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Why being a hospital employee is not the best solution for physicians

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Small Practices

Is the doctor buying binge in the healthcare industry unhealthy in the long run?

If there is one thing that is selling like hotcakes this season it is doctor’s practices. This ‘‘buying’’ trend is the aftermath of the healthcare industry’s latest reforms and not everybody is happy with it. Widespread acquisitions and integrations are leading to troubling questions and concerns.

For physicians who’ve struggled with rising costs, compliance bottlenecks and expensive technology, a regular pay check, reprieve from administrative tasks and lesser things to worry about can be a huge blessing. But it is not all gravy. Loss of productivity and heavy workload are some of the downsides of hospital employment.

Being a small fish in a big pond!

For physicians used to making decisions on their own dealing with the red tape and internal policies of hospitals can come as sticker shock. Most physicians feel like they are trapped in the proverbial gold cage.

“I’m used to making medical decisions based on my education, experience and sometimes gut instinct. I don’t have the same kind of privilege or independence now. It is all about playing by the rules and those rules are framed by the hospital bigwigs” rues Matt Dahmer a physician based in Carolina. And, it is this lack of autonomy that is giving physicians, nightmares!

A sharp decline in productivity…

Most hospitals follow the RVU system formulated by Medicare to calculate the productivity of physicians. Study after study points to the fact that there is a huge loss of productivity in physicians who work as hospital employees. The loss of productivity is attributed to several factors such as overwork, dissatisfaction with the work culture, long work hours or handling different kinds of patients.

The kind of ailments a physician treats in a small practice set-up can be very different from the care he renders in a hospital environment.

I don’t work with this insurer!

The payer mix is a lot more complicated and extensive in hospitals in comparison to private practices. Physicians will have to pay close attention to see how new insurers are going to affect their bottom-line. It gets all the more complicated for physicians who are compensated or given incentives for the revenue they bring to the organization. Physicians who have to navigate this complex maze often end up feeling frustrated.

Into a new world!

It can be disconcerting to work in an entirely new environment all of a sudden. The documentation methods and guidelines vary. The billing process is entirely different. Physicians who enter hospital employment, take a little while to orient themselves, and to get used to the faster clip, at which hospitals operate. It can be taxing, demanding and alien. And a regular pay check can just be a small comfort!

Are patients with high deductibles a threat to medical practices?

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It is time for medical practices to focus on patient collections!

Does high deductible mean low chances of getting paid?

Patient responsibilities have risen under the latest healthcare reforms. Coming forward, most patients would pay most of their healthcare bills by themselves. With payment responsibilities shifting to patients, managing patients with high deductibles is a risky proposition for medical practices.

High deductible insurance plans are the order of the day and physicians, who fail understand this emerging trend, will find themselves in an unenviable position. By the end of this year, an estimated 20 million patients will join the healthcare system and an alarming 80% of the newly insured patients, are at high risk for non-payment.

In a perfect world!

Higher out-of-pocket expenses are going to leave physicians with the unsavoury task of making patients pay their bills. In a fair world, patients would pay prior to treatment and coordinate with the doctor’s office regarding payment options. Patients would be well informed about insurance plans and guidelines.

But the healthcare world is anything but perfect. Everyday physicians face irate patients, lawsuits and threats to move to another provider.

Sounding harried over the phone?

The average time medical practice staff spend over the phone has increased and a call can last anywhere between 10 to 40 minutes. Blame it on complicated health plans and insurers who change payment regulations, constantly. Most private practices are understaffed and find it difficult to handle the deluge of patient calls.

Patient portals have been of tremendous help, but again, patients need constant support and education to access and use patient portals. Which leaves medical practices with one question- who does the tough job of receiving payment from patients?

Handling patient payment is a tough nut to crack!

Receiving patient payment isn’t just about sending sporadic statements, now and then. It requires close coordination with patients prior to a visit. Educating patients and helping them discover plans and payment options that best suit their needs, is essential. As is, following up with patients and sending out patient statements regularly.

And, always, ensuring, that patients don’t feel like, they are being cornered. Medical practices, now, rely mostly on collection agencies to handle their patient billing process. It avoids bad blood between patients and the medical practice. Trained professionals do a much better job and can free up in-house staff to focus on clinical activities.

Generate more revenue and increase your medical practice’s footprints

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Generate more revenue and increae your medical pracrtice's footprints

Position your medical practice as a market leader!

Great! Physicians have finally realized that they will have to move beyond the traditional approach towards practicing medicine and become savvy businessmen as well. All that murmurs and complaints have died down. The writing is on the wall, it is smart physicians who can also be mean businessmen who can survive.

