One Call Medical: Kent Spafford, CEO

by HCE Exchange on March 2, 2011

The fact that the current recession and its associated unemployment impacts businesses directly and indirectly is not lost on Kent Spafford. As the CEO of One Call Medical, a specialized Preferred Provider Organization that offers high-end imaging services at reduced-cost for worker’s compensation claims, his company is handling the ripple effect of there being fewer employed individuals in the nationwide workforce.

“The number of patients is dropping anywhere from 2% to 20% based on client feedback,” he said. “That’s strictly tied into unemployment. As more people are laid off there will be fewer worker’s comp injuries.”

Spafford predicts that this trend will continue through 2009, anticipating that unemployment will reach 9% by the end of the year. He believes there may still be layoffs for the next few months, but then pointed to signs that the slide is starting to bottom out.

“With this bottoming, we believe that unemployment will at least hold if not see some return move in early 2010,” he added. “Like everything else right now, the industry is clearly struggling, with probably a few more months of tough times before we see it holding, but then coming back.”

Established in 1993, One Call brings together a nationwide network of credentialed providers of MRI, CT and EMG imaging services, scheduling services to assist patients with access to those providers, and a method of reimbursement into one program. Spafford said that despite unemployment numbers, the company is closing in on nearly 400,000 worker’s compensation cases this year, with about 2% of all MRIs performed in the U.S. going through One Call’s network. He credits company growth to increased penetration within the network.

“Even though the overall unemployment market is down, we continue to grow as we take our share and deliver more services to more people within the worker’s comp industry,” he said.

Market Strategies

Spafford credits a newly launched website with helping One Call identify areas currently not being served, then stepping into those areas and expanding customer savings. Roughly one-third of all incoming referrals are now coming in electronically, he said.

While the new website has helped with referrals, the site has even greater value as a source of education. In particular, the company launched something called OCM University, an online CEU program for adjustors and nurse case managers nationwide, who want to participate in a calendar of programs offered. They can even earn CEU credits through programs posted on the site.

“That’s another way that we’re reaching out to the user community to gain access into the worker’s comp space,” Spafford said.

Quality

In today’s financial environment, the CEO said quality is becoming more important. All facilities in the One Call network are credentialed, and continue to initiate new oversight programs to make sure they’re delivering the highest quality services possible.

“We’re seeing more people recognizing that quality is critical to the study,” he said. “You’ll see a lot of things being written now about high-end diagnostic quality and we’re on the front end of that. The tagline I’m trying to build here now is that quality has to be built in. It can’t be added on after the fact.”

One Call has also conducted some provider surveying, using an independent firm to poll providers about the marketplace and the companies with which they deal. Survey results showed that turnaround times for medical reporting were ranging from 78% to 90% satisfaction. The competitors were around 35%.

“That’s very high satisfaction on behalf of the providers,” he said. “For One Call, if we don’t have the providers then we don’t have the network and therefore, we don’t have the means by which to service our payor community.”

Key Initiatives

One Call is looking for ways to access data in order to measure outcomes. Quality work can come on the front end but results are important as well. To begin with, the organization started some programs using Natural Language Processing software to evaluate large groups of medical reports to gather data that shows what the outcomes were as well. Spafford believes that this will enable them to answer questions in the marketplace about the quality of diagnostic scans.

On the customer service side, Spafford has a saying: “Every place we touch the customer we measure our performance.” He recognizes that good customer service is another critical feature in the current economy, measuring call center performance from start to finish at all three of One Call’s call centers, using very tight metrics. He said they consistently meet or exceed the metrics in every case, with a one-half of 1% abandoned call rate. Turnaround time from when a referral is called in to when that patient is scheduled in a facility and a report is sent to an adjustor or nurse case manager is vital from a measuring metrics perspective.

“Time is money,” he said. “The longer it takes for One Call to get a patient scheduled and get a medical report back in their hands the more money it’s costing the payor in the long-term outcome.”

Capital Expenditures

Adding to its efficiencies, One Call recently invested about $7 million in a .net IT platform with which the company converted all of its operating systems over to a .net program. This enables the company to communicate with customers almost regardless of their IT platform. Spafford recognizes that as the company grows, technology plays an important role in running the business effectively. In addition to the communication system, the company also uses an electronic data interchange billing system. That means a savings of time and cost for the company and it’s a high efficiency measure for customers, he said.

Competitors

Spafford sees unmanaged care as One Call’s true competition. The company currently has a 78% market share within the managed care arena. However, only about 35% of the entire market place is managed, while the remaining 65% are not using a managed care vendor.

“When you look at who is the biggest competitor it’s the people who aren’t managed and that’s where we’re focusing our effort,” he said. “That’s also where we’re getting our growth.”

Future Concerns

On the topic of reimbursement, Spafford keeps a watchful eye on government actions that can result in potential rate changes, such as last year’s Deficit Reduction Act (DRA) passed by Congress, which did have some impact on reimbursement for radiology services.

Overall, the CEO is pleased with his company’s advancements into the worker’s compensation and group health spaces. For the next 12 months, he expects continued penetration into the third-party administrator world. The company is also beginning to get some interesting models that deal with consumer-driven healthcare. Regardless of the method, Spafford and his One Call team are planning for post-recession workflows.

-by Kathy Knaub-Hardy

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