How to leverage new CMS outcome info to win over hospital CxOs

CMS recently put outcome-based data for readmissions out on the Hospital Compare website. How cool is that! Pretty cool, when you consider its importance as a sales tool when calling on your local hospital CxO to win more Medicare business. In any entry-level sales course, we learn to do as much homework as possible before making the first call. Well the government just made it really easy, in addition to a slick mapping tool recently published by USA Today.

Using the Hospital Compare website, you can dial in a zip code, get a list of local hospitals, and then pick three to compare with respect to customer sat results, mortality rates, and readmission rates. The latter two offer a comparison of The Big Three DRGs (pneumonia, heart attack, heart failure) against national averages for the three hospitals you’re comparing. So what? When planning a sales call, it’s great to know where hospitals are hurting because if you have or are thinking about specialization programs, you can really position value about how you can impact your local hospital’s bottom line. This is vital because starting in October 2012, total Medicare payments to hospitals with high readmission rates will be reduced 1%. And in 2013 that number will ratchet up to 2%, and in 2014, 3%. For a hospital dependent on Medicare revenue to drive profit, the 1% hit could be a big nut. I sized each nut by pulling each hospital’s Medicare revenue from Medicare’s Data site.

An example might be helpful. Say you are a Kansas-based provider with care operations statewide. Using a cool mapping tool launched by USA Today last month called Compare hospitals on heart attack, heart failure and pneumonia (real-time celebrity makeover of the Hospital Compare data I talked about above) you can quickly pull up the top 100 biggest offenders in the country with respect to readmissions and mortality. Zooming into Kansas reveals three hospitals with not so pretty readmission rates. If you know you can help where they have pain, you now have a great excuse for a hospital CxO to take your call and hear how you can cut their readmission rate in half based on whatever special sauce your rehab program offers. Prove it over time with hard data and you will win a lucrative and loyal referral source, one you could even woo into a long-term agreement. Leaders are doing this now, vs. waiting for ACOs to do it for them.

Data driven outcomes will be vital for success in the outcome-obsessed world of healthcare to come. Walls between providers are coming down, and those who can prove lower readmission rates will be positioned to take share from competitors…including those of a different provider segment. Long Term Living’s November cover story offers 5 ways outcomes will re-shape the industry.