The new outcomes-based reimbursement paradigm under the Affordable Care Act (ACA) doesn't really change the underlying fact that a physician's most valuable commodity is his or her time. No matter the specialty, income is still dependent on the number of patients seen and the complexity of the services provided.
According to a study by Medical Economics, primary care physicians (family practice and internal medicine) are working virtually the same number of hours they worked in 2013, yet incomes have dropped off significantly, due almost exclusively to the corresponding drop-off in number of patients seen.
Physicians and practice managers attribute the drop in weekly patient visits to a combination of additional administrative burdens on providers, difficulty with EHRs, and the new high-deductible insurance plans that keep patients out of the office for all but the most severe injuries and illnesses. Given that time is money for healthcare providers, it's clear that new approaches are needed to drive productivity and keep revenue up. These productivity boosters can help your bottom line.
1. Work to the Top of Staff Credentials
Research by Health Affairs shows that physicians in practices with a diverse mix of medical support staff and non-physician providers (NPPs) are more productive than those with less diversity in their patient care team. While this may seem obvious, the key is designing workflows that ensure each physician, NPP, and nurse is working to the top of his or her license and not performing tasks that non-credentialed staff can complete.
According to the Medical Group Management Association (MGMA), practices with NPPs do better financially than those without, and physicians in these groups have higher compensation. If your practice isn't located in one of the 22 states that give nurse practitioners full practice authority, make sure your workflows task them to the top of their credentials so that physicians aren't performing work for which they are overqualified.
Conversely, NPPs shouldn't be performing tasks a nurse is qualified to do, and nurses shouldn't be doing tasks a medical assistant can perform. Practices of every size should evaluate workflows and match credentialed and non-credentialed staff to tasks of appropriate complexity with an eye toward achieving an optimal mix of professional diversity.
2. Increase the Use Patient Portals
While EHRs and their occasionally onerous documentation requirements are a drag on physician productivity, patient portals are an effective way to offset some of this. The patient portal streamlines processes such as managing medication refill requests, disseminating lab results, handling routine billing inquiries, and exchanging secure messages between patients and staff. In fact, research showed a 30 percent decrease in call volume among practices who were diligent in introducing the technology to their patients.
Elizabeth Woodcock, an author and practice management consultant, suggests that front office staff actually introduce the technology to patients while they are in the office and walk them through its capabilities. She says practices who do these "enrollment drives" experience portal enrollment rates of 50 percent or more, well above average.
3. Workflow Mapping Audits
Tying items 1 and 2 together, the workflow mapping audits ensure that human and technology assets are in harmony to drive productivity instead of working against one another. Administrators and clinicians should evaluate:
- the patient visit from check-in to check-out
- the billing cycle from charge capture to payment posting
- the clinical process from ordering/completing tests to distributing results
Look for opportunities to maximize the benefits of your EHR; are you using secure messaging to deliver lab and test results, for example?
Productivity is not just a process, it's also a mindset, especially as you evaluate your office workflows. M-Scribe has solutions to improve processes in your revenue cycle; contact us today to see how we can help your practice.