Revenue GenerationGoals and Means Alignment of Goals
Personal goals Leadership goals Departmental goals Institutional goals
What means are needed to achieve your goals?
Why generate revenue?
Protected time Seed money and bridging money for
research Additional training Infrastructure Building new areas for practice,
research, and education Reserves for the future
Faculty Development
The Economic Future of Emergency MedicineWill ED utilization and clinical revenue change?
Risk contracts Effect of co-pays Patient behavior during hard times Reimbursement for professional services EMRs and patient per hour speeds
Economics of Academics
Hospital and medical school funds flow Federal funding of research Industrial funding of research Professional societies Development
Although prepared for martyrdom, Although prepared for martyrdom, I preferred that it be postponed.I preferred that it be postponed.
Know Your InstitutionWho controls the money?
Clinical income? Consultations? Indirect reimbursement for
grants? Societal and industrial grant
revenue? Moonlighting?
Practice PlansMushroom Management
Kept in the dark Fed bullshit When grown big, canned Loss of transparency Loss of trust Personal goals predominate over
departmental goals
Practice PlansThe Philosopher King or Queen
Trustworthy and equitable leader Inspires a shared vision in those they
lead Can produce remarkable revenue growth Depends on the skills of the leader
rather than the system
Practice PlansThe Secret Life of the Bees
Staff specialized into academic or clinical
Academic track receives lion share of development
Loss of shared incentives
Revenue generation depends on limited number of members in the group
Practice PlansPartnership with the Faculty Shared vision established as a group Complete financial transparency Mutual trust Taxation with representation Eat what you kill after taxes
Revenue Generation Golden Rules
One should treat others as one would like others to treat oneself
The one with the gold, makes the rule You can’t make up negative margins with volume Lost indirect revenue sinks departments
What do you call academic activities that cannot lead to revenue generation?
Sources of Revenue
Areas that you control financially Incentives based on performance Negotiations with your leadership
Principles of Departmental Taxation Equity: tax everything! Incentives: size matters Transparency: maintain trust Representation
Taxation with representation ain't so hot either.
Gerald Barzan
Revenue GenerationClinical: Every penny counts Easiest and most lucrative source Clinical revenue vs. cost of a provider Quality of documentation Coding, billing, and revenue cycle Knowing who the customer is volume
growth
Revenue GenerationClinical: Diversifying Clinical Income Observation units Emergency department contracts Urgent care Ultrasound
Revenue GenerationClinical: Subspecialization Toxicology Hyperbarics Sports Medicine Urgent Care Hospitalists Intensivists
Institutional Funds FlowAdministrative Stipends Leadership Residency and medical school Quality improvement EMS Hospital committees and positions
Revenue GenerationInstitutional Funds Flow Office space Lab space Administrative assistants Seed money and bridging for research Academic titles and affiliations
There ain't no such thing as a free lunch…
Revenue GenerationAdministrative Consulting Quality improvement Patient flow Patient satisfaction Revenue enhancement
A conflict of interest is a set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.
http://iom.edu/CMS/3740/47464/65721.aspx
Institute of Medicine
Potential Impact of Conflict of Interest in Practice
Education – introduction of commercial bias
Research – misrepresentation, suppression of data
Practice – compromises professional judgment, erodes public trust
Revenue GenerationEMS
Hospital support Medical direction
Municipal Private companies Fire departments Small community EMS
CME Government contracts and positions
Revenue GenerationEducation: Residency
Building an Education Fund for the Residency Program Medicare reimbursement for teaching Indirects for funded outside rotations Residency and research Extramural funding for international
trainees
Revenue GenerationEducation Speaker reimbursement CME courses
Regional, national, international Online education
Revenue GenerationConsulting and Education
Clinical simulation Residency development International activities
Jump starting academic emergency departments
Designing training programs Train the trainers
Revenue GenerationResearch
Value of grant salary vs. clinical salary
Wet space versus dry space
Share of the indirect costs
Federal versus Industry
Clinical operations and
future funding
Revenue GenerationPatents and Royalties
Know who owns the IP rights and the rules
Royalties are usually shared between the researcher, the department, and the institution
Creating corporations