Date
of Last Review 4/8/08
SME: Director of Financial Operations
This topic provides information about the contracted clinical services review process.
UTHCPC provides diagnostic and treatment medical services through referral, consultation, or contractual arrangements.
Reason: To ensure quality non-psychiatric clinical services required for care during the total inpatient stay at UTHCPC.
Administration
UTHCPC administration has the following responsibilities:
 | Make contractual arrangements with ancillary providers, medical facilities and medical specialty physicians |
| Include UTHCPC medical staff in the following annually: |
 | Discussion of the need for these arrangements |
| Scope of services to be provided |
| Preference for choice of providers |
Medical staff
UTHCPC medical staff has the following responsibilities:
| Monitor quality assurance measures of contracted services providers to determine adequate service delivery and outcomes |
| Report monitoring results through the Performance Improvement reporting structure using indicators |
UTHCPC renews current and/or obtains new contract services each fiscal year based on:
| The prior year's history |
| Faculty and staff requests for medical or specialized services |
| Regulatory requirements |
Medicare cost-based hospitals demonstrate cost containment measures through services' competitive bidding.
Administration periodically asks medical staff for feedback about service delivery and/or quality issues for a given contractor.
Examples of quality issues:
| Comments for improvement/change in scope of services |
| Recommendations to remove someone from further contracting services |
This table lists some of the UTHCPC services provided by contractors:
Service |
Contractual Provider |
Non-psychiatric clinical care |
UT Medical School departments through letters of agreement specifying scope of services Exception: UTHCPC must put out other clinical care contracts for bid at specific intervals |
Off-site ancillary diagnostic Examples: Radiology and Laboratory |
Outside contractors |
On-site ancillary Examples: Pharmacy, Food and Nutrition |
Outside contractors |
This table describes the documentation for each type of contracted service:
Contracted Service |
Documented/Monitored by |
Off-site treatment based on physician's order for consultation services |
Documented by consulting physician in the patient's chart Note: UTHCPC transports the patient's medical chart with the patient |
On-site consultations for medical services |
Charted by the medical professionals |
Contractor compliance |
Procurement Services Reason: To provide additional input to the medical staff for quality of services evaluations |
This table describes the contract renewal process:
Stage |
Description |
1 |
Administration asks medical staff for service delivery and/or quality issues related to specific contract services two months prior to the termination date of the contract. |
2 |
Medical staff provides feedback to Administration about service delivery and/or quality issues. |
3 |
Administration forwards feedback to Procurement Services. |
4 |
Procurement Services forwards feedback to Purchasing. |
5 |
Purchasing executes the contract based on the scope of service and terms specified. |
6 |
Administrator reports the completion of the process to the medical staff, informing them how their comments and/or recommendations were considered. |
7 |
Medical staff coordinator records the minutes of the meeting discussions. |
8 |
Utilization Management works with the medical staff to measure service delivery and outcomes. |
9 |
Clinical Services/Nursing reports utilization management and contractor compliance and institutes specific procedures to ensure improvement and/or enhancement of services as necessary. |
The Joint Commission : Leadership
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