Because unique problems require unique solutions
"I'm not finding what I need"
Your team sets goals for the year. Inevitably the subject comes up – what obstacles do we have to remove and what hurdles do we have to jump to make it to the finish line? When the issue is bigger than your team can tackle, you outsource. But do you find yourself settling for an arrangement that is less than optimal? Taking solutions that come in confined boxes with exact and inflexible parameters?
"We will figure it out for you"
Defining success and then creating a plan to get there is Hayes’ objective when it comes to custom consulting. We will work backward from where you want to be and by when, strategically defining all the steps in between. Through in-depth analysis and the creation of a working partnership, Hayes will create a work plan that results in a solution you can understand, use, and afford.
What does a Hayes consulting engagement look like?
There are multiple answers to this question.
- We've assisted health plans in making a one-time coverage determination when there is an absence of an established coverage policy.
- We've worked with hospitals and health systems to establish an evidence-based value analysis process.
- We also sit on clinical committees of health systems to provide insights and support around clinical issues, policy decisions, clinical standards, and best practices.
This just begins to scratch the surface. Below are a couple examples of how we have engaged clients from the payer and provider markets.
Hayes OnDemand tackles priority clinical problems and develops tailored, evidence-based solutions to reduce clinical variation and to drive quality outcomes. This service is available to support both the value analysis/supply chain committees and clinical committees responsible for developing evidence-based best practices, policies, clinical guidelines, and order entry sets.
|Client:||A large, multi-hospital health system headquartered in the northeast|
|Goal:||To eliminate clinical variation and improve outcomes over seven clinical areas|
|Strategy:||Develop and implement guidelines and order entry sets|
|Problem:||A narrow timeline and limited internal resources prevent the project from proceeding|
|Solution:||Partnering with Hayes to develop a dual-phase, evidence-based, clinical practice guideline on the diagnosis and treatment of sepsis in adults.|
Under the guidance of our Chief Medical Officer, the consulting team designed and delivered a two phase solution to meet the client's needs in the timeline and budget outlined.
|Phase I:||Phase II:|
|Critically assess existing and previous plans||Create an evidence-based implantation plan|
|Evaluate weak and conflicting recommendations||Identify barriers|
|Draft client-specific protocols and applicable time frames||Propose data-driven solutions|
|Finalize protocols per comments and review||Produce training resources|
|Provide an evaluation plan including success metrics|
With Hayes’ insights and through oversight of our clinical analysts and the projects with which they are engaged, the efficiencies gained and the speed of project completion and implementation can provide a significant clinical and financial return on investment.
Hayes Coverage Policy Support
Hayes medical policy experts bring more than 20 years of experience in working with clients to develop new evidence-based coverage determinations, update and maintain existing policies, as well as provide reconciliation services. Hayes customizes its support to each client’s specific needs and specifications with regard to topic selection, scope, format, and timelines.
|Client:||A mid-size health plan in the Midwest covering approximately 1.5 million lives|
|Goal:||Open the fiscal year with a catalog of fully updated policies|
|Strategy:||Complete a full review of coverage policies and update as needed|
|Problem:||Volume of work and reference material needed were out of the client’s scope|
|Solution:||Securing Hayes and assigning certain policies to them for review and updating|
Our coverage policy specialists worked with the customer to define the scope and complete and deliver the project in the assigned timeline.
- Conduct thorough research as appropriate to the policy
- Review, edit, and update existing corporate medical policies as needed
- Enter findings into a predetermined template generated by client
- Populate document tables for all investigational/experimental policies
- Consultations as needed with Hayes’ CMO and staff
This time-consuming endeavor can drain internal resources. Outsourcing the work to Hayes is a cost-effective solution
that results in defensible, transparent policies that meet your goals.