1.800.360.0603

GE Healthcare Camden Group Insights Blog

Is Your Medical Group Performing at Peak Efficiency?

Posted by Matthew Smith on Nov 30, 2016 11:40:05 AM

Is-Becoming-a-Physician-Right-for-You.jpgHaving a high-performing medical group affiliated with your system is more important than ever. Physicians are vital not only to the success in the medical group, but across the continuum of care. However, running a medical group is getting more and more challenging. Reimbursement increases are not keeping up with rising costs, government regulations are increasing, payment models are shifting from volume to value, physicians are harder to recruit and retain, there is increased competition from new providers such as retail, concierge, and tele-providers, and patient expectations for access and service are at an all-time high. 

If you have recently found yourself asking the following questions, rest assured that we have the right answers:

How do we improve the financial performance of our medical group operations? 

  • We found $19 million in bottom line improvement for a 600-physician medical group.

How do we improve patient access and efficiency? 

  • By redesigning work flows in a large primary care and urgent care network, we reduced the time physicians spent on administrative tasks and rework by more than one hour per physician per day.

Can we make our recruitment process smoother, so physicians achieve maximum effectiveness faster?

  • We redesigned a health system’s physician recruitment and onboarding strategy, saving over $1,000,000 in non-productive physician wages during the first year and an additional revenue gain of $780,000 from reduced timeframes between start-date and enrollment date.

How do we get our employed physicians energized around the success of our medical group? 

  • We created a new governance and management model for a hospital-employed group that actively engaged physicians in the strategy and operations of the medical group and designed a physician leadership development program to help support new physician leaders

Can we align our physicians’ incentives with those of our organization? 

  • We facilitated the development of new physician and mid-level compensation plans that support performance under new payment models by incentivizing quality outcomes, access to care, efficiency, and patient loyalty.

Is it possible to facilitate the collaboration our physicians seek, while positioning them for greater market success?

  • We recently merged seven cardiology groups into one new medical group, including legal structure, governance, management, compensation, and operations. 

GE Healthcare Camden Group has been helping improve the performance of medical groups since 1970. Our consultants include experienced practice administrators, physicians, nurses, revenue cycle managers, care coordinators, EMR experts, change management experts, and Lean trained performance improvement specialists.

We would welcome an opportunity to speak with you regarding your physician enterprise and how we might be able to help you answer your specific questions. 

To contact our physician services experts, please click the button below and complete the short form. Our team will follow up with you at our first availability.

Medical Group, Efficiency

Topics: Aligned Incentives, Employed Physicians, Medical Group, Physician Services., Medical Group Efficiency

5 Tips to Maximize Financial Performance in Owned Physician Practices

Posted by Matthew Smith on Sep 22, 2014 12:15:00 PM
By Lucy Zielinski, Vice President, Health Directions

Employed Physicians, Owned Physician Practice, Revenue CycleThe trend to acquire physician practices remains as strong as ever, yet many hospitals struggle financially after making the move. The median loss for employing a physician in 2012 was $176,463, according to a 2013 report from the Medical Group Management Association, its latest on the subject, while the average loss on an employed internist is $222,786. For a hospital that owns just 25 medical practices, that could translate into well over $3 million in losses annually.

How can hospitals minimize losses on newly acquired medical practices? In addition to setting realistic financial goals and benchmarks for hospital-employed physicians, much can be learned from the management techniques that have been proven most effective at helping private medical practices reduce losses and achieve stronger profitability.

At the core of an employed physician practice turnaround are performance goals that keep physicians focused on profit and loss and that are aligned with the physicians' professional aspirations. Strengthening collections processes also is critical. Most important, both providers and staff require a structure of accountability to keep improvements on track.

To apply these private-practice turnaround techniques to employed physician practices, hospitals should focus on five targeted interventions.

Help the Practice Develop a Vision and Strategy

With growing competition from walk-in clinics, a physician can no longer build a medical practice by simply hanging out his or her shingle. This reality is especially true for a hospital-owned practice, which can languish if not actively marketed. To create a strong patient base, a medical practice needs to be consciously differentiated from its competitors and promoted.

The first step is to help the physician clarify his or her professional aspirations. For example, a physician might have a strong personal interest in caring for diabetic patients. The physician's vision might be to create a practice that specializes in providing excellent diabetic care, with emphasis on careful patient tracking, self-management, and evidence-based interventions.

Notice two things about this vision: First, it has strong potential for connecting with a large patient base, and second, it allows the physician to work on something he or she is passionate about, setting the stage for strong productivity.

There are many possibilities for identifying an effective vision. One physician may love working with young families. Another may be driven by wellness care for women. Each vision can be realized through a tailored set of development strategies, and each offers high potential for building a productive practice.

Once the vision is in place, the physician will require help in focusing on development strategies. For a practice emphasizing diabetic care, enhancements could include hiring a nutritionist, adding appropriate testing services, upgrading patient registry software, and starting a diabetic support group. Marketing strategies could include public diabetes education talks and reaching out to specialists for referrals.

