Angela Watkins

Most physicians readily admit that classes on how to run a successful medical practice was not part of the curriculum in medical school. However, successful practitioners stress the importance of learning about the business end of health care. 

While you might hire a practice administrator or an office manager to put together a reporting structure, it is especially important for you to learn how to understand the basics. 

Without understanding information from financial reports, you might be missing key metrics that can lead to bad business decisions and result in the closing of your practice, noted Nick Fabrizio, PhD, principal consultant at MGMA Health Care Consulting Group. 

According to Fabrizio, financial reports provide key data points that can red flag potential financial problems. In addition, these reports can also shed light on areas to help grow your practice.	While "financial reporting," might not have been a class at your medical school, experts say you need to at least become familiar with understanding some of the basic reports. 

Slideshows

Just like your patient's vitals provide you with metrics for treatment plans, financial reports provide you with metrics on the "health" of your practice.

7 Financial Reports Your Practice Needs to Run

In 1999, as many as 15 percent of patient encounters were rated as difficult by the physicians involved, affording to FPM. Today, many physician practices report that number has grown to 30 percent."Patients can be difficult for several reasons. Some patients might have mental health disorders, which could lead to issues with behavior," said Michael Munger, MD president of the American Academy of Family Physicians (AAFP). "Other patients might be suffering from chronic pain and demand an increase in medication."Meanwhile, other patients, as noted by Dr. Munger, are feeling stress over financial factors, such as the loss of a job.Â  "With any interaction, it is important to know your patient, and know yourself," echoed John Cullen, MD, president-elect of AAFP.AdvertisementÂ No matter the reason, experts say the most difficult patients seem to fall into two categories:1. The angry patient2. The manipulative patientThese patients can put a strain on the physician/practice - patient relationship. According to Richard Cahill, associate general counsel with The Doctors Company, there should be clear guidelines on how to deal with myriad likely scenarios. Here are some tips on dealing with difficult patients.

Whether your patient is angry or manipulative, there are certain ways to deal with them. Here are eight strategies to employ.

8 Ways to Deal with Difficult Patients 

There's no shortage of practice management systems on the market. The difficulty becomes selecting the right system that makes sense for your practice and its future growth.

Heather McComas, AMA director, administrative simplification initiatives, says it all starts with creating a roadmap that will help you outline processes within your practice. Once those processes and touchpoints are defined, you can begin to identify those 'must-have' features for your practice.

In addition, CAQH, a non-profit alliance, created CAQH CORE, a multi-stakeholder effort that develops operating rules to streamline the most common business transactions in healthcare and drives market adoption. 

According to Gwendolyn Lohse, managing director of CAQH CORE, a CORE Certification is available for practice management systems. This can help produce information about patient insurance eligibility, copay, deductibles, year-to-date patient financial status, etc. in 20 seconds or less and match payments to services rendered.

So, other than looking for certification of a system, what are some of the features needed?

Why it's important that your practice management system can integrate with the EHR and six other features it must have. 

The 7 Must Have Features of a Practice Management System

The practice management system market is poised to reach $247.1 million by 2018, according to a 

 research report. With all advances in practice management system software available, physician practices are facing major investments.  

Some may be reluctant to buy into a new practice management system though. Robert Tennant, Medical Group Management Association (MGMA) Director, Health Information Technology recalls a response from one physician when he asked about the cost of a practice management system. The response, "Every dollar I spend comes out of my children's college funds." 

With the investment also comes opportunity to provide better patient care as healthcare transitions from volume to value, according to Heather McComas, AMA director of administrative simplification initiatives. "Some of today's systems align both the business and clinical sides of the practice," adds Gwendolyn Lohse, managing director, of the Council for Affordable Quality Healthcare (CAQH) and the Committee on Operating Rules for Information and Exchange (CORE)

With cost as one of the factors in selecting a practice management system, here are five steps to assist in selecting the "right" system for your practice:

Step 1:  Select an assessment team and create a roadmap

The team should include essential clinical and non-clinical employees.  The purpose of the team is to create a roadmap of the patient experience. "Think about your experience with patients from beginning to end – from the minute the patient calls in to patient billing and collections – and everything in between," explains McComas.

The roadmap serves as a worksheet for categorizing and prioritizing the workflow.

