In the past decade, there has been a surge in hospital mergers and practice acquisitions, creating lower costs and improved health care delivery; however, these benefits don’t happen without significant effort. Post-acquisition or -merger, the hospital needs to assess the whole operation to identify opportunities for streamlining and standardizing services across all entities. When it comes time to standardizing the cardiovascular services lines, particularly when different groups of physicians or different departments are involved, an area that needs to be addressed are the services, quality standards, protocols, and criteria of the non-invasive vascular lab.

The ultimate goal of any merger – reducing costs and improving outcomes – is realized through standardization of processes, increasing efficiencies through the combination of resources. Combining the best practices of one vascular lab with the best practices of another benefits patients both medically and financially, improving the overall health of individuals and the community. By combining resources, the money saved in one area can be used to improve service in another or additional services that would benefit the community can be added.

Having worked with multiple health systems over the past year, the need for standardization and integration of vascular testing is acutely apparent. Each hospital system has their own unique challenges to successfully standardizing and integrating their cardiovascular service lines throughout the system. One group merged seven hospitals in the past 10 years and they have yet to effectively combine their vascular testing, which raised complaints from the physicians utilizing the services. Another system has three hospitals in a rural setting, and they would like to standardize their services under one director and expand into their outpatient centers and physician practices. Yet another would like to establish a process for integration before they acquire more hospitals and practices because of the difficulty they had in previous experiences. They all have one thing in common – the desire to improve the services they deliver to the community.

But sometimes it is difficult for the new system to see the efficiencies and inefficiencies of their system and services lines. Creation of teams consisting of members of the merged facilities, including physicians and administrators who are or were integral to the operation of their separate labs, may lead to divisiveness or indecision on how to best precede with the integration. Sometimes it is best to bring in a neutral party; a company or firm who specializes in the integration of vascular services.
An experienced consultant that focused on vascular services can provide insight into how the current service is actually performing by looking at several key components that those directly involved may not see or being willing to see. A group specializing in vascular testing, who understands the economies of scale created when a cohesive service is created, may be the most cost-effective way to integrate the service. While some systems look at the direct cost related to hiring a consultant, the delay in integration and opportunity costs associated with those delays could ultimately cost thousands or millions of dollars in lost revenue, not to mention the costs associated with inefficient operations.

A good consultant will provide an assessment of the situation and meet with key personnel to determine the goals and values of the organization. They will get the input of all involved to determine the individual and group goals to minimize strife and maximize cooperation. Consultants should be asking some form of the following questions:

  1. What types of vascular testing performed?
  2. Do the technologists have comparable skills and experience to perform all testing modalities?
  3. What testing protocols and/or diagnostic criteria are utilized?
  4. the equipment capable of providing standardized testing?
  5. Do vascular labs have all of the equipment necessary to perform all of the testing offered?
  6. Is the reporting standardized throughout the system?
  7. Are the testing protocols and reporting methods conducive to accurate billing?
  8. the vascular labs IAC accredited?
  9. Who is responsible for the Clinical and Operational management of the testing area?
  10. How are the exams scheduled and do the schedulers know what testing is available and where?
  11. Do the area physicians know what testing is available and how to apply the results?
  12. Does the system capture all of the patients with disease and how are they being treated?

By getting the answers to these questions, a credible consultant can create a system-specific plan to consolidate resources, increase productivity, and standardize processes, all in an effort to improve the delivery of care. Sometimes a consultant can bring harmony where divisiveness previously existed since the consultant is a neutral party and can use benchmarking data to help standardize on best practices. The major benefit to the system is providing one standard of care across the entire system which will reduce costs and improve outcomes.

increasing pressures from Affordable Care Act as well as ACO type models, the future of a hospital depends on its success in maintaining a competitive edge and increasing number of patients served. With the ultimate goal of improving resource allocation and patient outcomes, some hospital systems and other facilities are more than capable of integrating services. Those systems with experience in these types of mergers may have the whole integration thing down pat. Other systems with less experience can lose revenue and increase expense if it’s not done properly. Any way you look at it, any time that patient care in improved it costs us all less money and improves the quality of life for everyone.
Based on a recent Becker’s Hospital Review Survey, the following are the top reasons why hospitals purchased physician practices:

  • Physicians approach hospital/seek to sell their practices 70% 70%
  • Build a competitive advantage 58% 58%
  • Part of a physician recruitment strategy 57% 57%
  • Maintain a competitive advantage 55% 55%
  • ACO formation 30% 30%
  • Improve patient safety 28% 28%