Ten Challenges Medical Practices Can Expect in 2014

Medical practices face many challenges in 2014. Here are 10 of the biggest challenges your practice may face:  

1. Increasing emphasis on patient payment collections. Collecting patient payments is never easy, but in 2014 it may require even more of your staff. That's because many of the health insurance plans offered through the health insurance exchanges require patients to shoulder more of their healthcare costs. As a result, your practice may need to step up its patient payment collection efforts to ensure it is paid what it has earned.

2. More complicated collections. In addition to stepping up patient payment collections, your practice may need to step up payment collection tactics in general. Due to healthcare reform, many of you will encounter new patients that are newly insured. In addition, some of your established patients may change plans. As a result, staff members will need to spend more time educating patients about insurance and verifying coverage information. 

3. New patient relationships. As more patients gain access to insurance, practices that accept new patients will need to focus on building strong relationships with them. Practices will also need to keep in mind that many of the newly insured patients may have undiagnosed chronic conditions or conditions that have gone untreated for a long time. Both factors could place a strain on already time-crunched physicians.

4. Continuing reimbursement declines. According to Physicians Practice's 2014 Fee Schedule Survey (the full results will be released in February), average commercial payer reimbursement for all new and established office visits fell nearly 9 percent between 2012 and 2013. Many experts predict that this downward reimbursement trend will continue. 

5. Partnering pressure. The ongoing reimbursement decline will place more pressure on practices to partner with other practices or larger healthcare systems. In addition, value-based reimbursement models, in which practices may be able to gain higher reimbursement if they provide higher quality care at lower costs, tend to favor integrated healthcare systems.

6. Recruiting difficulties. According to estimates from the Association of American Medical Colleges, the United States faces a shortage of more than 91,500 physicians by 2020. Many health systems (especially those located in rural areas) are already feeling the pinch, and it's likely going to worsen as more patients gain insurance. For practices hoping to recruit new physicians in 2014, competition will be fierce.

7. The ICD-10 transition. In October, practices must make the ICD-10 transition. At the 2013 Medical Group Management Association Conference in San Diego, Robert Tennant, the association's senior policy adviser, referred to the transition as "probably the biggest challenge we in healthcare face since [President Lyndon] Johnson signed into law Medicare."

8. HIPAA headaches. In September 2013, the HIPAA Omnibus Final Rule went into effect. It included new compliance requirements, such as those related to business associate agreements and notices of privacy practices. But it's not just complying with new requirements that practices need to pay close attention to. As penalties associated with HIPAA breaches increase, practices must do all they can to mitigate the risks of a HIPAA violation. One key area that could become more of a challenge for practices: managing HIPAA risks that arise due to technology use. 

9. Low staff satisfaction. As practices face the above challenges, many will ask their staff members to take on more responsibilities. But they won't be able to pay them for that additional work. According to Physicians Practice's 2013 Staff Salary Survey, one-third of practices cut or froze staff salaries in the past five years, and most had no plans to give raises last year. To make up for lack of pay increases, practices must find new ways to keep staff morale high.

10. Low physician satisfaction. It's not just staff that will struggle with morale in 2014. According to Physicians Practice's 2013 Great American Physician Survey, Sponsored by Kareo, more private practice physicians are working longer hours than in the past, feel that they don't have as much time for their personal life as they should, and wish they could change workplaces. Since physicians are the leaders of practices, they must strive to keep their own morale high despite these challenges.

What other challenges will practices encounter in 2014? Share them in the comments section below.