STRATEGIES

New Program Planning
Germain & Company has assisted multiple non-teaching hospitals determine the strategic, operational and financial implications of becoming a teaching hospital and starting multiple residency programs appropriate to the size, patient population and objectives of the hospital. We develop multiple year budgets and pro-forma financial projections to help guide and mange the start-up phase and implementation efforts.

GME Strategic Planning
The principals within Germain & Co. have been involved in over 50 different GME strategic planning projects evaluating at key strategies including:

• Mix and size of residency programs
• Evaluation of each GME program’s relative importance to the sponsoring hospital
• Improving economic and operational returns from sponsored GME programs
• Reviewing affiliation agreements with medical schools and/or multi-specialty group practices

GME Program Redesign
Many GME programs have not changed their educational approach even though significant changes have occurred in the operations and needs of the sponsoring hospitals as well as significant changes in the program’s teaching requirements. We work with the hospital and teaching programs to bring a fact-based and data-driven approach to redesign. Internal Medicine is an example of a GME program in need of redesign. The growth of a hospitalist service at many hospitals, shifts in program requirements to more outpatient training, and other reductions in inpatient loads all drive the need for program review and modifications in the way Internal Medicine residents train.

SOLUTIONS

Benchmarking
Germain & Company is proud to offer the most comprehensive and detailed GME benchmarking process currently available in the health care industry. Using our technology, a hospital can determine:

• The proper number of physicians needed to effectively run your residency program
• Benchmark costs for each component of residency training
• Benchmarking and understanding of the importance of scheduled Faculty Time in both a clinical and formal teaching setting
• Revenue from professional fee billing ( of faculty) which reduces the net cost of training residents
• Number and mix of resident activities based on the size of the residency program

Faculty revenue analysis and profiling
Using simple data extracts from the professional fee billing of the faculty, Germain & Company is able to dissect physician billing activities and identify any areas of improvement that will bring increased revenue to the hospital as well as improve the level of patient care. Metrics include:

• Breakdown of inpatient billing by code
• Breakdown of inpatient billing by code and level of severity (i.e. high, medium, low)
• Use of critical care billing codes
• Identification of existing billing irregularities
• Identification of missed billing opportunities

TECHNOLOGY

Germain and Company uses proprietary technology in order to support the benchmarking process and offer teaching hospitals a way to track and monitor program performance over time. Our technology is driven by two key inputs – scheduling information for faculty and residents as well as professional billing extracts. These two sets of information allow us to evaluate and identify ways to improve program performance in several different ways. Specifically, our technology and tools:

• Support ongoing tracking of program performance over time
• Allow comparisons of operational and financial metrics for each program against similar programs
• Support faculty and resident scheduling for clinical and non-clinical activities

Currently, most teaching hospitals do not actively track and manage physician time. The Medicare time studies are done as a ‘snapshot’, viewed only as an administrative burden and not considered a reliable source for understanding the breakdown of faculty time. Germain’s technology can provide teaching hospitals and residency programs with an effective and efficient way to manage resources and better understand how time is spent across the triad missions of academic medical organizations.