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Dialing=20 for dollars
By Dave=20 Whitney

Advice on reducing a hospital's telecom spending =

While all hospitals are susceptible to telecommunications = expense=20 errors, they are typically most prevalent in small or = midsize=20 organizations, where there is limited telecom expertise and = the onus=20 often falls on the facility

manager to analyze savings opportunities while juggling = his or=20 her various core responsibilities.

Hospitals often spend 10 percent to 35 percent more than = they=20 need because they pay for services or equipment they don't = use, they=20 are not on the cheapest rate plans or they are billed for = hidden=20 charges, fees and taxes that were not part of their = contract.

Opportunities for savings exist in all areas of a = hospital's=20 telecom network--voice, data, Internet, pagers and cell = phones--and=20 facility managers who have telecom responsibilities should = be aware=20 of the options available to them to avoid unnecessary = telecom=20 costs.

Getting started

To get started, a team consisting of people who know the=20 hospital's telecom technology and its telecom bills should = be=20 assembled. A project manager should also be assigned. = Because this=20 will be a part-time project for most members, it is = important to=20 have enough people to move the project along quickly.

Once the team is assembled, the data-gathering phase = begins.=20 During this stage, the following should be identified and = made=20 available to the team:

  • Three months' worth of telecommunications invoices;=20
  • Copies of all contracts;=20
  • Network diagrams;=20
  • Change management logs;=20
  • PBX configurations and recent traffic reports;=20
  • Any line and circuit inventories that may exist;=20
  • Vendor contact lists;=20
  • Any directory lists for phone extensions, pagers, cell = phones=20 and company-supplied home telephones;=20
  • Site list for all locations included in the project; = and=20
  • Customer service records ordered from appropriate = vendors.=20

Analysis phase

Once this information is obtained, the analysis phase can = begin.=20 During this, all information is reviewed, billing errors are = identified and recommendations to optimize services and = reduce costs=20 are developed. It is typically the most time-consuming part = of the=20 project.

The analysis often requires expertise in telecom billing = systems,=20 telecom engineering and telecom taxation to achieve maximum = results.=20 The following areas should receive attention during the=20 analysis:

  • Cell phones. Cell phones are typically one of = the areas=20 with the most savings. Employees are often on the wrong = rate plan=20 and hospitals usually don't take full advantage of shared = minute=20 plans. The vendor may do some optimizing, but someone with = a good=20 understanding of different plan structures works much = better.=20 Savings in this area can typically be 10 percent to 50 = percent.=20
  • Pagers. With the increased use of cell phones, = there=20 are many pagers that go unused. Most vendors will provide = a usage=20 report if requested. Three months of usage reports should = be=20 requested and the reports reviewed for all pagers with no = usage.=20 Hospitals should look to eliminate any that have not been = used in=20 that period. Savings in this area can typically be 10 = percent to=20 30 percent.=20
  • Local service. "Slamming" and "cramming" are = easily=20 visible on the invoice. Look for local toll rates of 10 = cents or=20 higher. These can typically be moved to an existing = long-distance=20 contract or negotiated lower with the local carrier. = Unused=20 services, such as wire maintenance, unused voice mail = boxes,=20 remote call forwarding lines and directory advertising = charges,=20 can be eliminated or reduced. All local lines should be = validated=20 regarding their use and traffic reports should be reviewed = for=20 overcapacity. Changing analog trunks to ISDN PRI service = can also=20 produce savings. Savings here can be from 5 percent to 50 = percent.=20
  • Long distance. A benchmark of contract rates = should be=20 performed against current industry rates. Renegotiation of = the=20 contract may provide significant savings. The invoices = should be=20 examined for compliance with contracts, and consolidation = should=20 be done whenever possible. Volume commitments should be = reviewed=20 to reduce the possibility of any shortfall penalties. = Savings in=20 this area can typically be 5 percent to 25 percent.=20
  • Data/Internet. Data circuits are particularly = ripe for=20 savings. Contract compliance is a big issue. For example, = as an=20 incentive, the vendor will offer free access charges. = However,=20 this will not always be reflected in the invoice. Other = incentives=20 indicated in the contract should also be validated. = Mileage=20 charges on circuits can typically be in error as well. = Circuits=20 can be canceled and not removed from billing. Savings in = this area=20 can typically be 5 percent to 30 percent.=20
  • Maintenance contracts. Many telephone system=20 maintenance vendors charge by the port for maintenance. = Often,=20 systems are at overcapacity in the number of ports they = actually=20 need. A review of the ports and consolidation can reduce = the cost=20 considerably. Savings in this area can typically be 10 = percent to=20 20 percent.=20
  • Tax issues. If a hospital is not-for-profit, = every=20 invoice should be validated to ensure it is being taxed=20 appropriately. This may require some special expertise. = Sometimes=20 a call to the vendor's tax specialist will provide the=20 information. Savings in this area can typically be 5 = percent to 20=20 percent.