Step 2:  Designate which functions can be automated

This includes such administrative functions as billing and collections, claims submission, and patient scheduling. In addition, consideration should also be given to clinical functions, which would require the system's integration with the EHR software.

Notes Tennant, "Automation can help reduce errors and costs." It also saves time. Lohse reports that some providers can be assured that practice management systems that are Phase I or II CAQH CORE Certified (meet certain operating requirements regarding the exchange of healthcare information) can produce information about patient insurance eligibility, co-pay, deductibles, etc. in 20 seconds or less. Overall in the industry, "The shift from manual to electronic administrative transactions can save more than $9.4 billion each year and hundreds of administrative hours when addressing challenges like chasing down bad debit," says Lohse.

Step 3:  Network with boots on the ground

Once the roadmap is completed and approved, it is time to research and compare software. McComas refers to this phase as "networking with boots on the ground," explaining that this is the stage for connecting with your peers to find out what has been working for them. Both McComas and Tennant also suggest reaching out to associations, which offer seminars and networking opportunities.

Step 4:  Create a Request for Proposal (RFP)

"Because of all the variabilities in software, an RFP helps the vendor provide you with the system that is the best fit for your practice," explains Tennant. "It also lets you compare apples to apples." An RFP lets the vendor know your practice needs and which software can best fulfill those needs.

Tennant adds that the RFP should also contain information about your practice, including size and specialty. It also allows you to provide more direction to your vendor as well as ask questions, such as staff training processes and costs and typical schedule of software updates provided as part of the contract.

Based on your practice, assign a rating scale on which functionality is:

Once the RFPs have been returned, the assessment team should reconvene and review the information. The team should weigh system features, opportunities, and costs that will impact the practice.  For example:

1. Does it have the basic features needed?

2. Does it have the advanced features needed? (i.e. integration with electronic health records)

4. Does it meet HIPAA security and administrative simplification requirements?

5. Do upgrades require your practice to purchase a new version of the system?

Once a decision is made, establish a timeline that includes installation and staff training.

Articles

Cost will be a factor in selecting a practice management system, but it shouldn't be the only one. 

5 Steps to Selecting a Practice Management System 

The New England Journal of Medicine published a study in 2011 citing that 1 in 14 doctors face a malpractice suit every year. In addition, the study predicts" that almost every physician will face a malpractice suit during their career.Doug McCullough, Esq., assistant vice president claims for The Doctors Company, a physician-owned medical malpractice insurer, noted that in today's litigious society, "It's not a matter of if you will be sued but when you will be sued."Patients sue their physicians for many reasons, notes Richard Roberts, MD, JD, FAAFP, professor of Family Medicine at the University of Wisconsin Medical School and past president of the American Academy of Family Physicians (AAFP) and the Wisconsin Medical Society. He says, "Overall, doctors win about 8 â 9 times out of every 10 suits that go to verdict at a trial.Â  However, money might be paid (i.e., a settlement) up to half the time that is suit is filed. It depends on the specialty and the state."Regardless of the outcome, Ericka Adler, partner, Roetzel & Andress, observes that malpractice suits are often at the top of the list of major stressors for most physicians. "A lawsuit can affect career and patient care decisions. It can also have long-term effects, both emotionally and financially." A physician must stay strong during the arduous process.Here are tips on what to do if you are faced with a malpractice suit.Â Click here to download a PDF of this slideshow.

Have you gotten a notice that you are being sued for malpractice? Here are some steps you should take, experts say. 

What to Do When You are Sued for Malpractice 

Since Congress passed HIPAA in 1996, regulations addressing the use of technology for transmitting or storing health information data have changed. That's because the technology itself is constantly changing."Healthcare is not operating in the same environment it did just five years ago," observes Ericka Adler, partner, at Roetzel & Andress. Some examples include the usage of cell phones, the establishment of patient portals, etc. "Policies and procedures used by practices should reflect the usage of new technologies and updated to insure compliance," she adds.Â David Holtzman, vice president of compliance strategies at CynergisTek, urges practices to "aim for more than just being compliant." He explains practices need to be proactive and take advantages of the many seminars and on-line information that is available regarding data compliance.Here are eight tips to help practices effectively deal with changing environment of data security compliance.Â Click here to download a PDF of this slideshow.

Since Congress enacted HIPAA, it is constantly evolving to address the changes in how practices use technology. Here are eight ways to stay compliant with the law.