How to Sell a Patient-Reported Outcomes Program to Your CFO
Some things you know about your CFO: who they are, their title, and how stern they sound going over projections in the semi-annual meeting.
Some things you may not know about your CFO: how to solicit their buy-in for initiatives? What talk tracks get them excited and willing to allocate funds towards projects? When is the best time to start a conversation?
You’ve spent your career refining how to best manage different types of people, gracefully implementing policies and processes, and so much more. So, when your higher-ups task you with navigating the PRO performance measure of IPPS 2023, getting staff to prioritize 1-year post op surveys, and spending hours of heads-down time formatting uploadable excel sheets to meet complicated tech-specs, you may start scrambling to find a better solution.
*PRO vendors enter chat*
Good news, there are companies that make undertaking this huge project easier to implement and maintain (hint: we’re one of them). But how do you evolve this possibility into a reality? Depending on the organization, there may be a number of steps you need to take: one of which is universal. To hire a PRO vendor that collects outcomes, champions capture rate, and maneuvers the ins-and-outs of registry reporting, the CFO needs to be on board. Here’s how to make that happen broken down in five (5) steps.
Step 1 | The PRO-Elevator Pitch
CFOs and other organization leadership have an acronym-dictionary of their own. As they’ve stayed focus on things like EBITDA (Earnings Before Interest, Taxes, Depreciation, and Amortization), CCA (Cost Consequence Analysis) and AAPCC (Adjusted Average Per Capita Cost), it never hurts to give a quick PRO 101 overview. In the easiest terms, what does leadership need to understand about outcomes and their importance? Lucky for you we have a starting point you can bounce off of:
“We can safe-guard our financial reimbursements with a patient reported outcome program.
By using validated survey measures to keep a pulse on the patient voice, our organization can get actionable insights on how to better our care, spot and remedy healing complications, and satisfy the requirements of complex bundled payment programs. It’s a win across the board! All we need is some implementation hours, and this program could be up and running— we won’t need additional personnel or training hours.
CMS is requiring outcome collection in 2024. When can we sit down and discuss steps forward to hit this upcoming timeframe?”
Starting point? Check! As you refine that 60-second pitch, there are few components you’ll want to triple-check are included.
- Do I explain what PROs are?
- Am I illustrating that a PRO program will better patient care?
- Is it clear that by implementing a program, the organization can lock-in funds?
- Am I making a strong case that we should outsource collection so we can focus on actioning? And
- Will leadership feel urgency to implement and have a clear next step to further discuss?
Step 2 | Example How PROs Are A Gold Mine
Although these requirements are a headache and seemingly catch many of us off-guard, patient-reported outcomes can be an awesome source of value to your program. We get it! It’s hard to fall in love with outcomes when they seem to be a distraction from your core responsibilities. But! If we take the hassle of collecting and maintenance off of your plate, the cost-benefit analysis of PROs is pretty sweet.
When talking to CFO (and/or any leadership), it’s best to begin with the end in mind—both make a case on why PRO programs are worth a sizable investment and plant the seed that the only efficient way to maintain the program is to outsource the data collection/maintenance.
So, what talk track resonates with CFOs specifically? And how do you weave in the benefit of outsourcing? CODE loves making your job easier (it’s a trend), so naturally we have some ideas for you to noodle. Some talking points you can rewrap and present:
1. Giving us the ability to benchmark sites, surgeons, procedures, and administrative performance, a PRO program enables us to continuously refine both our care quality and cost. With a collection vendor like CODE, we can invest the time saved into implementing and measuring data-inspired organization adjustments.
a. If tasked with the time-consuming responsibility of program maintenance, it would be unbelievably difficult to reserve time to promptly respond to any uncovered opportunities.
2. More and more APMs (also known as alternative payment models) are requiring PRO performance metrics that we aren’t currently collecting, let alone collecting within a singular source of truth. With so many established and new qualified registries, there are an increasing amount of incentive programs promising additional funds. We could tap into a substantial amount of new revenue.
a. PRO collection would be an absolute time suck for our team. With a vendor who independently champions capture rates and expertly navigates complex tech specs for registry compliance, we can refocus staff time from collection to providing the highest tier of service possible.
