Practice managers in today’s healthcare environment in
the United States are forced to work on a “putting out fires” basis as new
changes, policies, and requirements shape our practice’s daily operations. With
the shift from a fee for service to a value-based pay-for-performance
healthcare payment model, practices are struggling to keep up with new
requirements and quality measures while also maintaining a successfully
operating and financially stable organization. However, practice managers and
owners must ensure that they do not let the rapidly-changing healthcare
landscape overwhelm them and lead them to overlook other equally important components
of running a successful medical practice. In order to prevent this from
happening, it is important to look at the processes that may be improved in a
practice and to find potential ways to make those processes more efficient in
order to free up more time and resources to keep up with new healthcare trends
and requirements.
Some of the most common issues that may cost a
practice unnecessary time and money, or even harm the practice’s reputation,
follow:
1. Inefficient
processes take up too much time and labor
It is very easy to get
stuck in a process that may require unnecessary steps that could potentially be
eliminated, just because that is how things have always been done. However, in
order to maximize efficiency and productivity, it is important to look at your
practice’s current processes to see if the same actions or tasks can be carried
out quicker, in fewer steps, and with less employee labor involved. The Patient
Centered Medical Home (PCMH) delivery of care model proposes a great way of
reducing inefficient processes by conducting PDSA cycles – Plan, Do, Study,
Act. Such cycles involve planning and trying out new ways of doing things for
short periods of time, observing the results, and deciding whether or not the
new process should be kept or modified.
- Inappropriate
billing processes lead to significant financial losses
Sometimes billing
processes are set up erroneously from the start, and the practice loses or
under-collects money for years before realizing the mistake. For example, is
the correct code being billed for a certain procedure, or is there a more
specific one which is reimbursed at a higher rate? It is also important for
billing managers to be familiar with the reimbursement rates for the codes that
they bill most frequently, and to keep track of any reimbursement rate changes.
For example, Medicaid has multiple plans which set their own reimbursement
rates, but they still need to follow Medicaid guidelines. Sometimes, Medicaid
reimbursement rates will change but these plans will not follow suit as they
should—this needs to be caught and addressed with each individual plan before
losing out on large amounts of money and then embarking on long resubmission
and appeals processes.
- Outdated
technology causes delays in operations and inefficient processes
Technology is evolving at
such a rapid pace that it is impossible to keep track of all of the new
advances. However, sometimes new technology is introduced which can greatly
improve your practice’s current processes to speed them up and increase
productivity. For example, is your practice still using a conventional fax
machine and spending money on toner and paper? Have you considered using secure
e-fax services or HIPAA-compliant emails? Does your check-in process take too
long, backing up your physicians and slowing down your patient flow? Have you
considered electronic kiosks which allow patients to check themselves in? Do
your providers use apps on their phones such as the Physician’s Desk Reference
or Drug Interaction Checker apps to speed up their patient care delivery? Have
you activated your EMR’s mobile app on your providers’ phones so that they are
able to resolve patient issues securely from their cell phones? These are only
some of the ways that new technology and applications can be used to increase
efficiency and productivity at your practice.
- Hostile
environment and employee dissatisfaction lead to increased staff turnover
Does your practice have a
hostile work environment in which your employees are clearly dissatisfied and
frustrated? If there is a high rate of employee turnover, you are losing
significant amounts of time and money to hire and train new employees. Not only
does each new employee take weeks to be fully trained, for which you are paying
without getting an immediate return on your investment, but you are also
investing your time in interviewing, hiring, filling out new hire paperwork,
setting the employee up in the EMR system and payroll system, and other such
tasks. Additionally, you are also using up the time of your other employees who
will need to train the newbie—time for which you are paying which could be used
to complete other tasks. Furthermore, frustrated employees who leave your
practice can also bring even higher costs—they can bring forth frivolous
lawsuits, file for unemployment, and defile your practice’s reputation by
presenting it in a negative light to family, friends, and on social media and other
internet platforms, costing you new patients and tarnishing your practice’s
credibility.
These are just a few of the most common issues that
medical practices face on a daily basis which can be resolved with some time
and effort on the part of the practice administrator, practice owners, and employees.
It is beneficial to form a core multi-disciplinary team that will drive the
process improvement movement forward, and who will be able to speak for the
various departments of your organization. For example, your team can consist of
yourself, a physician who is invested in the practice’s success, your front
office supervisor or receptionist, a nurse supervisor or lead nurse, a billing
representative, and possibly a patient or two who have been coming to your
practice for years and are interested in helping it improve and grow. Sometimes
an outside consultant or partner may be beneficial to bring new perspectives
and ideas from an outsider’s point of view. Once your core team is formed, it
is important to set and maintain a regular meeting schedule. Ensure that
meeting minutes are recorded, and that all of your team members’ ideas are
considered. By setting forth an environment in which your team members are
encouraged to brain storm and present ideas for improvement, you are creating
employee buy-in and engagement. This will in turn make your team members
excited about seeing the changes that you are making create a positive impact,
and this excitement will be transferred to the rest of the employees. It is important
that all of your employees, not just the core team, are aware of your
improvement efforts, and on board with them. By letting all employees know that
they are welcome to bring forth ideas for process improvement, you are creating
an environment of open communication. Employees who feel that they are being
listened to and that their opinion and ideas matter will always perform better
than those who are simply following orders. Additionally, the employees who
work in the trenches day in and day out are the best sources of information and
patient feedback. Once you have created the right environment for process
improvement and engaged your employees, you will be amazed to see just how much
can be done to improve productivity, eliminate waste, and increase revenue.
Leading Management
Solutions helps medical practice leaders identify ways to improve operations to
increase revenue, employee engagement, and patient satisfaction. Learn more
about us at www.lmshealthpro.com.
About
the Author:
Sonda Eunus is the
Founder and CEO of Leading Management Solutions, a healthcare management
consulting company (www.lmshealthpro.com).
Along with a team of experienced and knowledgeable consultants, she works with
healthcare practice managers to improve practice operations, train employees,
increase practice revenue, and much more. She holds a Masters in Healthcare
Management and a BA in Psychology.
