There are many challenges involved in running a medical practice today – from paperwork and administrative work, EHR use and prior authorization to government regulations, rising costs, declining reimbursements, and negotiating with payers. Relying on an experienced medical billing and coding company is a practical option to submit accurate and timely claims. Experts say that there many things that physician practices can do to stay competitive and financially fit. Experts recommend the following strategies to boost medical practice revenue growth:
- Know where to focus attention: Practices need to focus attention on the specific area or areas that are lagging. In a recent Medical Economics article, one expert recommends that physicians should first compare their financials and benchmark to that of similar-sized practices. This will give them a clear idea as to how they rank and if their performance meets the standards of an average practice. Things to examine include: the number of patients seen per day, the average reimbursement levels, and revenue per provider. Practices can improve their financial performance by focusing on the right areas.
- Improve the patient experience: Consumer engagement has become increasingly important for the healthcare industry. In a 2018 Black Book survey, up to 92 percent of healthcare consumers said that improving customer experience should be a top strategic priority for medical providers (www.healthcarefinancenews.com). Today’s patients are seeking an overall satisfactory digital experience with personalization, various virtual access points, online scheduling, online payment options, and price transparency. This implies that to stay competitive, practices need to innovate and focus on meeting consumer needs and improving the consumer experience.
- Consider adding staff: Adding staff can increase operating expenses, but it can increase patient capacity, according to Medical Economics. The growing burden of chronic conditions has increased the complexity of care, and practices need to build a staff that can deal with all patient needs. For example, hiring a nurse practitioner can help primary care physicians see more patients in a day. Non-physicians providers and staff are also crucial to practice efficiency. The Medical Group Management Association reported that an analysis of U.S. medical groups found that hiring more non physician providers and support staff can drive practice profitability and productivity, (www.fiercehealth.com). Having support staff to manage patient messaging, prescription refills, and lab reports frees up physicians to spend more time with patients. Consultations can be improved with the help of scribes or medical transcriptionists. Adding non-physician providers can improve office efficiency, finances and patient satisfaction.
- Take steps to eliminate inefficiencies: Inefficiencies in the medical practice can lead to errors and waste of time, reduce productivity, and annoy physicians, staff, and patients. Proper time management is crucial to avoid backlogs and increase the number of patients that can be seen in a day. From the front office to the back office, there could be immense scope for improvement. Busy telephone lines are a common concern in small practices. While multiple phone lines can help keep patients from getting a busy signal, they need to be properly staffed. Practices need to look out inefficiencies, inaccuracies, long wait times and a lack of personal service caused by phone systems. Asking patients for feedback would be a good idea.
The layout of the office can also affect productivity if the physician has to waste time walking between exam rooms (www.medicaleconomics.com). Optimal design would be one that allows both physicians and patients navigate their way around easily, without wasting time.
Efficient patient scheduling is another key aspect when it comes to office efficiency and revenue. The goal should be to balance between seeing a sufficient number of patients to meet the financial needs of the practice while providing quality patient care. This can be achieved with the right mix of patients with chronic conditions and those with simple concerns.
- Generate revenue via value-based contracting: Value-based programs compensate physicians with incentive payments for the quality of care they give Medicare patients. To take advantage of these incentives, providers need to evaluate Medicare’s value-based principles and measures and determine their potential earnings. They would have to focus on developing high quality, transparent, and secure data reporting capabilities as well as standardized processes and internal controls to reap the benefits of value-based reimbursement. Handling value based opportunities efficiently can boost revenue.
- Negotiate higher rates with payers: Physicians should negotiate favorable contracts with commercial payers. Understand the value that that practice offers the payer, show that value, and ask for more money based on that. Here are some expert recommendations on this:
- Before negotiating with payers, organize your data. Analyze the fee schedule of all your payers and know your break-even point. An organized and well-documented data analysis would help the payer recognize the value your practice brings to its members.
- Perform an analysis of the practice’s “SWOT” (strengths, weaknesses, opportunities, and threats) status before meeting the payers.
- Share practice data that shows compliance and improved outcomes. If you are reporting quality data for HEDIS measures, show that data and negotiate rates based on that.
- Demonstrate your value by showing how your services/offerings differ from that of competitors. You can also ask more money if you are seeing more patients because your practice opened an additional office location, if your volume of patients has increased over time, or your practice offers extended hours or weekend clinics that help avoid costly emergency room visits.
- State that the costs of running the practice have gone up. You can negotiate a higher rate by showing that costs such as medical malpractice premium, rent, staff health insurance, and staff salaries have gone up.
- Back up your data with positive patient reviews.
Negotiating payer contract rates requires knowledge of coding, billing, and the reimbursements rates. Medical billing and coding companies have this knowledge and can help physicians negotiate with payers and get the most out of every claim. Coders can identify the services/procedures that the practice bills most frequently and also solve common payer-specific barriers to getting paid.