The Farley Group

In today’s world of healthcare, it’s extremely important that the women’s services and children’s (newborn care) compliment one another appropriately. Many facilities believe they must have a Level III NICU, but the ADC is running 2. And, others believe they can’t afford to have a Level III NICU, but each month they are transferring several moms and babies because they can’t accommodate that pre-term birth – for a variety of reasons. We will do an overall assessment of your facility, staffing, desires, and capabilities. We will also assess the surrounding environment such as patient demographics, competing facility offerings, and trends in the community. We will help you develop a short-, mid-, and long-term plan for future success

It’s becoming much more difficult to compete for OB physicians, and patients, without that “safety net” of 24/7/365, in-house coverage. This is a very costly venture for hospitals. The majority of these programs will require a significant subsidy, and the decision on how to best proceed down this road is crucial. We will provide a thorough assessment of your program. That assessment will consist of an extensive pre-consult survey that will provide us the information we need to start the initial evaluation of your program. A 2-3 day on-site visit will follow; that will give us the opportunity to thoroughly assess your current provisions, and help us to better define, and design, a program that meets your needs – a program that makes the most financial sense, by maximizing future revenue and minimizing expenses and subsidies.

The decision to implement an OB or OB-GYN Hospitalist program, requires a methodical approach to decision-making. These programs are expensive and have a huge impact on the future of your facility. There are multiple factors to be evaluated and we have the experience to walk you through the process of a comprehensive assessment so that the end-product exceeds your expectations.

It usually takes hospitals several months, often years, to decide to move forward with an OB or OB-GYN Hospitalist Program. When that decision is made, the expectation is for the program to be up and running within 4-6 weeks. Obviously, that’s not possible, but the way to get closest to that target date is to out-source that service to one of the four major national Ob-Gyn Hospitalist program vendors. This is not to imply there aren’t other smaller, quality vendors – we just personally aren’t aware of those, and most are probably locally based. An out-sourced OB or OB-GYN Hospitalist contract will cost an estimated $1.8-2 million annually. That’s before any “revenue offset” or “cost reduction” is applied. And, it always involves the talk around “the OB ED” (addressed below). In-Sourcing OB-GYN Hospitalist Services is an option many have not considered, and an option of which many aren’t aware. This is an option for hospitals facing hurdles that seem to prohibit them from moving forward with out-sourcing the services. These hurdles could be related to things such as patient volume, location, staffing, or financial concerns. In-sourcing can often times lead to a less expensive approach to your OB-GYN Hospitalist Program, and may prove to be the best overall way to introduce a program.

The Farley Group, LLC has many, many years of experience in the business of OB & OB-GYN Hospitalists. We can help you make a smart, informed, forward-thinking decision about your future with the OB-GYN Hospitalist concept.

This is a unique approach to your 24/7/365 in-house L&D coverage, or OB-GYN Hospitalist Program. While not that common, these programs can be very successful. It simply requires the right OB medical staff, in the right facility, at the right time! This program is basically a combination of in-sourcing and out-sourcing. There are several reasons hospitals have developed these types of programs. We can help you determine if a Hybrid Model could be the best approach for your facility.

If you make the decision to move forward with 24/7/365 in-house L&D coverage, whether it be in-sourcing, out-sourcing, or the hybrid model, implementation of an OB-ED will be a hot topic. The OB-ED idea is a great one, but there are several regulatory requirements (just like your main ED) that must be respected, implemented, and followed! We can’t stress this enough! Our consulting services will help you through this process. Often, the implementation of the OB-ED requires a significant re-model of your current facility. We have helped facilities strategically overhaul their “old triage area” into their new, compliant OB-ED. We can also help you with the staffing model for the OB-ED, billing, patient through-put, and bed designation. Do NOT assume that once you have established your OB-GYN Hospitalist Program, you have established a compliant OB-ED!

We are seeing more hospitals deciding to create their own internal OB or OB-GYN Hospitalist Programs, i.e. in-sourcing. The primary reason for this is financial. The Farley Group, LLC can provide your in-sourced program with management services and/or consulting services. This list of services is extensive, and some of those services are listed below.

• work with the physician team to assure the program is functioning to meet all clinical expectations including quality patient care, improving patient safety, and improving  outcomes
• help develop short- and long-range objectives, goals, and plans for your facility
• revenue cycle management
• payroll services
• helping to maximize revenue while minimizing expenses/subsidies
• identify ways to expand perinatal service lines
• facilitate development and implementation of the OB-ED
• annual budgeting
• contract negotiations
• contract renewals
• business development
• assembling RFPs
• reviewing RFP responses

If your facility is considering outsourcing for OB Hospitalist services, you are probably considering the RFP process. And, honestly, anyone investing in these services should take the time to develop an RFP specific for OB Hospitalist services, release the RFP, review all proposals, assemble a committee to review proposals, and then schedule a proposal presentation day for selected vendor candidates. TFG can assist you through the entire process – from helping compose your OB Hospitalist RFP (if you don’t have one), reviewing each proposal in detail, to facilitating the presentation day and decision making process.

In an attempt to decrease the U.S. maternal morbidity and mortality statistics, more and more states are moving toward an official survey process to designate the appropriate level (I-IV) of maternal care for all hospitals. If your facility is seeking a Level II, III, or IV designation, you will require a state survey. This survey is a 2-day process and requires months of preparation, commitment from nurses, physicians, other hospital departments, and all ancillary services. The Farley Group can help you prepare for these surveys through remote, or on-site consulting. In addition, we offer a 1, 1.5, and 2-day on-site mock designation survey. Dr. Farley has experienced two surveys personally,  and performed several surveys as a MLoC surveyor in Texas.

Effective July 1, 2020, 13 new elements of performance (EPs) will be applicable to Joint Commission-accredited hospitals. These new requirements are designed to improve the quality and safety of care provided to women during all stages of pregnancy and postpartum. Once again, the focus is on reducing maternal morbidity and mortality. These 13 EPs focus on maternal hemorrhage (7EPs) and severe hypertension/preeclampsia (6EPs). The Farley Group,LLC can help you prepare for your next JC survey with regards to these maternal safety initiatives, the content, the requirements, the rationale, and techniques for meeting all requirements.