And physicians are not half as pathetic as businessmen as most people would like to believe. The tremendous efforts medical practices take to position themselves as leaders in their specialty or niche is proof enough that physicians are savvy businessmen in their own right.

What are the best ways to increase the authority and reach of your medical practice?

There are several ways you can ensure your medical practice is a step ahead of the competition. And most importantly, to end every day on a happy note, despite mounting financial pressure… So what is the secret behind insanely successful medical practices? Apart from best of class medical care there is a lot more healthcare professionals need to do to have a firm footing in the industry.

This may sound clichéd and you’d have come across this a million times but these tips to increase and expand your authority and client-base also explain how to break a complex process into small, bite-sized pieces!

These are the areas you need to be focusing on…

There are no two ways about it- increase patient engagement

1.  A strong social media presence

2. Cleverly designed marketing strategies

Here is how to increase patient engagement!

Providing undivided attention to patients during a visit is one of the best ways to engage patients. Automate tasks by using apps to record encounters, outsource or automate tasks such as transcription and documentation of medical records. Most EHRs come with full featured patient portals and walking your patients through it will increase patient engagement.

Dissemination of information is vital. Providing electronic access to medical records to patients will help drive up patient engagement and also make them more involved in their healthcare.

A clinic based in Cleveland allows patients to input their health information into the clinics patient portal. It doesn’t take a genius to figure out that it is a great move by the clinic. It reduces patient information errors, increases engagement with their health and saves up precious staff time!

Time to go social!

Having a strong social media presence is vital to stay on top of the game. Hire experts or step up the effort and time you spend on social media. One sure fire strategy to grab eyeballs is to add pictures and videos to your Facebook page or Tweets. Share information about latest healthcare updates, drugs, equipment or experiments specific to your specialty and organize regular surveys and polls.

It is the quickest and easiest way to position yourself as a leader in your niche. Be responsive. Mention names and Twitter handles to show that you are paying personal attention and be prompt with replies, always!
Have a marketing plan…

Medical practices hardly spend time in marketing efforts. It sounds almost gross to physicians. But to gain a strong toehold in a fiercely competitive industry, getting on the marketing bandwagon certainly helps. Distribute pamphlets or drop flyers at your neighbourhood supermarket during the flu season, school physicals etc… Have a toll-free helpline for patients to reach you at all times. Have a strong recall system and scheduling plan.

Conduct regular market assessment studies to know where you stand and what could be the best way to leverage your strengths. Maintain an implementation, process and results log to track the implementation and end result of your marketing efforts. Spruce up your website and contribute to healthcare journals, magazines and e-zines.

Post your contributions and that of the physicians who work with you in your website and notice board. It will build credibility.
Nothing beats freebies!

Here is the secret sauce. Provide free screenings, health camps, blood checks, BMI checks and blood pressure screenings every few months. This will get the word around and help in “brand” recall.

Organize health awareness seminars and summer camps for kids. Being known as the friendly doctor down the lane is probably the best marketing tactic, afterall!

Top 5 Reasons For Claim Denials! You Cash In On Your Medical Practice

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Claim DenialsThough physicians are very careful in filing the claims to the payer, still most of their claims are denied.

Here are top 5 reasons for claim denials which most physicians face but either realise later or are not able to figure out:

Duplicate claims:

Have you ever tried to resubmit a claim for which you have not received any response? If yes then you shouldn’t, as it creates confusion for the payer and may ending up as a duplicate claim.

Claims/service lacks information:

Make sure you get CO16 code which says information is incomplete to process the claims. A remark code is required for additional information.

Benefit for this service is included in the payment:

The insurance company denies the claim for a service as it has already paid for another service on the same date (as a part of bundled service).

At least one remark code must be provided:

This may include either a Remittance Advice Remark Code or NCPDP Reject Reason Code.

The time limit for filing has expired:

The maximum filing limit of Medicare is 2 years and minimum 1 year. If you have filed your claim within the time limit then appeal it with a required proof.

Infographics: Automate.Integrate.Outsource the new mantra of the healthcare industry

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Automate.Integrate.Outsource the new mantra of the healthcare industry

Work smart; automate and outsource business processes!

The much anticipated Black Book survey findings are out and they indicate a strong possibility of medical practices undergoing a completer makeover! For years together physicians handled two very different and almost contradictory aspects of their workflow. It was a tight-rope walk between patient care and managing the business side of their medical practice.

The business side of medicine has almost become a catchphrase in the healthcare industry. There was no clear definition or a strategic plan to manage it. What was once regarded as a niggling pain, that one had to live with, has snowballed into a serious issue that demands to be dealt with. And dealt with immediately!

