Yearly Archives: 2014

Marcus Lemonis -- the investor/fixer who stars in CNBC's "The Profit" -- believes that the keys to success for any type of business boil down to three fundamentals: people, process, product.  Once you understand that all the shortcomings and the positives of any business will fall into one of these three areas, it's easier to see how to fix the problems that prevent a business from reaching its potential. These basics absolutely apply to medical practices, too. People:  Do you have the right staff? The right providers?  Is everyone doing the right things?  Are staff members empowered to solve problems? Process:  Is your patient flow process free of unnecessary friction, or are extra steps, poor communication and other inefficiencies slowing you down? Product:  Do your providers provide the services that are needed in your area?  Are patients getting access when they need it?  Are you committed to the technology options and other patient experience innovations that patients want and need?  Do you know what patients want? In this video (one of an excellent series from Inc.), Lemonis states plainly that if you want to understand whether your process works or not, "You really just have to stand on [the other] side of the counter and say, 'What is the consumer actually seeing?'" This is, in fact a big part of what we do as practice management consultants.  We shadow patients, we sit in reception areas and at the front desk, we go through the same processes your patients do.  It's how we learn what the patient experience is like, and how we spot problems in workflow (which usually reveal themselves almost immediately!).  Your staff can also help you understand the patient experience -- let them share with you what they see at your front desk, in your hallways and in your reception area, and let them take initiative to fix problems that are within their control.

Themes seem to emerge each season in our medical practice management consulting business; in 2014, one of the most striking has been the connection between physician productivity and physician compensation.  It's an issue we've seen play out in nearly all our engagements, in both start-ups and established practices, in both private practices and hospital-owned groups. As many practices face big organizational changes and others launch new strategies to adapt in the changing healthcare environment, it's natural that physician compensation needs to evolve, too.  But what's more surprising is that this particular issue seems so resistant to the clarity and structured decision-making that guide so much else in the medical world. Instead, too many practice owners view the idea of a productivity structure or clear goals as "insulting" or even unnecessary with "professionals." This idea seems to take root in private groups in particular – the physician owners are especially leery of offending their employed colleagues. Sometimes I wonder if a misperception of business compensation contributes to the resistance physician owners and practice administrators have to tying physician compensation to productivity (or even discussing it!).  Perhaps there is a sense that other professionals don't have the burden of having their performance measured.  But nothing could be further from the truth.  In business, even executives who don't generate revenue directly typically have objective goals.  Marketers may be measured on unique visitors to a website, inbound calls, awareness or other objective criteria besides revenue.  CIOs may be measured on uptime or the response time of systems, or cost containment, or some combination of results.  Customer service professionals may need to demonstrate that their teams beat benchmarks on hold times and call length. Sales executives are always measured on sales performance -- even when they're not.  Even when an organization sets a compensation plan for sales executives that doesn't directly tie weekly or monthly sales to regular compensation, the connection is in there somewhere.  Perhaps a big part of compensation is a bonus that depends on annual performance.  Or perhaps a sales executive collects all her compensation from day one, but she knows her

The culture of the medical practice is shifting dramatically: the way we think, the way we work and the way we care for our patients. It’s no longer simply about what’s the matter with the patient; it’s time to focus on what matters to the patient! The patient-centric practice is in the limelight and being fueled by the Affordable Care Act, which places more emphasis on the patient relationship. The ultimate goals are to: Improve compliance Reduce healthcare costs Obtaining better outcomes Achieve a higher level of patient satisfaction This is a major shift for many medical practices that have previously focused primarily on the tasks required to diagnose a patient’s condition and create a treatment plan with the assumption that patients would follow its orders. Think strategically when it comes to creating a patient-centered culture. Managers and physicians need to accept the responsibility to make the changes required to accomplish this and commit to success. How can you pose issues effectively and what obstacles must be overcome to get team buy-in to changing the way things are done? You start by building the change management team. Determine who will be the champion for this project and increase your odds for success and which team members will contribute to creating an effective plan that will be endorsed by staff. The champion needs to be someone that is trusted and respected by everyone and believes that the changes the practice makes will lead to greater success in strengthening the relationship between the patients and the practice. The change management team will be required to establish standards and method of accountability that involve everyone. No balking allowed and no sacred cows! The plan needs to be structured and supported by management. Once the plan is agreed upon and in place, the champion must sell the vision and be the role model that inspires organizational change by leading the efforts, keeping the communication open and celebrating steps of progress. Check out my free mini-webinar on this topic, presented by the American Osteopathic Association -- part of the Power Up Your Practice series.

A not-too-surprising-but-still-interesting tidbit: a new poll by Sermo (the physician-only social network) shows that a majority of doctors disagree with the decision to hire a non-physician political professional as the "czar" leading the nation's Ebola defense. Read more about it on Sermo's blog: http://blog.sermo.com/2014/10/20/doctors-reject-ron-klain-as-ebola-czar/ Do you agree with the majority?  

