Stuart Oertli, COO, Asks: “Are you Planning for the New LTACH Rules this Year?” What are your plans to combat a decrease in admissions and lost revenue?

The WoundCentrics Specialized Wound Services program, designed for Long Term Acute Care Hospitals, is proving to be an option to help hospitals flourish under the new LTACH rules.  Our focus on wound care services will improve quality wound care, improve clinical alignment for both patients and providers all while continuing to demonstrate a substantial return on investment for hospitals who contract with WoundCentrics.  

I would like to offer a couple of observations from our newest LTAC Hospital partner.  Prior to engaging WoundCentrics,  there was significant concern from both local administration and corporate leadership that the need for wound care would be greatly diminished as blended payments phase out starting this fall.  Additionally, there was no plan to admit primary wound DRG patients once true site neutral reimbursement began.

The argument against incurring a new expense for a specialized wound care program was that the LTAC Hospital currently had a very well respected, albeit a very busy, local wound care Medical Director in place.   He was affiliated with multiple Acute Care Hospitals and usually, rounded at the LTACH once or twice a week, typically at the end of the day or after 6pm.  Due to his busy day schedule, it was impossible for him to fully integrate with the hospital’s bi-weekly IDT team meetings, nor did he have the time to support the facility wound care nurse on a daily basis.

Additionally, the LTACH facility was already staffed with a well educated, employed wound care team already in place.  The facility had a strong corporate commitment to quality and decision support to assist the staff on the ground.  The local CEO was recently recruited from a major LTAC Hospital ownership group, with a great deal of LTACH experience and pushed to implement our Specialized Wound Services program and worked hard to receive the support from his corporate leadership and full buy-in from his clinical team.

Here is the ROI example I wanted to share: 

The WoundCentrics employed Nurse Practioner wound specialist started seeing patients under the management of the WoundCentrics program at this 38 Bed LTACH in early May.  During the first 2 weeks,  the clinical team identified and completed 7 unique wound debridements,4 of them on LTACH compliant admissions despite the fact that their current payer mix was about 50% site neutral, 50% LTACH compliant). 1 of the debridements was on a patient with a commercial payer who extended authorization due to the active wound care being provided and the final 2 were site neutral Medicare payers.

Four (4) of the wound debridements have been coded thus far and are shown below. I provide this information in hopes that ROI will be immediately evident: 

Patient 1: Admission DRG 207 (1.8542), Post-Debridement DRG 166 (2.4628). Revenue Increase $27,223.83 

Patient 2: Admission DRG 592 (0.9330), Post-Debridement DRG 570 (1.3477). Revenue Increase $18,550.32 

Patient 3: Admission DRG 207 (1.8542), Post-Debridement DRG 166 (2.4628). Revenue Increase $27,223.83 

Patient 4: Admission DRG 208 (1.1033), Post-Debridement DRG 166 (2.4628). Revenue Increase $60,813.02 

Total Revenue Increase from first two weeks of program = $133,811.00.

Assuming net of 50% after expenses (incremental costs are likely much less), the net revenue would be $66,805.50. We proposed a $7,500 monthly fee for single locations, and a corporate rate is available for multiple facilities.  Thus, the entire first year program cost was covered within 2 weeks of program implementation and before considering the additional benefits from commercial and site neutral revenue changes. 

During the third week, 2 additional unique debridements were completed bringing the total revenue increase from the first three weeks of the program to $195,975.29:

Patient 5: Admission DRG 699 (0.6746), Post-Debridement DRG 856 (1.5413). Revenue Increase $34,940.46

Patient 6: Admission DRG 207 (1.8542), Post-Debridement DRG 166 (2.4628). Revenue Increase $27,223.83

This early success with our Wound Services program has our new LTACH client off to a great start.  Continued focus on quality wound care and constant revenue cycle review with administration will provide the revenue to keep the facility financially viable and in position to offer their valuable services to patients in their healthcare community.

What is Your Plan to Survive the new LTACH Rules?

The WoundCentrics Specialized Wound Services program has provided quality wound care for all our facilities and the revenue example provided above repeatable and reliable. It is consistent with every LTACH facility where we have been able to implement our full program with the support of and in coordination with the locate wound care team.  We have historical performance data that shows we have achieved similar results (many times far better) in every single location where we've created an LTACH partnership.

If you are considering plans to attack lost revenue related to decreased volumes and full implementation of site neutral payments for LTAC Hospitals in the coming months, please contact us for more information on how the WoundCentrics Specialized Wound Services program might work with the Wound Care team in your facility. 

For more details about WoundCentrics visit our web site:    www.woundcentrics.com                                                              Contact:  Ken Rideout, VP Development(281) 989-5398