Shifting landscape makes it vital for practices to buckle up or die a quiet death!

There was a time, not very long ago, when physicians had to just take care of patients. The filing and transmitting of medical claims was something that the biller did. A cursory glance over the month’s collections was all that physicians did, as managing their medical practice’s finances was not their job.

The Affordable Care Act, which opened the doors to millions of uninsured, PQRS and Meaningful Use measures, an entirely new coding system and increased financial pressures, have shaken physicians out of their comfort zone. The alarming rate at which small medical practices shut their doors and the growing threat to the survival of independent practices, are a huge wake-up call across the entire healthcare continuum.

Desperate times call for desperate measures. The Black Book study that includes the perspectives and opinions of 400,000 respondents has indicated three emerging trends that are going to challenger the traditional way medical practices are going to function.

Upgrade, integrate, outsource…

This seems to be the magic formula that can save medical practices from drowning under a sea of reforms. Though most medical practices have finally got the hang of technology and are experimenting with different workflow models, there hadn’t be a clear sense of direction or collective change insofar.

Challenging old notions…

The Black Book survey challenges the common belief that physicians are still unwilling to let go of archaic methods of working.

There is a huge move to eliminate outdated software and about 21% of medical practices surveyed, are planning to upgrade their RCM software within the next 6 to 24 months.

91% of medical practice business managers feel that EHR systems that are not integrated with a full- fledged revenue management system can back their practices, further into a corner.

Facing the bitter truth!

The study also clearly illustrates that physicians are no longer in denial mode. About 90% of physicians surveyed admitted that their billing systems needed a facelift. There is also a huge demand for integrated systems so physicians will have to coordinate with a single point of contact. Speeding up workflow is the major objective of most medical practices and automating their workflow seems to be the perfect solution.

Utilizing system intelligence to perform business functions such as appointment scheduling, insurance eligibility checks, sending patient reminders and payment posting can quicken tasks and reduce headcount. Most medical practices still hire FTEs to perform tasks that their systems can do. Automating tasks can not only shorten the time taken to perform tasks but can also help in resource optimization.

Automating administrative functions: the way forward…

The administrative functions of medical practices can drive up efficiency. Prior to automating a process draw up a checklist of objectives and see whether through automating you actually end up saving time. Automating for the sake of automating can do more harm than good. Like investing in an automated voice recognition system and wasting productive time editing and correcting the transcripts.

Have a clear work-plan, educate staff about the software and strategy you are going to use and compare your existing process to the revised one, to make sure your switch to automation is successful. A spread-sheet that details the transition can ensure everybody in the medical practice is on the same page.

Creating a flow-map can standardize your automated processes and improve efficiency. You don’t want your staff to be bewildered by the sudden change in workflow processes. Listing out repetitive tasks is the easiest way of freezing on tasks that can be automated.

Here is what to automate…

Automating can be healthy but it can quickly turn into a major headache if not handled with caution. Medical practices should take care not to let their workflow processes spiral out of control. Though automation of tasks is common in other industries, automating workflow in the healthcare field is still at a nascent stage.

Here is a list of tasks that can be automated efficiently…

  • A patient portal can automate everyday tasks to a large extent. Implement a patient portal that enables patients to fix up appointments based on available time-slots. Prescription refill requests can also be sent online. Patients can also be encouraged to pay online through a secure payment gateway.
  • Setting up error prevention alerts and a thorough claim scrubbing tool or software can eliminate denials.
  • Charge review alerts can reduce no-charges.
  • E-prescribing allows physicians to communicate directly with pharmacies and can save medical practices from the tripwire of misplaced prescriptions.
  •  Setting up an email reminder or automated call reminders can reduce no-shows and late appointments.
  • The ability to gather the financial performance data of a medical practice and track metrics will result in actionable and current financial being just a click away! This will help set targets and benchmarks.

There is no magic wand that can wipe away manual efforts completely!

Great! So now all physicians can just shop for software, or tool that can automate practice functions and go back to taking care of patients. But it is not as simple as that. The heterogeneity of workflow processes in a medical practice demand different methods of working. Automating completely, a practices business functions can prove to be counterproductive. As many as 90% of small medical practices and 95% of independent physicians are planning to outsource their medical billing and revenue cycle management functions and that could be because relying on tools alone cannot deliver the goods.

An increasing number of medical practices are downsizing to cope with financial bottlenecks and processes that were previously handled in-house are being outsourced. The increased need for outside expertise has been the major driver behind the shift to outsource business functions.

The bottomline…

It is the survival of the fittest out there! Healthcare organizations that successfully, integrate, automate, and outsource processes, will come out at the other end, more streamlined, productive and compliant.

