The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts

How to Write a Business Plan and Market Your Program

Trina Limberg, BS, RRT, RCP, Saturday, December 6, 1997.

Objectives:

1) Outline and discuss components for developing a plan of fiscal solvency. 2) Identify "hidden" costs. 3) Learn marketing options to generate new referrals.

Making an assessment of what is needed and networking with established programs is recommended. New programs will need a business plan that includes personnel, space, equipment, funding and revenue projections. Planning a financial budget is necessary.

Identifying sources of reimbursement is required. Most programs are predominately Medicare (fee-for-service) reimbursed however, this is shifting due to increased senior enrollment in managed care plans. As reimbursements shifts from fee-for-service, program coordinators need to be more business minded. Pulmonary rehabilitation programs are unique. They provide support services to hospital patients and they are also able to recruit new business from the community, not every hospital system has a pulmonary rehabilitation program. This can be an opportunity to generate new referrals from other hospital systems, physician network groups and managed care plans.

Whether your starting from "scratch" or work in an established program, the information below can be used to make a purposal to managed care groups or hospital administrators.

Putting a Plan Together and Making the Pitch:

* Background information - benefits of pulmonary rehabilitation, prevalence of disease. * Demographics - data on top hospital admitting diagnosis including LOS, ER and urgent care. Include references demonstrating cost-savings. * Identify sources of revenue/reimbursement - Medicare, Champus, Veteran Hospitals, HMOS including Medicaid managed care plans. Find out what managed care provider contracts your hospital has. How many are seniors? Ask for the number of enrolled lives to identify the size of the population. * Purpose Statement - Our hospital needs a rehabilitation program to decrease utilization in patients diagnosed with asthma and COPD. A disease management program is suggested to identify high risk/high utilization patients in capitation plans in an effort to reduce costs. Quality of care is still important but remember cost is what is driving decisions in capitation climates. * Describe the services you want to offer - pulmonary rehab for LVRS candidates, lung transplant, asthma training programs, standard clinical rehabilitation. Will disease management ideas be incorporated? * Draft a start-up budget - identify what is needed to get the program going. * Identify staffing needs (state the need for some clerical support, even if it's shared). * Figure salary plus benefits (check with the finance department they will have a multiplier for figuring benefit costs) * List needed equipment (purchase vs. sharing) and supply costs including forms. * Include the cost of an information system - a PC with software to improve efficiency with charting and correspondences. * Include membership fees for joining AACVPR and state organizations. * Add in marketing costs - (and ideas) develop brochures, fact sheets, stationary. * Consider licensing fees if facility needs to undergo this process. * Draft revenue projections/income. * Offer recommendations for the charge master or price index - What should your prices be? Check with other programs. * Research your Medicare carrier for coverage and find out what CPT codes should be used.

If you are purposing the start of a new program be sure to include when a pay back of start-up costs can be expected. Keep in mind that pulmonary rehabilitation programs are labor intensive and generally do not produce high profits. Even if your program breaks even the cost-savings generated is justification alone. Recruit a medical director to help you sell your ideas to hospital administration and marketing departments.

AARC 50th Anniversary, December 6 - 9, 1997, New Orleans, Louisiana.

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