Practical strategies for developing the business case for hospital glycemic control teams.

Many business models may be used to make the business case for support of a multidisciplinary team to implement targeted glucose control in the hospital. Models may be hospital-supported or self-supporting. In the former, the hospital provides financial support based on improved documentation opportunities, reduction in length of stay, and improved resource utilization. In the latter, clinical revenues for diabetes management offsets costs of salary, fringe benefits, and overheads. A combination of these strategies may also be used. The business plan presented to administration must justify return on investment. It is imperative to involve hospital administration, particularly representatives from coding, billing, and finance, in the development of the business plan. The business case for hospital support will be based on opportunities related to improving accuracy of documentation and coding for diabetes-related diagnoses, including level of control and complications present, on reduction in length of stay and on optimization of resource utilization through reduction in morbidity and mortality (cost aversion). The case for revenue generation through billing for clinical services will be based on opportunities to increase the provision of glycemic management services in the hospital. Examples from the literature and of analyses to support each of these models are presented. (c) 2008 Society of Hospital Medicine.