5 ways hospitals can reduce their physician shortage rate!

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physicians

Is your hospital facing a shortage of physicians?

The country has been hit by massive physician shortages. Bureaucratic pressures, financial constraints and the sheer pressure of offering medical care while trying to deal with complex electronic systems, have forced physicians to retire early. Recent studies suggest that the shortage will only become more acute over the years.

Retaining physicians and providing a healthy environment to work in has quickly become the biggest worry and challenge of hospital CEOs. Physicians quitting their jobs and leave can lead to dissatisfied and confused patients.

5 ways to improve physician retention…

The magic of a shared vision!

There is nothing that works like teamwork! Explain about your hospital’s goals, aspirations and vision for the future. Let new recruits know beforehand the patient population they are most likely to handle and the volume of work per day. Being transparent can invoke trust and make physicians feel a part of a team and not well-oiled machinery.

Provide administrative support…

The deluge of admin work every single day can catch most physicians, off-guard. Delegate staff to junior staff, hire scribes or outsource tasks such as billing and transcription. This can, not just unburden physicians but also cut down on administrative expenses.

Perks matter!

To make physicians stay longer offer perks that most competitors don’t. Profit-sharing options, paid holidays, fitness and entertainment space, allowances, lesser working hours and a positive work atmosphere and culture, can stop physicians from looking for other employment opportunities.

Is there space for professional development?

Every healthcare professional likes to grow, to fledge. An environment that stifles their growth and wears them out means they are going to quit sooner rather than later. Include professional development activities such as conducting regular workshops, seminars, group discussions etc… This will not only ensures your employees are actively involved, but also, more aware of current healthcare regulations. A working environment that is conducive to growth can make physicians stay back longer at your hospitals. It is not just perks and incentives, but the fact that they can navigate tricky learning curves with your organization that will help them stay put!

Offer EMR training!

The major reason for befuddled and disgruntled physicians is complex EMR systems. Hire EMR consultants and experts to train new physicians. Manuals and discussion forums can only be of so much help. Hiring someone to offer remote or on-site EMR guidance to new recruits will prevent them from feeling lost and increase productivity at the practice.

The AMA Suggests That Physicians Should Focus On Billing. Are You?

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clinic medical

Are you losing out on billable dollars ?

This is not the best time to be a healthcare provider! Financial constraints and regulatory pressures are giving physicians, sleepless nights.   Doomsayers have crawled out of the wood works to proclaim that medical practices are going to fold up and die.

It is certainly not like healthcare is circling the drain hole. But it is essential that medical practices up their game to stay afloat.

Still stuck with a payment contract that is five years old ?

The major mistake that healthcare practices make is to get paid much lower than the services they provide. Nobody likes getting on the phone and haggling with insurers. But what has to be done has to be done! Frequently negotiating reimbursement contracts will go a long way in increasing revenue.

Thorough claim analysis and evaluation of top paying CPT codes every three months can prevent and clot the bleeding.

It is okay to discuss money with patients !

Do you feel delicate when discussing about money with patients? Instead of dillydallying be forthright with your patients about treatment costs and payment options. Give them a lowdown on what and how much the insurer will cover.

A lot of patients promptly sue their doctor the minute they receive a bill. Discussing about payment prior to a medical procedure will prevent heartaches and heated arguments.

Don’t rely on straight- out of a- can solutions…

Most EMR/EHR systems come with coding and billing features. But no matter how loaded your system is, don’t lean on it completely. There are certain factors such as duration of treatment or the extent of injury that play a crucial role in increasing reimbursement. Middle of the road coding isn’t going to cut it anymore.

Why work just eight hours ?

As pressures mount and operational costs skyrocket, outsourcing has become a viable option. It makes a lot of sense to work with a billing company that works 24 hours. You not only process claims faster you can clear revenue backlogs.

Furthermore it is a nice feeling to walk in to your practice the next day knowing fully well that your biller has transmitted your claims to the insurer. And that now, finally, the accent will once more be on patient care.

A Few Survival Strategies For Healthcare CFO’s To Handle 2014

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Time for healthcare CFO’s to step up their plate !

2014 is going to be a year of change. Federal mandates, financial constraints and heavy penalties for non –compliance is going to make 2014 a challenging, tumultuous year. It is time to up the game to ensure medical practices don’t crumble under pressure. And as always it is the man at the helm who needs to up the game!

Focusing on wellness programs can help you save on taxes !CFO

The PPACA requires all healthcare organizations to review the wellness plans of all full time employees. Choosing a wellness plan that is highly deductible can be a major tax saver. CFOs will have to examine the current coverage plans.

