Transport capabilities are a necessity for regional neonatal and pediatric centers.
Stand-alone or unit-based transport teams may not be financially desirable if evaluated as independent entities. The contribution of the transport service to the additional charges and revenue (including diagnostic, procedural, personnel, global, and ancillary charges) generated for the health care system by transported patients needs to be considered when evaluating the financial impact of a transport program.
However, in the current environment, prospective diagnosis-related group (DRG) payment to the hospital is likely to mitigate the value of “downstream revenue.” The value proposition for transport teams will need to change in light of the development of value-based payment plans and current third-party prospective payment plans. Still, the value of a reliable and efficient transport system cannot be overstated with respect to community perception and public relations. Goodwill, defined as an intangible asset that provides a competitive advantage, such as a strong brand or reputation or high employee morale, and an altruistic attitude, however, are not enough to keep a transport team solvent. Because most neonatal-pediatric transport teams exist as subsidiaries of larger organizations, it is important that transport team management personnel become and remain familiar with fiscal issues germane to transport and program management. In this chapter, a number of budgetary and fiscal issues are discussed. This is not an exhaustive review, and readers are encouraged to explore the noted references, readings, and other resources.
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