CHLM successfully guides hospitals and health systems to improve utilization, compliance, and performance in the inpatient, outpatient, and surgical settings. Our team provides healthcare systems and their executives with options to better incorporate PAs and NPs that aligns with the executive strategy as well as guides operational staff with prioritized recommendations and facilitated implementation.
Areas of Focus
The under-utilization of the provider workforce and inefficient use of PA and NP time and skills in the hospital environment may hold back your organizational performance and lead to increased time for patient processing, suboptimal use of provider time, reduced employee morale and turn-over. The optimal integration of PAs and NPs must be based upon a thorough understanding of each practice’s unique needs and firmly grounded in applicable federal and state laws and payer guidelines.
CHLM helps develop comprehensive strategies to achieve optimal PA and NP utilization. We provide the knowledge and resources to identify opportunities for effective utilization of PAs and NPs in the hospital environment, while maximizing productivity and limiting clinical redundancy.
Medical and surgical services delivered by PAs and NPs are covered by Medicare, Medicaid, TRICARE and nearly all private payers. However, private payers have their own coverage policies. For example, Medicare pays for medical and surgical services provided by PAs and NPs, but has myriad policies and regulations that must be followed to maximize reimbursement and avoid allegations of fraud and abuse. CHLM provides information and a wealth of resources to help hospitals optimize reimbursement and understand the risks for professional services provided by PAs and NPs.
Healthcare organizations are held legally responsible for granting staff privileges only to competent physicians, PAs, NPs and other healthcare practitioners who provide a “medical level of care.” CHLM supports healthcare organizations as they establish PA- and NP-specific qualifications for medical staff appointment and clinical privileges that are aligned with the operational realities facing your organization.
As vital members of today’s multidisciplinary healthcare teams, PAs and NPs are in increasing demand. However, the process of integrating PAs and NPs into hospital practice can prove challenging, largely due to the variability of state laws governing physician oversight requirements, prescriptive authority, and scope of practice. To be successful, careful planning and a principled, thoughtful approach is essential to achieving good patient outcomes and a meaningful, positive experience for PAs, NPs, physicians and the entire provider team. CHLM’s recommendations for a disciplined and insightful approach assure that an optimal return on the hospital’s investment in the integration of PAs and NPs can be realized.
A lack of understanding about how provider roles have evolved, generational and clinician training experiences and preconceived notions of clinical support staff, management and clinical operations, can influence system efficiencies. CHLM assesses corporate culture and guides the implementation of an appropriate governance structure, which can move your organization from good to great.
What We Offer
75+ Years of Collective Healthcare Experience
Guidance to Maximize PA and NP Billing Opportunities
A Full-Time Legislative Team
A Customized Assessment Survey
A Broad Collection of Case Studies
Recommendations to Minimize Billing & Compliance Risk
Our team is not comprised of typical healthcare consultants. Our expertise lies in the niche market of PA and NP utilization. PAs and NPs are the fastest growing healthcare providers in the U.S. CHLM is uniquely positioned to provide the most current legislative updates in billing and reimbursement, best practices, and provider satisfaction, hiring, and retention strategies.
Our team is supported by a group of national experts in advocacy, compliance, billing and reimbursement, and utilization research. This not only allows us to provide recommendations and solutions based on current legislation, but also takes into consideration potential legislative changes coming down the pipeline. Using this vast expertise, we provide both strategic and operational guidance on how institutions can best utilize their PA and NP workforce while maintaining alignment with the goals of leadership within the organization.
We approach all advisory services engagements with a phased approach that begins by gaining a better understanding of how PAs and NPs fit into the institution’s overall strategy.
CHLM first performs a needs assessment to assess areas for improvement, evaluate capacity for change, and prioritize the focus areas.
Next, our experts visit with key stakeholders on site to conduct interviews and focus groups.
Recommendations and Implementation
Finally, after careful analysis, we provide a report on our findings that includes recommendations for implementation and next steps.