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.
2. 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.
3. 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.
4. 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 atwww.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.