Increasingly, Gynecologists, Urologists and UroGyns seek profitable ways to outsource diagnostic testing procedures. Much of the attraction is to reduce the headaches associated with capital purchases and staff allocation. Improving the bottom line is an added bonus. A prime example is bladder testing procedures and equipment.
Firstly, medical equipment is expensive. It can take years for a practice to pay off urodynamics and Anorectal Manometry (ARM) testing equipment, for example. Moreover, the costs are skyrocketing, so it pays to seek out opportunities to reduce expenses, especially with equipment that is used only occasionally. Most practices use urodynamics on only a select number of patients (maybe 5%-20%), thus the return on investment is relatively low when compared to equipment used on a daily basis, such as ultrasound. In the case of ultrasound, the capital investment makes sense. With urodynamics testing and other studies not performed daily, however, outsourcing at a fixed price is a better choice, because the testing vendor brings their own equipment onsite to perform the test.
Using outsourced equipment has other benefits, as well. Practices are in flux in today’s healthcare environment. They are being bought, merging, being sold, key practitioners are retiring, etc. Adding additional equipment to the mix never helps. For example, if a practice spends $30,000 on urodynamics equipment and is then bought the next year by another practice, they effectively lose the $30,000, because it does not get meaningful consideration in the transaction.
Also factoring into this new trend is the human nature aspect of nursing duties. Make no mistake; nurses have their preferences for the tasks they perform daily. Some enjoy ultrasound testing, and others enjoy vitals testing. However, most nurses cringe at the thought of performing urodynamics because of the invasive nature of the procedure. Extracting urine and dealing with feces up close and personal for 30-45 minutes per patient can be messy and uncomfortable for both patient and nurse. Outsourcing this test usually includes having a nurse from the testing company come in and perform the tests. And these nurses generally like doing urodynamics testing. That’s their calling, and they are good at it. Because they test on a consistent basis, they are more likely to produce a clean study, free of data artifacts that can compromise the test results.
As with any procedure, there are training standards that must be adhered to. Often a practice has the equipment and a trained nurse on staff, and suddenly the nurse leaves the practice, creating a void in urodynamics skills. At this point, someone needs to be trained, or a new nurse with the requisite training must be hired. The revenue lost during this gap can be significant, especially considering that it could take months to find a qualified nurse. All the while, the practice is still paying for equipment that sits idle, and patients are going without testing or being referred elsewhere.
Generally, testing companies charge on a per-patient basis, and the practice will see reimbursement rates generously exceeding the cost of testing. This model of pricing generates a profitable revenue stream for practices. Some practices have sold their testing equipment and decided to outsource to reduce costs, streamline pricing, and improve staff morale. Others have added outsourced testing to create a new revenue stream rather than referring patients to outside testing centers. There are several reputable companies offering turnkey testing, and clinics are taking note. Brighter Health Network and Cathex Solutions are both key players in the testing industry.
With testing comes interpretation. Most testing companies provide detailed documentation and interpretation of the data, pinpointing the problem and recommending treatment options. This frees up physicians to concentrate on higher-value procedures, such as surgery.
It’s easy to see why most practices seek to outsource testing diagnostics. It makes sense, both from the business and the patient care standpoints.