Laurie Morgan

Did you know that a study in 2013 by the American Institute of CPAs found that more than half of Americans surveyed didn't know the meaning of at least one of three key health insurance terms (deductible, copay, premium)? And that more than a third thought that premiums were paid directly to doctors? Considering that health insurance is such an important part of personal finance, these results are rather shocking. But if you work in a medical practice, they're probably not surprising, especially if you happen to be a medical biller. If you're a biller, odds are that handling questions and misunderstandings about deductibles and other amounts billed to patients has come to occupy a significant chunk of your time. It doesn't seem like explaining health insurance terms should be your practice's responsibility. Shouldn't the vendor (i.e., the payers) take the lead in making sure the consumer knows how the product works? And what about employers who offer these products as benefits -- shouldn't they explain what their employees are receiving? In an ideal and logical world, practices wouldn't wind up having to explain how someone else's product works to their patients. But, unfortunately, the fact that patients don't understand how their financial responsibility is calculated (or even why they are being asked to pay) can have steep consequences for your practice. When patients don't understand what they owe, they're more likely to resist paying. The bottom line is that when patients don't understand their financial obligations, they are less likely to meet them. Even when patients do pay, collection costs rise when payment is delayed by misunderstandings. Even though educating patients about their payment obligations shouldn't be your practice's job, you must make it your practice's job if you want to be paid more reliably. Educating patients about their financial responsibilities should start before they arrive at your door. Working financial education into your practice workflow is more important than ever as deductibles keep rising. Learn more about the why and the how of clearing up misunderstandings about insurance in my webinar on 4/26. It's free -- hosted by

Phreesia recently invited me to present a short (20 min) webinar on "The Patient of the Future," and how practice managers can anticipate emerging preferences to do a better job attracting and retaining patients. We have an interesting advantage in our field in that we have a bit of a lag before the trends of today become cost-of-doing-business requirements. (Except, perhaps, for pediatrics and other specialties that serve millennials -- you've got to try harder to stay ahead of the curve. Lots of interesting data shows why.) I think you'll enjoy listening to it (I'm biased, of course :)). It's a little headier than our typical tactical webinar -- nice to have a little variety.  And it's available on-demand, for free. Here's the link to sign up and view/listen on demand. If you do check it out, I'd love to discuss it or hear your feedback. Visit this page to contact me or any of us at C&M via email or phone.  

Kaiser Health News, citing a new California Department of Managed Care analysis, has reported that health plan directories in California are still plagued by errors. In fact, it appears that health insurers' lists of physicians may actually be getting less accurate. The author of the state report said that 36 of the 40 insurance directories she evaluated had inaccuracies that will lead to fines. Last summer, California introduced legislation mandating that insurers keep these directories up-to-date. The state is concerned about incorrect directories because patients rely on these listings to choose doctors who accept their coverage. Inaccuracies are hassle for consumers. Worse, if a patient inadvertently chooses a physician who is not in-network for an expensive service, the patient can end up owing a large balance. More fines may be appropriate for the health plans who've failed to keep their directories current, but I'm doubtful they will improve directory accuracy -- at least not immediately. Inaccurate directories have long been a problem that causes trouble not just for patients, physicians, and health systems, but for the payers themselves. The challenge is maintaining directory data when managing a directory is not you core business -- as is the case with health plans. I've said it before, and I'll say it again: maintaining health plan directory data accuracy shouldn't be the job of practices, but you nonetheless must take responsibility for it. Otherwise, you risk missing opportunities to serve patients who can't find you if you're improperly excluded, and you risk inadvertently seeing patients who aren't covered when you're improperly included. It's a bit labor-intensive, but reviewing and fixing directories is not difficult. I explain out to do it in my ebook and my new print book. It's a great task to delegate to one or more staff members to work on a bit at a time during down-time.