Implementing the plan

Once recommendations are developed and validated, the=20 implementation phase begins. Often, this can be a = time-consuming and=20 tedious process. Working with vendors to receive credits on = billing=20 errors, change services or simply to get more information = can take=20 multiple phone calls and require persistent follow-up. = Sometimes,=20 good recommendations never get implemented because staff = doesn't=20 have the time or patience to overcome the barriers.

The time to complete a project of this type depends on = the size=20 of the organization and the ability of the team members to = work on=20 it. For one hospital, it can easily take 150 to 200 hours of = time=20 for an experienced team to do a telecom cost reduction = project.=20 Consequently, there are several companies that offer to = outsource=20 the responsibility of reviewing telecom bills. Most of these = telecom=20 spending reduction companies offer their services on a = contingency=20 basis, making money only if they are able to recover = dollars. The=20 industry standard fee is 50 percent of the credits recovered = and=20 estimated savings for the coming year.

Rules of thumb

While the process of analyzing telecom expenditures for = errors=20 and savings opportunities is an individualized procedure, = there are=20 some rules of thumb that can help hospitals decide if the = process is=20 required in the first place.

For instance, if a hospital's telecom environment (e.g., = voice,=20 data, Internet, pagers and cell phones) frequently changes, = it=20 should consider conducting a review of its costs. Likewise, = it=20 should consider conducting a review if there has been = substantial=20 turnover both within the hospital and at its telecom = supplier, or if=20 management receives a variety of bills from a multitude of=20 suppliers.

Additionally, a review is recommended if a hospital = answers "no"=20 to two or more of the following questions:

  • Does the hospital have a complete and accurate = inventory of=20 all telecom equipment and services?=20
  • Is management certain that the hospital doesn't pay = for any=20 services or equipment that it does not use?=20
  • Has a department within the hospital been assigned the = task of=20 overseeing internal telecom changes or purchases?=20
  • Are all bills checked for accuracy?=20
  • Has the potential of a rebate from existing telecom = suppliers=20 been fully investigated?=20
  • Is the hospital certain that it has the best available = rate=20 plan based upon its actual usage?=20
  • Can management identify and minimize fraud and call = abuse?=20
  • Does the hospital have a telecom review process or = procedure=20 in place that lets it keep a handle on telecommunications=20 expenditures?=20
  • Has the hospital conducted a telecom cost reduction = project=20 within the past six months?

Once the telecom cost reduction project is completed, = many=20 organizations outsource the ongoing monitoring = responsibility to an=20 outside telecom vendor. Others, usually large telecom users = whose=20 monthly bills are in excess of $15,000 per month, may find = it=20 beneficial to establish in-house departments and purchase = software=20 to meet this responsibility.

Most likely savings

Telecom expense monitoring can be a confusing job, = especially=20 when the professional put in charge of it is responsible for = many=20 other activities.

However, the advice above should provide a general guide = for=20 tackling it and finding the most likely savings.

Dave Whitney is managing director for = ISI=20 Telemanagement Solutions, Schaumburg, Ill. He has worked = with many=20 health care organizations, including HCA, Kaiser, Adventist, = Kindred=20 Healthcare and Provena. He can be reached at dwhitney@isi-info.com.

<= /SPAN>

This article 1st appeared in the = December=20 2004 issue of Health Facilities Management Magazine.



HOSPITALS & HEALTH = NETWORKS | HEALTH=20 FORUM JOURNAL | HEALTHCARE'S MOST WIRED = MAGAZINE |=20 TRUSTEE |=20 HEALTH=20 FACILITIES MANAGEMENT | MATERIALS MANAGEMENT IN HEALTH = CARE |=20 BUYER'S=20 GUIDE FOR THE HEALTHCARE MARKET

Copyright =A92004 Health Forum. All rights = reserved.
Please=20 report problems to webmaster.healthforum@aha.c= om
HFM=20 is published by Health Forum, Inc.
an American Hospital Association=20 information company.

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