3. Under CMS’ IPPS ruling, we are required to submit outcome data. Failure to comply could result in some huge financial losses. We can avoid loss and bolster revenue without offsetting profit by outsourcing patient-reported outcome collection. With a strong program, we can improve our capture rate by at least 20% and increase total joint procedures payments.
a. The more funding we invest in internal training, maintenance and employee turnover costs, the less benefit we’ll see. We can keep nurses happy and sustain a controlled profit by letting CODE Technology do the menial labor.
4. With direct and full-picture exposure of the patients’ experience, you can quantify provider performance, more effectively deliver training programs and minimize litigious risk in the workplace.
a. Vendors like CODE Technology collect outcomes free of internal team bias—allowing us the best opportunity for neutral and consistent evidence. With level-based visibility permissions, this information can be secured to the ‘need to know’, legitimize hard decisions and clearly highlight high-value contributors.
5. With 6-7 PRO measures per survey, we can confidently expose problematic procedures and qualify low-risk practices. Choosing a vendor that can confidently collect data up to a year post-op will strengthen our derived insight and allow our organization to enact best practices that factor in long-term procedure results.
a. Keeping a high margin of survey completion over the course of a year or more is no easy feat. Unlike when the surgery is top of mind, patients usually need more than one touchpoint to fill out a PRO survey at the 12-month mark. A collection vendor has the bandwidth and determination to deliver patient-focused and human-centered survey distribution—allowing for the best potential for completion.
6. Patients look at provider awards and decide on care options based off them. By putting our organization’s stats against external registries like CODE’s own, we can push well-supported marketing efforts and ultimately get more patients in the door.
a. With a constant and impartial PRO collection from a third-party vendor, our rankings and subsequent claims would be supported with neutral patient information; minimizing the variability of outcome collection across competitive organizations.
Now that we’ve started thinking about PROs as the gold mines they are and started perking up CFO ears with the “what’s in it for them” arguments, it’s a perfect time to lay out the options. In theory, there are several avenues you can explore that give you the end result of outcome dashboards that help you analyze and action analytics: which is why we should frame the conversation as the “journey” and not the “destination”. The question we need the CFO to answer is: what is the most efficient, practical, and cost-effective PRO program solution that ensures a sustainable and scalable foundation for revenue-based ambitions? With that question in mind, let’s explore the options.
Step 3 | Determine Who Is Doing The Grunt Work
The PRO industry can easily be broken up into two categories: a DIY (do it yourself) collection software, or a full-service experience that maintains and upholds program integrity. One of our go-to metaphors: a meal.
In one category, you’re cooking. Making the list, driving to the store, shopping, putting things away, dicing up onions, and investing effort and time to make all of your parts and pieces into a meal (if you don’t cook very often, it’s probably something you wouldn’t risk taking to a potluck).
In category two, you’re going to a restaurant, sitting down, putting in your order, and enjoying the beauty and benefit of an expert team who specializes in making meals.
“Making a meal” is a fun take on the difference between in-house and full-service PRO vendor options, but in all seriousness, it is more akin to a chore: building a house, filing taxes, diagnosing and fixing a fancy car. In the year of Google, it’s entirely possible that you could accomplish some of these things at a semi-professional level—but realistically who are you going to lean on when Google doesn’t understand the niche complexities of your specific project? What happens when there is a bump in the road? Or an unknown element comes into play?
Metaphors aside, if you choose to collect using an in-house team, start thinking about employing additional personnel, conducting wide-span training of multiple departments, hiring a multi-discipline registry expert, developing a standardized process for collecting, scoring, and reporting the data, onboarding a software vendor, ironing out the hand-over process, and soliciting excitement across the board. An initiative this size will require support from administrative and clinical team members and many hours of planning, roll-out, and maintaining (even as other goals come into focus).