Every January, employees around the country secretly resolve that this will be the year they find a better job. If you're hunting for new employees, this burst of interest in job-hunting is good news for you. But are you missing out on some of the best candidates for jobs in your medical practice? Candidates who are currently employed are often the best prospects. But in our world, getting out of the office for an interview during normal work hours can be a significant obstacle. This is especially true for employees at the lowest levels. While we've all occasionally used "doctor's appointment" excuses to depart early for an interview, that can be more difficult to do in a practice setting. Certainly, it's not usually easy to do that more than once in a while, making it hard for employees to take on multiple interviews. As a manager looking to bring on the best talent, one way to sell your opening more effectively is by making it less stressful to apply for it. Initial screenings that can be done by phone or Skype, in the evening or on the weekend, will accommodate more candidates who are currently employed -- and will allow them to speak with you without tipping off their employers about their job-seeking. When final candidates are identified, consider setting aside a Saturday or Sunday afternoon to meet with everyone they'll need to interview with at  your practice. Working on free time is not everyone's idea of a good time, but it will help ensure you can speak with every great candidate. And if doctors need to be involved with the interviewing, they won't have to sacrifice appointment time during the week. If your process allows you to be more flexible in interviewing candidates, mention it in your postings, so people know they might have a shot at your job, even if they've held back on other opportunities because they worry about getting time off from work.

2016 was a busy blogging year for us. Here's a rundown of our top five most-read posts of '16: "It's everyone's responsibility, but nobody's doing the job" "Are you missing out on excellent solutions to front office challenges?" "The upside of staff downtime, the downside of multitasking" "Copays are declining, and that's not good news" "Office squabbles? Three areas to look for a fix"

Last month, Capko & Morgan prepared a white paper on physician burnout for Kronos, drawing on survey research we helped Kronos field with MedData Group. Using MedData Group's national database, we were able to survey physicians in more than 25 different specialties, in locations all over the country. In some ways, the results were unsurprising: more and more data are pointing to burnout as a very real risk for physicians, and our survey was no exception. But our research offered a few new data points. For example, we asked physicians about whether burnout is a problem in their practices, not just for themselves personally (87% said yes). And we also asked physicians to identify possible contributors to burnout, with the goal of looking for potential solutions. The idea to survey physicians about burnout came from Kronos's own experiences implementing physician on-call scheduling solutions, and how their customers learned that automating that process could help ameliorate one source of physician stress. To read the white paper: [ddownload id="5167"]. (It's free, no registration required.)

In case you missed it ... Fake emails featuring HHS letterhead and the "signature" of the director of the OCR are circulating. These emails aim to fraudulently draw clicks with a message that the recipient be included in a HIPAA "rules audit." Like many phishing schemes, the emails are very convincing. They even include a "from" address (OSOCRAudit@hhs-gov.us) that looks quite a bit like the actual OCR/HIPAA audit address (OSOCRAudit@hhs.gov). Alert your employees of this possible scam.  More information is available here.

More productivity, better morale, and better patient service, with no extra costs?  It may sound like a dream (or maybe an illusion?), but that's the idea behind employee engagement. Engaged employees go above and beyond the objective requirements of their job. They're observant about ways to provide better service to your patients, and take steps to do so -- without being asked. You can also count on engaged employees to bring you ideas for how to improve the practice -- ideas that are often spot-on, because the employees who suggest them are closest to problems you might not see. Sounds wonderful,right? So how do you foster engagement?  This is a subject I'll be delving into in detail in my upcoming webinar on Tuesday, Dec 13 at 10PST (sign up for free at this link). I hope you'll join me. But in the meantime, here's a preview: Employee engagement goes beyond morale. It's an emotional connection to and sense of responsibility for the organization. The feeling of a shared mission, of providing valuable services, is essential to engagement. (Because of the nature of their work, medical practices have a head start on fostering this sense of mission.) Communication is key. When leaders communicate regularly, that helps employees feel like they're part of a team that works together towards shared goals. Encouragement is invaluable. Employees spend a huge proportion of their time at work. They want to feel like they're succeeding. By focusing on employees' strengths and accomplishments, leaders encourage their teams to continue to give more. We'll explore more specific ways to engage employees in the presentation -- plus we'll look at the research that shows that employee engagement is not just a fluffy idea, but rather a proven way to improve your practice, without spending a penny. To register for the webinar, visit this link.        

