Like any other business, a health care facility that
provides treatment services to patients suffering from alcoholism and other
drug addictions must operate like a well-oiled machine. The professionals who run this type of agency
are tasked, not only with the goal of creating financial solvency, but also
saving lives. Therefore, the operation
leaves very little room for error without significant consequences. Similar to other medical facilities, managing
the day-to-day operations of a drug treatment center is a long and complicated string
of processes that, if not followed properly, can result in either a loss of
revenue or jeopardize patient care. The
only thing worse than a breach of protocol is the establishment of inadequate
policies that lack the structure necessary to create a continuum of quality care
that also perpetuates profit.
The information contained in this article is not the type
of information that can be learned in school, but rather acquired by years of
working within the field and encountering the many scenarios that present
themselves throughout the course of time.
The Business
Notwithstanding the clinical aspect, the administrative aspect
of running this type of business is extremely complex. There is seldom a dearth of addicts that
require treatment in any given area.
However, unlike other areas of the medical industry, many addicts are
not interested in receiving treatment.
Some addicts have been known to lose everything they have in order to
keep their addiction. Even law enforcement
agencies find themselves losing this battle when presenting probationers or
parolees the ultimatum of going to treatment or going to jail.
If everyone who needed substance abuse treatment was in
treatment, every rehab clinic would be tremendously successful. However, since we are faced with the realization
that many addicts are disinterested in recovery, facilities must be creative in
order to keep numbers up. Even when
facilities are at full capacity, administrators are faced with the challenge of
being paid by the worst payers on the planet…insurance companies.
Government vs.
Private
From a financial perspective, government-run agencies
have the luxury of sitting back and waiting for tax dollars to roll in to help
keep the lights on. Even not-for-profit
organizations are able to receive grants to assist with operating expenses. Private agencies rely solely on the
reimbursement from insurance companies and patients who pay out of pocket. This forces private facilities to operate
more efficiently and to be more creative in terms of marketing their services.
There’s also a natural bureaucratic element that exists
at treatment facilities that are run by the State. If employees do something wasteful that loses
money, it’s taxpayers’ money so there are less consequences. When an employee does something that loses
money at a privately-owned facility, they have to account to the business owner
for the loss. This forces a check and
balance that we don’t often see at government agencies.
Employee
Challenges
In corporate America, employees generally know that if
their company does well, it’s good for them too. When a company generates more revenue, there’s
more money to go around so employees receive raises, offices get bigger and
working conditions become more comfortable.
For some reason, in the substance abuse treatment industry, many
employees lose sight of this fact.
In the world we live in, money very often motivates
people. In the microcosm we call the
substance abuse treatment industry, many people seem to be more motivated by
recovery. That doesn’t necessarily have
to be a bad thing, as we all know that substance abuse counselors should be innate
and inherent caregivers. At a rehab
center, employees should be interested in the progress of the patients. However, they must also realize that the facility
is a business and must make money.
Without money, the facility cannot remain in existence so that it can
continue to help the many people undergoing treatment there.
As administrators, this may seem simple and basic to us
but to our clinical staff, it may not.
There’s always a struggle to get clinicians to think about finances
because their brains usually aren’t wired in that way. It doesn’t mean that administrators are
smarter than clinicians or vice versa.
It just means that their interests are not aligned. Even many doctors in private practices seem
to let their office managers tend to their money. It’s a phenomenon that exists and must be
properly dealt with in order to run a medical facility.
How do you get clinical employees to be equally as
interested in the financial stability of the company as they are in the clinical
stability of their patients? It’s not easy and sometimes seemingly
impossible. Some employees respond to
employee incentives. Consider paying
your clinical staff a lower hourly rate and have them earn the rest predicated
on how much revenue the facility generates each quarter. This could be in the form of bonuses so they
recognize that the company making money is just as important as the quality of
care.
The Intake
Process
Admissions is a critical function of the facility and if
not done properly, it could result in major deficiencies. Not every patient assessment
will lead to an admission, as some individuals simply don’t require treatment
or the type of treatment they require is not provided at your facility. One way to maximize business through
admissions is to identify dual diagnoses.
For example, in addition to alcohol and/or drug abuse/dependence, a
patient may also be experiencing mental health disorders or may be a victim/offender
of domestic violence or sex offense.
If you have these types of dual-focus programs, treatment
at your facility could be more conducive to their recovery. If you don’t have
these types of programs and find that your admissions department is assessing
these diagnoses frequently, you may want to consider developing special
programs for these patients. Doing so
could lead to more patients going to your facility specifically for those
programs which could lead to an increase in revenue.
Referrals
In addition to patients finding their way to your
facility on their own accord, many patients may be referred by other agencies
or professionals within the field.
Conversely, your facility may be in a position to make outgoing
referrals from time-to-time. Both
incoming and outgoing referrals are important.
Incoming referrals should be tracked and monitored on a
regular basis. It’s important to know
who is sending you your patients. It’s
also important to determine if smaller referral sources could be sending you
more patients than they are. Sometimes
when a big referral source is unhappy about your services, they will issue a
complaint. Other times, they will just
fade away. If you’re not regularly monitoring
the flow of referrals, you will never know which referral sources just stop
referring. You may also not realize
which potential referral sources should be referring to you that aren’t so that
you can make contact with them to discuss your company’s services.
Outgoing referrals are important from a business and
marketing perspective as well. If your
operation is large and there are many employees at your facility, you may have
less control over where patients get referred to. If a patient requires treatment not provided
by your facility or if they need to be referred as part of an aftercare
treatment plan, it’s important that these patients are referred to facilities
that you have a cooperative working relationship with, rather than your
competitors. If one facility is
referring patients to your facility, they will expect referrals in return. Not only is it important to reciprocate
referral efforts with your allies, you certainly don’t want competing agencies
to benefit from your employees who don’t recognize why they shouldn’t be
sending patients to them. As with
incoming referrals, outgoing referrals must be carefully monitored for this
reason.
Documentation
In an arena threatened by the possibility of malpractice
lawsuits, documentation is critical.
When it comes to running this type of a treatment facility,
documentation is all we have to either prove or disprove certain elements that
are sometimes called into question. To
the legal world, if it’s not documented then it didn’t happen. Employees must be trained to document incidents,
progress, lack thereof and any other pertinent information that could be relevant. Even if it doesn’t seem relevant at the time,
it’s best to document certain events in some manner so it can be retrieved if
necessary.
Regulatory commissions will also critique the manner in
which your entire operation is documented.
A missing signature, date or diagnosis could be considered a violation
of the regulations. Sometimes
documentation could make the difference between your facility being paid or
not. Certain states have been known to
demand that payment be returned for subsidies, grants, Medicare or Medicaid
reimbursements if documentation is inaccurate or insufficient.
Patient
Retention
Launching a community-based marketing campaign to draw
more patients to your facility should certainly be an important part of your
operation. However, keeping existing
patients is equally as important as trying to find new ones. It also costs less from a marketing perspective. If your administrators haven’t discussed the
topic of retention, it’s time to start thinking of ways to improve it at your
facility.
In order to maximize your existing business, you must
have a plan to keep the patients you have coming back. This doesn’t mean treating them longer than
they need to be treated. It simply means
engaging them when they do. There are
various ways in which to accomplish this.
Follow up, appointment reminders, social media, patient surveys,
outreach, company newsletters, etc.
Anything you or your staff can do to improve your patients’ experience and
keep an ongoing dialog will help to give them a reason to return.
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