If you go the full-service vendor route— that to-do list dwarfs. With a 90-day implementation process and a dedicated team of account managers at CODE Technology, you could be reporting to registries and deducting organizational improvement plans in a few months’ time. We’d handle anomaly reports, distribute surveys, answer registry questions, respond to patient inquires—a true, full-service experience that allows you to enjoy the beauty and benefit of an expert team who specializes in the collection and aggregation of patient reported outcomes.
Step 4 | Tell Em’ What You Need
You don’t have to put a name on it: a beginning-to-end solution will be easier to implement and work harder for your goals. Here at CODE Technology we truly love outcomes and, although patient-reported ones are our key focus, we have internal measuring protocols to get actionable insights for our program. We’ve spent over a decade finding the right software and service mix that promises high-quality results with minimal variability per client. Simply put, CODE Technology can do what software alone cannot. So, you’ve made a recommendation with your CFO! And we have another asset to seal the deal.
Let’s work through a total joint example that explores the cost and savings of a PRO program:
Assume you have an average of 42 new patients per month for either THA or TKA procedures and have 5 surgeons you wish to include in your PRO initiative. With 42 new patients per month you will actually have to manage about 840 survey sets in the first year (assuming one pre-op and one post-op survey set) and about 2,310 survey sets over a two-year period. This would likely require the part-time involvement of a nurse, two administrative personnel, and a data analyst (assume at 10, 15, 15, and 10 hours/week at a minimum). Using their fully burdened hourly rate this would accumulate to about $145,000 over a two-year period. Using a vendor, it’s possible to outsource this activity for about $37,000 to $45,000 over two years. This shows your CFO that you have thought through the approaches and have a way to accomplish your goals with a minimum of $100,000 savings over two years.
Now for the affiliate benefits that come with a high-performing outcomes program. There is so much value in the intelligence you get from benchmarking and other aspects of the data you obtain. As mentioned previously you will be able to identify best performing physicians and transfer that knowledge to other providers. Let’s say that you are able to reduce complications requiring readmission from a TJA procedure by only 1/year. This alone will likely pay for an outsourced approach to this program.
You can be sure this will get your CFO’s attention: time for the next step. You’ve built and nurtured a strong business case, your CFO is onboard (or at least not going to be a blocker in your next conversation), and you are ready to take this to a larger group of stakeholders. It’s time to cement a date and time to pitch a formalized proposal with the head honchos: before diving in, here are a few thoughts to consider for optimal success.
Step 5 | Setting The Proposal Up For Success
Being in the right place at the right time? Matters. These discussions are more likely to lead to action if you can line up conversation with budgeting season, good days, and periods of time when there are upswings in incoming funds. These are wonderful “nice to haves”, but they are just that. With IPPS reporting starting in 2025, collection needs to start in 2024, and if you’re proactive and start this year? Your organization will have a “practice round” to learn from and perfect before the real deal sneaks up. Knowing when budgeting season starts and ends is a great resource to have in your back pocket (and if the stars are aligned it’s worth leveraging the timing) but it shouldn’t stop you from pursuing program adoption.
Let’s dive in! Ask around and get familiar with your organization’s procedure for funding requests. Is there a proposal? Is there a submission window? Who do you need sign-off from? While investigating, get a pulse on how other submissions and requests are being received. Are there other initiatives that would be supported by the implementation of a PRO program? How does your CFO like their coffee?
Having this information in your arsenal will help you respond to rebuttal inquires in your pitch. Being dialed into the specifics of a PRO program will help you with tactical debate, but C-suite leadership loves to consider a 10,000 foot view. Being able to show how your request will further other initiatives, maximize return-on-investment, and help the organization succeed at scale, will entice leadership to adopt the plan.
It’s your time to shine, and we’re ready to support you in every way you can. If you’re looking for some more specifics or just want to run your pitch by someone who does this on the daily, let’s schedule a time to work through it together.
Schedule A Call With a PRO Expert!
Need more help with your PRO related questions? CODE can help! Schedule a call with a CODE expert today to get you on your way to better harnessing your patient reported outcomes.