When Judy, Joe, and I begin consulting engagements with practices around the country, we're almost always asked, “Do you think our practice could be overstaffed?” Usually, the administrator or physician leader who asks seems to assume that overstaffing is a terrible mistake, one that will surely undermine the organization’s profitability. Oddly enough, I don’t think I can name a single occasion when a physician owner or manager wondered anxiously if there were too few people employed in their organization. When it comes to staffing in healthcare, the worrying seems pretty tilted towards overstaffing. It’s easy to see why. Staffing is typically one of the biggest expenses in any healthcare organization. Employees are easy to see, and if they’re not fully utilized at all times, that’s easy to see, too. Cutting staff (or expenses related to staff) may not be simple or painless, but it’s much easier than trying to reduce other overheads like rent or other building costs. In fact, most other large expenses are fixed, or nearly so; staffing may be the only area where cuts can readily be made. And if you can see that there’s slack in the system, isn’t it smart to try to tighten it up? Perhaps—but it depends. For example, are you sure you’d have no trouble accommodating an unexpected surge in demand with fewer staff? Would you still be able to maintain your service standards with a smaller team, even if some members unexpectedly needed to miss work? And are you sure that every important task is already being done? It’s easy to overreact to idle time because it’s so easy to spot. But a little bit of idle time may simply reflect the occasional unpredictability of clinic workload. If you overreact to it, you can end up with bigger problems than a bit of staff under-utilization. When our clients are concerned about staff sometimes seeming unproductive, we suggest they consider whether any important tasks were dropped off the priority list in recent years. In many healthcare organizations, tasks related to patient collections have crowded out valuable non-essentials. For example, receptionists probably spend

Committed, well-trained employees can make all the difference in patient service. After all, your employees are usually the first point of contact for your patients. Your employee costs are also probably one of your largest practice expenses (if not the largest). So how can you be sure your investment in staff is delivering the kind of patient experience you're aiming to provide? Employee engagement is a concept that aims to address this question. When employees feel a strong connection to their place of employment, that can lead to more confidence and more motivation to do a great job. So how do you cultivate that sense of engagement? Join me for my next complimentary webinar (sponsored and hosted by Phreesia) on December 13 at 10AM PST, and we'll explore what factors encourage or detract from employee engagement, best practices for engaging your team, and the ways that culture and hiring impact engagement -- among other intriguing, related themes. Use this link to register.

I recently authored this white paper for Kronos on automated on-call scheduling. This is a critical task that has long begged for a reliable technology solution; thankfully, technology innovation is finally catching up to that need. Click the download button to check it out. [ddownload id="5140"]

If you missed my webinar earlier this month ("Tips for Choosing and Managing Outsourced RCM"), a recording is available on YouTube -- courtesy of the host, 4MedApproved, and the generous sponsor, Care360.

If you've been on Facebook a while, either solely as an individual or with a practice business page, you have probably noticed that it's a lot rarer for business page posts to show up in users' newsfeeds. This is a frustrating problem for businesses that previously relied on Facebook to reach their communities with regular updates.  But there is a way to restore a bit of that connection: verifying your page. Not sure if your page is verified already?  If it is, you'll see an encircled check mark next to your page name, like ours has, below. Verifying your page is easy.  Go to "settings, general" and choose page verification. The standard approach is to receive a phone call with a pin code sent to your public number, but this may be unworkable if your practice has a phone tree. So choose the 'verify with documents' option to verify using a business document such as a utility bill or business license.

When we work with practices that are not as profitable as planned, or that are even struggling financially, the managers and owners almost always ask, "Are we overstaffed?" And almost always -- contrary to expectations -- our opinion is that they're not. In fact, when we work with practices that are struggling, it's more likely that we will end up recommending more staff. It seems counter-intuitive, I know.  The costs of staff are so visible, and sometimes seem so burdensome, it's no surprise that managers and physicians instinctively want to minimize the size of their teams.  But this overlooks the value that staff can bring -- value that can go right to your bottom line. This isn't just happy talk or a kinder, gentler management approach.  If you've been consciously driving your own practice's headcount lower and lower, there's a good chance you've cut enough that you're actually reducing your income. Staffing optimal requires attention to the details that drive practice profitability.  It's more complicated than just figuring out how to get by with less.  But the rewards for staffing better are manifold: not just more money in  your pocket, but less stress for everyone, and happier patients, too. My new ebook, The People-Profit Connection: Smarter Staffing for Practice Profitability, explores these ideas in detail.  It presents case studies drawn from our experiences with real practice clients, with actual problem-solving examples you can apply to your practice today. To check it out, visit this page on Amazon.com.