Guidry & East assists transplant programs to develop all-encompassing strategic plans including staffing, finances, operations, and patient access. Most of our engagements are very specific and tailored to the needs of the transplant center. Guidry & East meets with Senior Leadership to develop the specifics that the client wishes to accomplish in developing a Transplant Center Strategic Plan.

Typically, a Transplant Center Strategic Plan addresses topics such as program growth, finance, current and future staffing needs of lay staff as well as physicians and surgeons, patient access from pre-transplant evaluation through post-transplant care, assessment of transplant clinic and office space.

Organizations engage Guidry & East to conduct Transplant Center Operational Assessments for a number of reasons. Transplant Center Operational Assessments are customized to the unique needs of each Transplant Center. The methodology for an operational assessment typically focuses on such topics as Leadership, Operations, Staffing, Pre-transplant Donor and Recipient Evaluations, Patient Access, Physical Space, and Organ Utilization.

Leadership

• Organizational leadership structure and make recommendations on appropriate supporting resources required for operational success of the Transplant Center
• Physician and administrative management structure, including appropriate reporting relationships

Operations

• Transplant clinic scheduling, patient flow, and medical records. Make recommendations to ensure efficient and cost-effective care
• Time of referral to UNOS listing

Staffing

• Current staffing model and functions, and provide optimum staffing model
• Physician and staff recruitment needs based on volume projections for the Transplant Center
• Pre-transplant cost recovery for staff

Pre-transplant Donor and Recipient Evaluations

• Appropriate clinical documentation for compliance and cost recovery
• Electronic patient identifiers
• Recipient pre-evaluation, and donor pre and post-donation follow-up

Patient Access

• The pre-transplant registration process
• The transplant financial clearance process

Physical Space

• Current capacity of the Transplant Center and infrastructure support, and determine future needs based on volume projections and plans for future expansion
• Current clinical space
• Lay staff office and work areas
• Surgeon and Physician location and space

Organ Utilization

• Cadaver organs excised in facility
• Cadaver recipient organs
• Live donor organs
• Medicare secondary for organ acquisition reimbursement
• Organs discarded and/or sent to research

Integrated Multi-Organ Transplant Centers have broken down the traditional silos and operate under a separate cost center to streamline transplant services. The Integrated Transplant Center is a multi-organ revenue and cost sharing center agreed to by the Chairman of Surgery, Chairman of Medicine, and the CEO of the hospital. The hospital and physician practice plan share in the profit and/or loss. The benefits are an improved and more efficient decision-making process with greater accountability of Surgical, Medical, and Administrative staff toward achieving the Transplant Center's clinical and financial goals.

A critical component of adopting an Integrated Multi-Organ Transplant Center is establishing a governance and oversight structure with Transplant Physicians, Transplant Surgeons, the Transplant Administrator, and Senior Leaders. This enhances a Center's ability to achieve its goals, both in terms of quality patient care, physician and surgeon productivity, outreach, managed care contracting and program growth.

Streamlining the reporting structure for a Transplant Center and providing direct access to Senior Leadership facilitates an Integrated Transplant Center's ability to respond to and resolve issues quickly and efficiently. The more flexible and responsive an Integrated Transplant Center can be to changes in the environment, the better positioned to grow the Center's Multi-Organ Transplant Programs.

An Integrated Multi-Organ Transplant Center supports easier identification of direct and indirect costs associated with transplant services and facilitates tracking of program revenue. Direct costs include departmental compensation and benefits, supplies, and other costs directly incurred by the Integrated Transplant Center. This enables improved cost accounting which supports more complete Medicare Organ Acquisition Cost Reports, financial analysis, and pricing so transplant costs and revenues can be easily identified and tracked.

Guidry & East contracts with hospitals to analyze Managed Care contracts for renal and extra-renal transplant programs. We review spot contracts as well as national network contracts to determine that the facility is being paid properly for Phase I, Phase II, Phase III and Phase IV. We will also determine if the contract language is appropriate for the institution to claim Medicare secondary in reference to organ acquisition when there is Medicare remainder liability for the organ.

Guidry & East will review and assess Medicare Advantage programs to determine not only that the insurance company is paying the appropriate amount for the actual hospital admission for the transplant event, but also for costs incurred for organ acquisition.

In the final analysis, we will make recommendations based on our assessment of the terms of the current contract language, the payments for the various phases of care, and the cost to the hospital for the transplant services rendered.

An Operational Assessment of the Histocompatibility Laboratory (HLA) includes the examination of the administrative reporting structure, staffing, compliance, patient registration, equipment, allocated space, on-call issues, and allocation of appropriate costs/charges. We will also review the total number of tests performed along with direct costs associated with providing specific HLA Tissue Typing tests.

Guidry & East submits a detailed written report on our findings of the Operational Assessment of the Histocompatibility Laboratory. In a meeting with Senior Leadership, key components of the report are presented and discussed.

Guidry & East is a full-service transplant consulting firm specializing in the audit and clinical analysis of Medicare Organ Acquisition Cost Reports. Our transplant consultants have assisted medical centers in developing transplant business solutions specifically designed for growing transplant programs, improving transplant operations, and the transplant financial product line. Additional offerings to transplant centers include the development of transplant strategic plans, transplant outreach programs, transplant feasibility studies, interim transplant management, and review of transplant Conditions of Participation (COP). Guidry & East also provides transplant consulting for hospital-based HLA Labs as well as Independent HLA Labs.