Finance

Physicians in general - and primary-care doctors in particular - are caught between the high aspirations of healthcare reform and the daunting realities of daily practice. This contradiction arises from the fact that, while physicians are expected to improve quality and prepare themselves for new reimbursement methods, many doctors feel like hamsters on a treadmill because the basic facts of practice life haven’t changed.

The plain fact is that Medicare accounts for a fifth of the nation’s total healthcare spending. Physicians who turn their backs on that are endangering the long-run financial health of their own practices. And, sooner or later, the government will have to fix the Medicare reimbursement formula.

In the current economic environment, physicians across the country may soon be facing pressure - not only from Medicare, but also from commercial payers - to lower their incomes substantially.

Executive editor Bob Keaveney speaks out against the pervasive practice of cost-profiling physicians.

Our fifth edition of PayerView uses real claims data to examine and rank payers based on financial and administrative performance, as well as efficiency. Here’s to friendly competition that helps docs get paid.

The importance of primary care in restructuring our healthcare system is widely recognized. As a current article in Health Affairs points out, avoidable hospital admissions for asthma and diabetes complications in the U.S. are twice the average for advanced countries, and that isn’t because the United States has a greater prevalence of these conditions.

Medicare is getting more aggressive with audits through its Recovery Audit Contractor program. Here’s how to assess your billing procedures to avoid audits, and establish a process for when a RAC does come knocking.

Plastic surgeon Eugene J. Strasser runs into trouble when an angry patient insists he bill Medicare for an elective procedure and he rightly refuses.

Coding is hard. It’s tedious. Yet it is how you get paid for the services you perform. So we asked the experts where things go wrong most of the time - and how to fix them.

It’s tough to get away from the office without worrying you’ll come back to a mountain of work. But taking time for yourself is crucial. Here’s advice on doing it right.

Advances in care delivery and technology are taking root now that could significantly change the way care is delivered in the future. Healthcare’s innovative thinkers and practitioners give us their predictions for the future.

Knowledge is power in the payer game. Expert Lucien Roberts explains how to evaluate your payers and then use that information to negotiate better reimbursements.

Major changes in the healthcare delivery system are coming, and they will affect every physician. The question is whether those changes will have the effect we all want or whether they will lead to unintended consequences that we don’t want.

The historic reform bill that Congress passed on Sunday will immediately affect physicians, but the impact will be much greater in the long term.

Many pundits have weighed in on the likely consequences of not passing healthcare reform, which is expected to come to a head within the next few days. But a recent blog post by Matthew Mintz, MD, an internist in Washington, DC, puts things in perspective for physicians.

Concerned about Medicare’s new Recovery Audit Contractors snooping around? Though your practice may not be affected by RACs for at least a year, the time to ready your defenses is now. Here’s how.

Consultant Susanne Madden offers a step-by-step guide to handling payer take-backs and not getting bullied into writing a check without researching the situation.

Most practices waste scads of money - then wonder why they need a microscope to see their bottom line. To keep you on the right road, we’ve posted the signs to a more efficient and productive practice.

Considering outsourcing the business side of your practice to a revenue cycle management firm? Let someone deal with the claims and collections headaches … right? Maybe. We examine the pros, cons, expenses, and benefits.

Economic woes continue to pinch practices, and that sometimes leads to hard staffing decisions. Here’s how to handle your staff with care when payroll goes under the knife.

A lingering recession and declining reimbursement make for stormy weather for practices. Check out our suggestions for how to stay dry - and in the black.

In this podcast, consultant Betsy Nicoletti explains the changes in CMS’ 2010 final physician fee schedule that could affect your practice.

New technology is supposed to reduce your staffing needs. But how do you get staff on board with a change that may end up costing some of them their jobs?

Laptop and PDAs have become the office-away-from-the-office for many. But physicians, especially, need to be aware of the potential security risk posed by a lost gadget. Protect sensitive data with encryption software - before it goes missing.

Hospital-doctor bundling schemes are a near-certainty in any healthcare reform. Will physicians get the short end of the stick?

The worsening economy is taking its toll even on the best practices.

You’ve got questions - lots of ’em. And we’ve got the answers. We compiled some of the most common practice management questions we hear - from collections issues to dealing with staff problems and so much more - in one place, and got answers from some of the top experts in the business.

The best measure of physician productivity is the “relative value unit,” or RVU. But a physician trying to figure out how much she’ll be paid under this system doesn’t know where to start, or even what an RVU is. Here’s help.

With the recession lingering on, many practices are feeling the sting of unfilled appointments caused by patients who have lost their jobs and insurance coverage.