By: Craig Allan Ahrens
The Business of Healthcare
A talk show and discussion forum dedicated to the strategic issues impacting the business of healthcare

It is a new year with ambitious personal goals. As most of you are aware, I am completely redesigning the www.thebusinessofhealthcare.com website and related podcasts by the first quarter of this year and that is why you have not seen new podcasts posted. I apologize, but I want to migrate all the podcasts to the new site and I hope that this doesn't impact the loyalty of my listeners. The wait will be worth it with new services, material, and innovative programming!

On another note, I discovered on my birthday (New Year's Eve) that I was going to a large health system to be an interim executive for neuropsychiatry. The neuropsychiatry program is part of a large neuroscience institute. It is very exciting to lead a department related to a newly recognized sub-specialty. In 2004, the American Neuropsychiatric Association (ANPA) achieved the recognition of neuropsychiatry certification. Since neuropsychiatry is relatively new to most markets, it is often misunderstood as to what the clinical purpose and benefits are for patients in a neuroscience program. This leads to challenges in program development. In case you are unaware of the purpose of neuropsychiatry, the following is the definition of the specialty:

Neuropsychiatry (definition Wikipedia):

Neuropsychiatry, as a subspecialty of Psychiatry, is the branch of medicine dealing with mental disorders attributable to diseases of the nervous system. It is closely related to the field of Behavioral Neurology, which is a subspecialty of Neurology that addresses clinical problems of cognition and/or behavior caused by brain injury or brain disease. Another closely related discipline is neuropsychology - with its roots in neurology and psychology. It focuses more on psychological testing procedures, and is practiced by clinical psychologists who have further training in neuropsychology.

Nowadays, these three related disciplines play important interactive and somewhat different roles in brain-behavior studies.

Challenges to Program Development:

1. Turf Issues: Since neuropsychiatry is a relatively new subspecialty certification, there are significant turf issues that must be addressed with the introduction of a program. Neurologists are often the most threatened specialty because some of the neurodiagnostics utilized encroach upon their traditional domain. It is important to effectively commmunicate that neuropsychiatry is meant to complement neurological services. Neuropsychiatric services are often the best to manage difficult care choice decisions between behavioral versus surgical options of care.

2. Marketing: It is important to develop and educate referral channels concerning the clinical benefits of neuropsychiatric services. One must identify referring physician champions who will communicate neuropsychiatric success stories in a manner that meaningfully demonstrates the importance of the subspecialty.

3. Reimbursement: Significant Medicare changes in neurodiagnostic reimbursement have recently occurred that lowered the reimbursement to less than half what it was previously. Neurodiagnostics drove a large portion of the profitability for the service, so either volumes need to be increased to compensate for the change or new sources of revenue need to be created. Some potential new revenue sources to explore include: stroke assessment, pediatric neuropsychology, and VNS collaborative initiatives.

I would be interested in hearing your opinions. Please provide comments via this blog or email. Thank you.

You can listen to the previous podcasts on my website or on Itunes!

A podcast is up on the "The Business of Healthcare" website or on the Itunes store under the Business of Healthcare. Our last guest was Parveen Chand, who is a facilities and business development planning executive for BJC Health System's Barnes Jewish St. Peter's hospital in St. Louis, Missouri. We discussed their innovative approach to facilities planning and budgeting.

If any of you have any ideas, people, or topics that you think that would be interesting for the "The Business of Healthcare" podcast, please email me at info@thebusinessofhealthcare.com.

Thank you.

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Most recent podcasts:
Show 8: Healthcare Facility Planning and Strategy - A New Approach
Show 7: Roundtable Discussion with Three Healthcare Leaders: Strategic Issues - A Midwest, East Coast and West Coast Perspective
Show 6: Service Line Success and the Strategic Impact of the Rebasing of DRGs
Show 5: Orthopedic Service Line Planning
Show 4: Neurosciences Planning for Healthcare Institutions
Show 3: Human Resources as the Critical Hospital Strategic Partner?
Show 2:Patient Satisfaction and Customer Service as a Hospital's Strategic Priority
Show 1: Surviving and Thriving as an Independent Hospital in a Competitive Market

Mr. Ahrens is a healthcare strategy consultant at ECG Healthcare's Midwest office with expertise in general hospital strategic planning, operational turn-arounds, physician business development, and service line planning. You can reach him at info@thebusinessofhealthcare.com.