Spine Center Marketing: How to Reach Third-Party Payors

How to Reach Third-Party Payors
  • Perform a retrospective study of inpatient and outpatient services for musculoskeletal, chronic illness, and pain management ICD-9 diagnoses treated at the hospital over the last 12 months to identify potential leads for new business from referring physicians, case managers, attorneys, employers, third party payors and chiropractors/allied health providers.

  • Analyze the contractual base as well as demographics of existing referrals to the hospital to identify opportunities for promotion of the Spine Center.

  • Develop targeted marketing campaigns geared towards regional carriers, TPAs, case management groups, employers, etc. with a high density of at-risk occupational groups whose employee population has a high incidence of musculoskeletal injuries.

  • Conduct migration studies to determine forces and trends of referral patterns for the region for neurosurgical, orthopedic and musculoskeletal admissions and develop strategies to recover lost market share.

  • Conduct a retrospective outcomes analysis on key spine and musculoskeletal procedures, such as laminectomy, and disseminate results via a white paper to key payors, primary care physicians, employers and case managers in the region. Highlight treatment protocols used to generate the outcomes. Set up a prospective outcomes data collection system by an independent third party and provide aggregate data on a quarterly or bi-annual basis to key employers, payors and contracted entities in the region. Provide this data on the web site as well.

  • Set up regional on-site payor seminars and inservices with continuing education credits for payors, risk managers, case managers, adjusters, claims examiners, TPAs, and managed care organizations on operative/nonoperative spine care; host-day seminars featuring surgical demonstrations, didactic lectures and patient testimonial panels.

  • Identify patterns of referrals from third-party payors, urgent care centers, skilled nursing facilities and employers for operative/nonoperative spine care; develop carve-outs to direct that business to the Spine Center, at the time of, or immediately post-injury.

  • Host separate education/social events for payors/employers, physicians, and patients co-sponsored by industry as kick-off activities for the Spine Center.

  • Secure directed payor/employer contracts for operative/non-operative spine care based on three criteria:

1. Accountability and objective outcomes,
2. Cost of care,
3. Return to function/work

  • Target indemnity insurers, HMOs, PPOs, and IPAs and establish sole source gatekeeper contracts for spine and pain care. Utilize outcomes data to demonstrate the economic benefits of referring patients directly to the Spine Center and its spine program. Highlight the diagnostic, clinical and therapeutic benefits of the program, including the integrated delivery of operative and non-operative care. Use critical pathway tools, outcomes measures and the recruitment of ancillary specialists to significantly increase contract opportunities with these groups.

  • Set up quarterly Spine Center educational outreach programs, including webcasts and newsletters, addressing state-of-the-art advances in research and treatment of spinal disorders for payors, case managers, adjusters, TPAs, employers, and medical directors of large managed care or employer organizations in the region.

Updated on: 12/09/09
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