Leaving nothing to chance: The steps one practice took to stay viable in a poor economy

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Tens of thousands of job seekers have fled Michigan and its down economy. Those who remain face decreasing healthcare benefits. With fewer referrals, Cancer Care Associates had to re-tool quickly and intelligently in order for their practice to stay viable and true to its core principles of quality care, teaching, and research. In this article, the author explains the how and why of specific steps the practice took to decrease the wait time to obtain an appointment, reduce patients' office visit wait times, increase patient follow-up, improve the response to phone calls, launch a survivorship program, and smooth the flow of the infusion room. By following practice guidelines for antiemetic use, flagging low white blood cell counts, and evaluating patients with bone metastases for those who would benefit from zoledronic acid treatment, the practice found additional opportunities for revenue. Other steps included providing a central contact for patients who need help to navigate treatment and strengthening communication with referring physicians.

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The telephone has become almost as important as the stethoscope in managing cancer patients. Telephone contacts between triage nurses and patients seen in a community oncology office are an integral part of healthcare coverage. These calls focus on everyday concerns, such as pain management and chemotherapy side effects. They alert nurses to early signs of cancer recurrence. Unfortunately, telephone contacts are not normally billed directly to patients or indirectly through third-party payers. Although currently these telephone contacts are not a reimbursable expense, they provide a service that often helps avoid the high cost of an emergency room visit or hospitalization.