We Offer 
PDS is a web-based revenue benchmarking tool used by hospitals to optimize revenue.  This database of paid claims delivers the market intelligence hospitals need for: 


     -  Effective managed care contract negotiations 

     -  Accurate forecasting of business development opportunities 

     -  Data driven strategic planning   

 

 PDS offers free educational webinars to our customers, as well as one-on-one training and custom reports to help you maximize results.   Learn More