Look for new opportunities under healthcare reform to work with payers and other providers. “Value” is the big buzzword or concept under accountable care. Although sometimes difficult to identify, quantify or define, there will be multiple opportunities over time to participate in new methods of healthcare delivery and reimbursement. These methodologies are still evolving and include medical homes, case management, bundling and accountable care organizations. With these new opportunities come the challenge of better understanding your costs, partnering with other providers, and entering a variety of financial risk and reward agreements relating to population management. All of this requires practices to have access to appropriate data and national benchmarks, such as information from MGMA-ACMPE.
Consider developing your own internal quality incentive programs. Administration and physician leadership should work together to identify a short list of specialty-specific targets that are meaningful and measurable.
When negotiating, or renegotiating payer contracts, embrace the change happening in our industry. Do your homework and learn more about opportunities for your practice. This will benefit your organization and, in the long term, your patients seeking quality care within their budgets.
Independent consultant MGMA Health Care Consulting Group Englewood, Colo.