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Managing complexity of medical practice

Getting back to basics

Manage the increasing complexity of medical practice from the inside


By Dr. Susan Turney
Posted: October 20, 2012 - 12:01 am ET
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It's a familiar refrain—uncertainty, confusion, pressure, frustration. I often feel like a broken record when I'm describing our members' assessment of their current professional lives and the environment for medical practices. The ongoing Medicare payment uncertainty, steady increases in operating costs for medical practices and administrative burdens plaguing every practice administrator are unprecedented.

Medical practices are in a state of flux. Some speculate that medical groups will be forced to integrate or risk extinction. I don't buy into that prediction. Exemplary practice management will be the key factor that keeps many practices afloat. Your success depends on what you do now to prepare for the future. These responsibilities can be daunting, but I believe it's possible for medical practices, large and small, to thrive.

Being a successful medical group means doing the right things with the right staff at the right time. Solid groundwork allows groups to be nimble and adapt more rapidly, especially when the industry calls for innovation. Just as a football team needs to know the basics of blocking and tackling before running complicated plays, a renewed focus on completing the right tasks when the time is right and building a team most qualified to lead your practice will put you on the path for success.

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Doing the right thing in your practice boils down to a few basic principles. The first is being productive. The most successful practices examine ways to deliver better quality care and more of it. This may mean carefully examining the scheduling process and making sure you're adequately staffed to accommodate your patients, or it might mean more effectively anticipating and managing same-day appointments.

It might also be necessary to employ nonphysician providers so your physicians can remain as productive as possible. According to the MGMA Performance and Practices of Successful Medical Groups report, high-performing medical practices use nonphysician providers in a very strategic way. When having nonphysician providers on staff, better performing primary-care groups reported that their total nonphysician provider cost as a percentage of total medical revenue was only 4.8% compared with 8.3% in practices not designated “better-performers.”

Those professionals can support the physicians, rendering doctors more productive and allowing them ample time with each patient.

Striving to be efficient means carefully examining processes to eliminate unnecessary waste or redundancy in your practice. A key component of this is to understand costs and benchmark your practice. Our recent Cost Survey report details cost information and is the perfect place to examine how your practice measures up. In fact, in multispecialty physician-owned practices, clinical support staff and business operations staff increased in 2011, evidence that properly staffing your office can help streamline operations.

This is a new world, with new rules. Start by really understanding how your practice operates—at its peak times, slow times, crunch times and slack times. This will help guide your efforts if adjustments need to be made.

Also, a careful review of your collections process will assist in your foundational efforts. Make sure you are being properly reimbursed for the work you're doing.

Patient collections start with proper staff education, adequate training, attention to detail and follow up. Start by ensuring physicians and staff fully understand payer rules and regulations, documentation and coding. Then train and train again. This stuff is hard. And pay attention to the details. Every patient is important, every CPT code is important, every dollar is important. Constant monitoring of the different aspects of the revenue cycle is critical, and fine tuning your efforts requires determining what might be causing poor collections and why it's happening.

Assembling a team that is flexible and capable of effectively managing the practice is another key component of building a solid foundation. A qualified team should include a competent practice administrator. The practice administrator has a demanding role in the practice.

He or she is the champion for safety, quality, information technology capabilities and compliance, as well as managing the other day-to-day tasks, such as collecting from patients and scheduling appointments. The coordination of those efforts is essential and leaves physicians the time to do what's most important—care for the patient. The administrator is at the intersection of the practice workflow, navigating the many moving pieces and parts. Without exemplary practice management, these items, big and small, might get lost in the shuffle.

Spend time properly recruiting and training practice staff, and seek employees who are certified by the American College of Medical Practice Executives.

Dr. Susan Turney, CEO of MGMA-ACMPE
Turney
Individuals who have earned the certified medical practice executive credential have validated and verified their expertise and experience in medical practice management. The certification process is based on the Body of Knowledge for Medical Practice Management, which reflects the knowledge and skills necessary for success in this fast-paced field. Employing that kind of expertise and excellence will bolster your practice in the long run.

The best time to examine your productivity, efficiency, collections process and staff is now. Amidst the change and uncertainty in our industry, get back to basics. The most successful practices carefully examine their internal efforts and processes so they can adapt and be innovative, even before the industry calls them to be.

We don't know exactly what the future holds for the healthcare industry, but exemplary practice management is critical. If you get back to the basics, you'll be prepared to tackle ongoing legislative uncertainty and pressures, rising costs and the administrative complexity in which we're immersed. In the midst of ongoing transformation and innovation, you'll be poised to succeed.

—Dr. Susan Turney is president and CEO of the MGMA-ACMPE.



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