If you haven't signed up yet, there's still time to join my upcoming webinar on patient collections on 9/23/14 (9AM/12PM).  "Front Desk Collections: the New Linchpin of Practice Profitability" is sponsored by Wellero and hosted by Physicians Practice.  It's free!  Register here.

Sending a key staff member - whether a biller or a practice manager - to a medical practice management or billing conference can seem like an expensive perk. It can be an especially difficult decision for a small practice.  But there's just no substitute for the learning and connections that are possible by spending a few days at a high quality conference. Case in point.  I just returned from the HBMA conference, where I presented to about 200 motivated and engaged billing service managers and owners.  Attending as a speaker gave me the opportunity to listen in on some of the other speakers, and to hear attendee feedback.  Now, the HBMA is a vibrant organization that provides plenty of valuable information throughout the year through its list-serv, payer-focused groups, and other resources.  But the conference adds another layer of value -- and it does it very efficiently. For example, I sat in on a presentation about changes in bundled payments and other coding and payment issues -- including the four new modifiers the CMS recently announced.  Everyone in the room valued an update on this (so far, still confusing) new information from the CMS.  When you're working by yourself in your practice office, juggling all the normal day-to-day tasks and priorities, it can be all-but-impossible to get a clear answer on some of these kinds of issues.  Programs like PQRS and PCMH are very difficult to parse through alone; it's hard to feel confident that you're on the right track, and the consequences are expensive.  Being taught by an expert at a conference can be a lot cheaper than going it alone and getting it wrong. Of course, not all conferences are created equal.  Be picky.  Choose events by respected organizations, with well-regarded speakers.  Review the agenda to be sure it hits the topics most relevant to your practice.  And don't forget to consider the value of the audience: conference networking creates connections that can help your managers get help problem-solving long after the conference ends.  So think about who will be there when selecting.  It might cost a bit

Front desk collections are more important than ever before.  Trends in insurance plan terms mean that patients are more responsible for the cost of their care than at any time in recent memory.  Mastering front desk collections is not just a way to be more profitable -- it's essential to maintaining any level of profitability and keeping your practice healthy!  And there are important implications for patient relationships, too. This is why my new, free webinar is called "Front Desk Collections: the New Linchpin of Profitability."  It's simply essential that front desk staff are empowered to fulfill this critical task.  To learn more about the whys and hows of collecting from patients at the time of service, join me on September 23.  I'll share some of my observations about how to optimize your front desk collections, plus there will be time for any question you'd like to ask. Join me for "Front Desk Collections: the New Linchpin of Practice Profitability" on 9/23/14 (9AM/12PM) -- sponsored by Wellero and hosted by Physicians Practice.  It's free!  Register here.  

Group visits can be a great complement to many medical practices that provides many benefits. The emergence of group visits, sometimes referred to as shared medical appointments (SMAs), began when physicians and their managers recognized access for patients with chronic illnesses was inadequate. Patients with chronic conditions such as asthma, COPD and diabetes ended up coming in when their symptoms were exacerbated and out of control. This was either because they couldn’t get an appointment sooner or they were simply non-compliant with keeping regular appointments. Their health condition was being compromised and physicians were frustrated because there was not enough time to address complications sufficiently during the typical time allotted on the schedule. Group visits enable a practice to bring a small group of patients with the same disease together to discuss the common issues they share and how to better manage their chronic condition. At the same time, each of the attendees has individual time with the physician or other provider for an examination and specific treatment recommendations. In 2002 this was defined as a revolutionary access solution in a Group Practice Journal article authored by Edward B. Noffsinger, PhD, a pioneer in the development of group visits. The first clinical applications of this mod Many patients like the group practice visit and getting support from people that share their problems. It can be very affirming. The shared visit often contributes to improved compliance, as some patients report their condition improving when they adhered to their treatment regime.   It’s a win for the patients, the practice and the payer as access improves, cost of care goes down and better clinical outcomes are achieved. Physicians can actually see more patients in less time and the practice gets paid for the level of care provided, since each patient is billed the same as an individual appointment and the co-pay amount remains unchanged. The insurance companies don’t seem to care as much about where the patient is seen as they do about the level of service the patient is getting. It is expected that the group visits will expand rapidly to provide

All Things Considered (NPR) has a great story that I think any doctor or healthcare professional will find worth a listen (~5min).  Emergency physician Ryan McGarry talks about the new documentary film he directed called Code Black, which goes behind the scenes at always-busy LA County Hospital's ER.  Click here to listen on the NPR site. McGarry speaks passionately about the changes he's seen in his time in the ER -- including the intrusion of regulations and record-keeping into the patient relationship. For more on the movie itself -- include release dates for various cities around the country -- visit the Code Black movie site.

If you weren't one of the 100 lucky winners of my medical billing service ebook, Get the Best From Your Medical Billing Service (Management Rx), you might be able to borrow it for free.  If you're an Amazon Prime member, you can borrow the ebook for free for up to a month.  (If you're not yet a member but are thinking about it, click here for Amazon Prime Free 30-Day Trial-- once you sign up, you'll be able to borrow my ebook and loads of other interesting stuff (one at a time) as well.)