As a medical practice manager or executive, what does your job entail today? Are you a billing and coding expert? Are you implementing an EHR in your practice? Do you educate other staff about HIPAA compliance? Your profession requires you to be an expert in human resources, financial management, business operations, governance, patient care systems, and risk, information, and quality management. You are the educator, implementer, coach and manager.
There is unprecedented change occurring in our industry and this may require straying from the way you've typically conducted business. You have to determine more efficient and effective ways to manage your medical practice and enhance the way you serve patients. Medical practice executives are paving the way and doing business differently in this changing healthcare environment. You are an integral part of the healthcare framework and this transformation offers opportunity to forge ahead and reinvent your profession.
Here are six reasons to think about your job and the business of care delivery differently.
1. Patient care delivery models are evolving.
There are many new ways in which providers and organizations are formally and informally collaborating and integrating. Medical practice executives can evaluate options, and strategically guide alignments that will be beneficial for your practice. There isn't a one-size-fits-all model for success, but certainly, exploring new ways in which to deliver care and serve your community will be paramount moving forward.
2. Quality measures will impact future reimbursement.
According to the Medical Group Management Association's (MGMA's) Physician Compensation and Production Survey: 2013 Report Based on 2012 Data, physician compensation has begun to include quality and patient satisfaction components. Payment mechanisms are changing as healthcare moves to value based reimbursement.
3. Clinical and business operations are more integrated.
Collaborations between clinicians and medical practice executives will be crucial to adapting to new payment and care delivery models. In this new environment, practice executives will design and facilitate patient care systems that leverage technology, focus on chronic disease prevention and management, and seamlessly integrate the business and clinical operations of the practice.
4. Patient expectations and needs are changing.
Caring for patients doesn't just take place in your office. It's crucial to coordinate your patients care across multiple settings and around the clock. Consider a patient who has uncontrolled Type 2 diabetes; she is at risk for her disease progressing and may need increasingly complex, invasive, and costly care for her disease. This patient will likely have a completely different experience in the future when the intake staff will know why she's visiting and what tests she may need. They'll have communicated with her other providers and will know her up-to-date status from her shared records. Her lab results will be automatically available to her clinician and she can see her test results and keep track of her appointments on her own computer or mobile device. She can choose to meet with a registered dietician or attend a group visit with patients with her condition. Not only are patient's needs changing, but they will expect a coordinated care plan in the future.
5. Coding changes will require optimized technology and documentations.
The upcoming transition to ICD-10 will change your current billing and coding procedures and will likely require updates to your practice management system and electronic health record. Medical practice executives will be identifying and implementing these new processes and infrastructures. The goal of this coding transition is to replace outdated and obsolete terms that are inconsistent with current medical practices. ICD-9 codes have limited data about patients' medical conditions and hospital inpatient procedures. Although the transition will be costly and rather difficult for practices to undertake, it will be especially important to access data in new and meaningful ways, to serve your patient population more effectively and provide data to make informed business decisions.
6. Patients are empowered.
Your patients are engaged in their medical care and more empowered than ever before. They want to be involved in their care and they are looking for guidance and expertise from their clinicians and healthcare community. As there is an entire business and structure behind effective care delivery, practices are working to improve their patients' experience and satisfaction with their visits beyond the time spent with the clinician.
There are many reasons to think about your profession differently. With immense industry change comes opportunities to think outside the box, and determine ways to position your practice for success in a value-based care environment. So while you're already an educator, a manager, and an implementer, consider innovative ways to collaborate with clinicians and enable better patient experiences. Leading this charge will make you a trendsetter. An innovator. A trailblazer. A pioneer.
Susan Turney, MD, MS, FACP, FACMPE, is the president and CEO of Englewood, Colo.-based MGMA. An internist, Turney has broad experience with both practice management and association management. She is also a featured speaker at the inaugural Business of Care Delivery Conference in March 2014. E-mail her here.