And freeze in on a wellness plan that works both for their employees and also saves on taxes. This could well be the major priority of healthcare CFOs in 2014.

Systems to record the quality of care…

The healthcare landscape is undergoing a period of transition. From volume based payments. To a model that is based on the quality of care and patient outcomes. It is essential that CFO’s implement systems and upgrades to report and measure clinical variations. Maintaining, longitudinal health records that are detailed and contain data across the care continuum, is important.

Will your clinical documentation cut it ?

Do you maintain pristine clinical documentation ? If yes you are lucky. If, like a majority of health care providers your answer is, no, then it’s time you upped the ante. Review your revenue cycle that coordinate with coders and physicians to ensure more accurate and updated clinical documentation.

Analyze every phase of the RCM to see where you can reduce costs. Have your billing team give a detailed report of key financial metrics.

Outsourcing can be a huge cost saver !

Reducing the number of full time employees can help you cut back on costs. But this is a move that has to be taken after weighing in the pros and cons. 

Here’s a quick presentation for CFO’s to handle the practice.

Forget The Incentive. Can Your Practice Escape MU Penalties?

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How do you avoid MU penalties ? There is just one way, demonstrate meaningful useMU. The primary worry of all healthcare providers is missing out on incentives. But taking steps to avoid the fast approaching penalties should be the top most priority right now. It is time for physicians to get in on the ground floor and work towards MU.

Working hand in hand with patients !

To, meet compliance deadlines, it isn’t enough, that you adopt an EHR, and optimize, your, workflow. Remember that it all boils down to just one thing, the quality of care you provide patients. Explore better ways of working with your EHR to avoid nasty payment cuts and penalties.

Eligible professionals, who are going to demonstrate meaningful use to avoid payment adjustments in 2015, must kick start their EHR reporting period by July 2014. You will have to work at breakneck speed to reach the finishing line on time.

Ramping up patient portal efforts…

Under stage two of Meaningful Use patients should be able to view their data, download it and be able to transmit it. Do you know that a functional patient portal can help you meet, 3 core objectives and 4 menu objectives? That it could be the easiest way of meeting the patient engagement criteria?

 Though a patient portal can be available in the provider’s website or function as a stand -alone online application. A patient portal that is integrated in to your EHR can improve functionality and ensure data security.

Patient engagement the big “gotcha” !

Laura Kreofsky the principal advisor for Impact Advisors predicts that patient engagement and public reporting are going to be the major stumbling blocks for physicians. Make sure you option for an EHR with a robust patient portal. If you are an EHR user insist that your vendor provides you with a fully functional patient portal.

The payment cuts for physicians who’ve missed the boat…mu-penalties

Source:Practice fusion

Smartphones Can Help Your Practice To Achieve MU !

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What do you do when you go meet a physician ? Explain in detail about your medical history and pray that you haven’t left out anything. Now you just need to hand your smartphone to the doctor. The trend of accessing medical data through smartphones is growing at a fast clip.

And major smartphones such as iPhone and Android apps offer applications to, store, download, and manage patient information.

A success story…

The University of Pittsburgh Medical center found that patients joining the medical practice’s patient portal grew exponentially after reports were available through smartphones. The project launched in 2011 has been a roaring success with 700 patients joining the portal every week. Patients’ being able to access their medical records is a major criterion for qualifying for MU. And smartphones have just made it easier for doctors!

How do you get Mrs Linder interested ?

Despite the optimism and euphoria surrounding the success of smartphones to help patients use patient portals, engaging them is a key issue. Mayo clinic found out the hard way that engaging patient is no easy task.

Patient engagement ; an on-going challenge…

When they launched a web based portal three years ago, 240,000 patients joined. Reason to celebrate! But wait. The clinic is having a tough time getting patients to using the portal. To receive MU dollars patients should use the patient portal. Patients who are too old or those who are suspicious of technology need to join the bandwagon as well.

Show that you care !

To engage patients it is important that patient portals are designed from the patients’ perspective. Address their needs and make the portal fit in with their overall healthcare plan. Making the portal easily navigable and using images and text that are easy on the eye is important. And yes the assurance that their data is completely secure.

Not everybody understands encryption protocols or static passwords. Educate and train your patients in handling healthcare IT. Encourage patients to use graphical authentication techniques. And, to separate medical data, from, the other regular features, of their, mobile phones.

Fighting the good fight !

It can be frustrating, pointless and time consuming. But staying the course can help your practice not just receive MU incentive dollars and achieve compliance. But also make hundreds of your patients happy and more involved in their healthcare.

Here is the info-graphics with few stats on patient portal

patient-portal