As explored in the recent Vizient Medical Device Tech Watch, Volume 1, 2021, neuromodulation is rich in novel technology and treatments. However, embracing the innovative technology is not enough to ensure a successful and sustainable program. The process requires deliberate and careful assessment, planning and execution to achieve clinical and business objectives.
Whether leading an established neuromodulation service, expanding the scope, or developing new programing, professionals need to attend to the fundamentals of program development as outlined in the tech watch report: assess current services, engage staff and physician leaders, evaluate market opportunity, partner with strategic suppliers, substantiate quality and outcomes, and inform consumers. In addition, here are seven critical considerations for a successful and sustainable program:
- Create a business plan—Building a comprehensive business plan will help ensure all components are taken into consideration and goals are achieved. The elements to analyze and include:
- Financial and reimbursement implications
- Clinical staff perspectives and goals
- Market assessment and demand forecasts
- Internal operational assessment
- Key supplier relations
- Desired and predicted outcomes
- Prioritize financial accuracy—It is critical to have a complete understanding of reimbursement from all revenue sources, not just the surgery and the device. Downstream revenue sources such as imaging, physical therapy, occupational therapy, psychological testing and electroencephalogram monitoring should be measured and then allocated back to the service line for an accurate financial analysis. Clinical documentation of comorbidities can also contribute to reimbursement.
- Engage stakeholders—Leadership should cast a broad net to capture the input and support from key stakeholders. This includes neurosurgeons, pain management specialists, neurologists, physical therapists, pharmacists, imaging and neuropsychiatry specialists. Additionally, a multitude of specialists may refer patients for treatment, including spine specialists, cardiologists, pain management, neurologists, psychiatrists, urologists, gastroenterologists, primary care physicians, pulmonologists and others. This adds to the complexity and importance of communicating with and involving clinicians across the continuum of care.
- Streamline care coordination—Care coordination, as a patient advocacy process, creates and maintains critical linkages between the clinical, administrative, outcomes and customer service elements of care. When administered intentionally and efficiently, it can add value to the process and enhance the effectiveness of each treatment and medical specialist.
- Plan your program structure—Clarifying the scope of services—specialties, places of service and coordination of care (especially across multiple sites)—is an essential early step in the planning process as is the recruitment of highly competent clinical and technical staff. Organizations with an existing base of neuromodulation services need to understand and leverage complementary and related enterprise services to achieve coordination and strengthen the referral base.
- Standardize case selection—Define a process for case selection to achieve targeted clinical results. For example, you may find it beneficial to establish a patient suitability checklist and track compliance to streamline decision-making across the organization.
- Share results—Collect, measure and report your operational, clinical, financial and functional outcomes to key audiences. The transparency will build trust and grow buy-in from stakeholders as the program evolves.
The future of neuromodulation is bright. Novel and numerous technologies and growing indications will require providers to strategically rethink traditional business practices. An overemphasis on compelling technologies—a common strategic flaw—can weaken a neuromodulation program and impede sustainability. Whereas a greater emphasis on collaboration and a more intimate understanding of the needs of patients, providers, physicians, and strategic supply partners will help clinical, financial and operational results to be realized.
Special thanks to Stacy Lang, Executive Administrator II Department of Neurosurgery, University of Pittsburgh Medical Center, for providing her perspective and insight into this topic.
About the author: Patrick Vega, MS, is a consulting director for Vizient’s Advisory Solutions. He supports member hospitals, health systems and physicians in musculoskeletal services with a focus on high-value care, aligning cost and quality. Patrick consults, writes and speaks about spine, orthopedics and neurosciences in the areas of strategic assessment, planning and program development. Additionally, he writes a quarterly column for OrthoKnow, a vendor-facing publication about key vendor-provider issues.