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Improving Financial Viability of Medical Practices

Medical Practice Financial Management

By Christy Clodwick; MHA

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To combat the climate of barriers and frustrations in medical practice today, physician executives and administrators need to create innovative ways to change and improve medical providers’ outlook in the health care marketplace.

Many Barriers

The barriers—federal anti-trust laws, lack of state or federal regulatory action, marketplace resistance and tremendous cost pressures—are being confronted throughout the healthcare sector and are being felt by medical practices of all sizes, including hospital organizations, medical organizations as well as independent solo practitioners. Although there are tremendous financial pressures in operating a healthcare practice, the demand for healthcare is on the rise. To remain viable in today’s healthcare market place, strategic planning is needed at all levels of every practice’s processes.

Disenchanted Doctors

It is increasingly acknowledged that physicians in today’s health care market are becoming disenchanted with the reimbursement compensation from managed care. This also affects the outlook that they have on the medical profession as a whole. It is important to point out that there are ways to put processes in place to combat or, at the very least, survive all the changes taking place. Strategies can be put in place to offset the high demand for quality care and the discouragement and outrage that physicians are feeling about reimbursement. Physicians did not learn the business side of medicine in medical school, although many physicians today are choosing to diversify their careers by going back to school to get an MBA, or even just further business knowledge, to stay abreast of the changes. Selecting an outside source to assist a practice with the needs of business growth planning can be difficult, if the physician or practice administrator does not know what the needs really are. The best option would be to ask for a recommendation from a colleague who has hired consultants to assist in his or her practice, or to call on the local hospital administrator for assistance in locating an appropriate consultancy firm or management company.

The Planning Process and Process Improvements

The planning process of any business operation should always include management systems that clarify the business strategy and the metrics that most reflect success with that strategy. They should provide the framework to prioritize resources for projects that will improve the metrics, and leverage leaders who will manage the efforts for rapid, sustainable, and improved business results. This plan should also include improvement of processes that are already in place.  In essence, this should be a corporate wide approach to process improvements and management of the processes to control the outcome of the progress of these changes.

Driving Success for Plan Development and Implementation

During the plan development stage, all aspects of operations have to be included in the plan in order to ensure a successful outcome. The plan for a healthcare practice should include time management, cost containment, third party reimbursement (to include annual contract(s) review as many practices have 100-200 contracts), insurance coding and compliance, accounting, business management, capitation economics, marketing and business development, medical advertising, and especially important is the health information management system. Plan development, in short, should focus on:

  • Understanding and managing patient demands and requirements (this is clinical material).
  • Aligning key business processes to achieve those requirements.
  • Using rigorous data analysis to minimize variations in those processes, i.e. fee analysis, revenue analysis, and time management.
  • Driving rapid and sustainable improvement of business processes.

Future Health Economic Policy

With all the changes that have occurred in healthcare, it is safe to assume it will be a struggle to come up with a perfect plan that will sustain all future changes in such a volatile healthcare market.  Practice reimbursement would be a good place to start since this is the lifeblood of any healthcare provider. Income from fees has not nominally increased for more than a decade. The introduction of the Resource Based Relative Value Scale (RBRVS), as well as the adoption of a national fee schedule by Medicare, has virtually eliminated a practice’s ability to generate more income from insurance plans by increasing what the practice charges for its services.

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Conclusion

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Physician Use of the Internet

The Slow Evolution of a Healthcare Tool

[By Carol S. Miller; RN, MBA]biz-book15

The Internet is a constantly evolving service that continues to grow at an exponential rate, especially in physician practices. Primarily, the Internet is used as a means to electronically and expeditiously transfer data via e-mail as well as obtain information from a variety of sites.  Initially, in the physician’s office, the primary use was e-mail communications with peers, hospitals and others. Next providers linked to hospitals and managed care organizations to obtain more direct connectivity for clinical information and benefit coverage. Today physicians are finding other beneficial avenues to expand their utilization of the Internet. Several examples include:

 

  • Direct e-mail inquiries from the patient to the physician.
  • Patient educational newsletters and links to other healthcare educational web sites.
  • Continuing medical education (CME).
  • Chat room consultations, conferences or presentations with other providers.
  • Nurse to patient e-mail connectivity.
  • Immediate data on lab results with alerts for abnormal high or low values.
  • CPOEs (Computerized Purchase Order Entry Systems).
  • Radiology images.
  • EMR (Electronic Medical Records).
  • Monitoring of patients blood sugars or EKGs via the Internet.
  • Appointment scheduling on-line by patients.
  • Patient appointment reminders via the Internet.
  • Secure physician portals such as Medicity, located at www.medicity.com, which allows access to pertinent and prioritized data from a wide range of sources and vendors to include, labs, imaging centers, hospitals, payers and others.
  • HIPAA compliant Application Service Providers (ASP) for dictation, recording, routing and speech recognition and transcription services, such as Speech Machines at http://www.speechmachines.com.

Access Management

Besides the value to the patient and the physician, the physician can utilize his or her Internet connection with software firms such as NextGen to automate the registration, scheduling, eligibility verification, billing and “clean” claims processing via innovative Web-base solutions in real-time scenarios. All the physician’s office needs is a PC, a standard Internet browser, and a connection to the Internet to take advantage of this service.

Assessment

snow-highway1These resources and more, via the Internet super highway, enable physicians to have quicker and easier access to clinical information and improve productivity. Furthermore, these tools will quickly assist providers with accurate and timely medical decision making, thus improving patient care and outcomes.

Conclusion

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