As we continue on our outpatient clinic recruitment mission, Mate and I have had the opportunity to learn a lot from the healthcare providers with whom we hope to partner.
Firstly, Billing.
Our first few patients have had their billing submitted and we are awaiting the results of how much (or how little) our new service will be covered by various insurance companies. The question of co-pay seems to be a recurring theme with every physician visit we have had so far, which makes sense. If physicians are going to refer their patients to another service, they would like to be able to say "Oh, and this service usually has X number of dollars associated with the co-pay." So far, the only thing we know for sure is that for patients without insurance, the co-pay should be reasonably priced. But is our price even set at a reasonable cost for a patient with no insurance coverage? Also, we have gained approval from our hospital to have this service provided at no cost to employees covered under our ACO. This is very exciting and promotes many new opportunities. Importantly, we now realize that our marketing extends beyond patients and providers to our colleagues that we interact with every day.
Next, the other business aspects of marketing our new service.
We did not realize going into this endeavor that some prescribers are leery about giving rights to a pharmacist to order labs because that could potentially take away from their daily business. We made sure they were aware that we wouldn't be ordering labs unnecessarily (ie, if a patient had an A1C in the recent past we clearly wouldn't need a new one), but for some reason this was of concern.
Other barriers we didn't forsee:
- Making this service convenient to physicians is probably the number one aspect we overlooked. Sure, we have all of our forms well thought out, easily accessible, and are willing to visit physician offices to address any questions or concerns regarding setting up referrals. Most prescribers do not want to fax uneccesary paperwork, understandably. They have voiced that getting this referral into our system so that it would be set up similar to every other referral they utilize would make them MUCH more likely to use our Medication Management service.
- Clarification of the referral sheet itself. Adding ICD-9 codes was the first step in making our referral form more user-friendly from the physician and billing perspective. Also, we have a "recommendations only" option which has caused some confusion as well. Our intent was to have prescribers "test out" the service if they would like to receive a note with recommendations without any management of medications.
- Continued promotion of the outpatient clinic to providers is challenging. With the hectic and busy environment of healthcare, repeated exposure to new services is almost necessary. Everyday, all healthcare providers are constantly bombarded with information, so how do we make them notice us? This is an ongoing challenge, but we have had success with select providers who are acting as our "champions" and promoting our services to others.
- Prescribers voiced concern over the progress of their patient in between visits... the emphasis that we are a collaborator in patient care and not taking away from their service is essential in our interactions. Providers want updates, progress, and communication lines to be wide open between pharmacist, patient, and provider - something we fully intend on providing.
Things are definitely looking up, despite all of our obstacles. We have had several opportunities arise as a result of our outpatient clinic gaining more exposure . . . Stay tuned!
#outpatientclinic #InpatientCarePractitioner