Recreate "Ownership" Incentives

A common early effect of becoming hospital employees for physicians is a diminished personal drive to improve practice profitability. To counter this effect, physician compensation should be tied to the practice's bottom-line performance.

One approach is to base physician pay on practice revenue, with compensation equaling a percentage of collections. The problem with this approach is that physicians are not responsible for net profit or bottom-line performance. An effective variation is to tie compensation to practice profitability. The advantage of this technique is that it creates individual responsibility for expenses.

It is important to balance individual versus group-focused incentives. Many hospitals negotiate individual contracts with each employed physician, inadvertently promoting an attitude of "every man for himself" that can undermine the practice's success. Another important first step, therefore, is to create meaningful group goals. One possible approach is to tie 60 percent of physician compensation to individual productivity and 40 percent to group objectives, such as total net collections.

Provide Performance Targets

Private practice turnarounds have been shown to work best when overall financial goals are broken down into specific performance targets for providers and staff. This step is equally important for employed physicians.

Targets for physicians should be built around metrics such as patient visits and charges-metrics that allow providers to make a direct connection between their work and financial outcomes. Such targets are key to the success of compensation plans that are based on productivity and revenue.

Physicians whose pay is based on practice profitability should also be aware of expenses. Many physicians in private practice gauge practice spending by their bank statement balance, not a spending plan. Hospital-employed physicians should understand the practice's budgeted expense categories and help control spending where needed.

Design Effective Front-End Processes

Medical practices routinely lose 15 to 25 percent of potential revenue through a combination of lost charges, high denials, missed copayments, and other uncollected balances. Hospital finance managers can help physicians reduce these losses by establishing sound revenue cycle processes on the front end, specifically in the following three areas.

Patient eligibility. In this economy, many patients are switching jobs and many employers are switching health plans. Every time an appointment is scheduled, staff should verify insurance to ensure eligibility on the service date. Consistent verification helps to prevent future denials and costly rework.

Charge capture. Generally, charges should be set at about 200 percent of Medicare rates for primary care practices and potentially higher for surgical practices. However, fees should also take into account factors such as the local market and payers. To ensure full charge capture, charge tickets should be completed by the provider (electronic medical records help capture charges quickly and accurately). Processes should be in place to ensure charges are submitted to the payer on the same day of service-for a practice that generates $50,000 a month, a one-week billing lag can delay cash flow by more than $10,000.

Point-of-service collections. A clear financial policy should be established, and shared with all patients, requiring collection of patient copayments and past-due balances at the time of service. Office staff should have a clear set of daily payment goals and receive training to post payments at the time of service.

Hold Monthly Check-Ins

Performance targets are important, but they cannot work without accountability. To help keep practice performance on track, monthly check-in meetings should be conducted with physicians and practice staff.

The hospital should use the short meetings to review performance indicators, check them against the practice's goals and industry benchmarks, and look at long-term trends. Checkpoints should include budget variance reports and metrics for productivity, billing, and overall financial outcomes.

Giving physicians a monthly numbers report without reviewing its meaning is not only useless, but also creates a mindset of neglect. Physicians absorb financial information more easily when it is presented visually, so bar charts should be used to present revenue and profit trends. An effective check-in meeting provides the opportunity to identify performance shortfalls, investigate causes, and come up with solutions.

For example, say the hospital is reviewing charges for a three-physician practice, where the charge report shows monthly totals of $74,000 (Physician A), $72,000 (Physician B), and $59,000 (Physician C). Investigating why Physician's C's charges are so low could lead to an examination of issues such as charge capture practices and patient mix. Most important is to compare Physician C's practice patterns with those of his or her peers. Relatively simple adjustments to workflow can often increase charges considerably.

The value of these five turnaround techniques is that they engage employed physicians in the financial success of a hospital-owned practice. Used on a consistent basis, they can help hospital leaders maintain an employed practice network as a financially sustainable enterprise.

Employed Physicians, Employed Physician Practices


Topics: Employed Physicians, employed physician practices, Healthcare Finance, Hospital Employment, Hospital Physician Employment, Employed Medical Practices

Infographic: What Factors Drive Physician Employment?

Posted by Matthew Smith on Sep 21, 2014 11:51:00 AM

With expenses like payroll, record-keeping and insurance, it's no wonder that many physicians seek employment with hospitals or health centers rather than opting for their own private practice.

This infographic from staffing company CompHealth highlights what makes hospital employment attractive to today's physicians.

Physician Hospital Employment

Topics: Employed Physicians, employed physician practices, Healthcare Finance, Hospital Employment, Hospital Physician Employment, Employed Medical Practices

A Profile of Physicians' Practice Environments & Ownership Status

Posted by Matthew Smith on Jul 18, 2014 4:17:00 PM

Survey, Employed PhysiciansFollowing are the results of physicians' employment and ownership status, according to a survey by Jackson Healthcare, a healthcare staffing company. The survey examined practice environments (including participants' employment and ownership status) as well as practice capacity and workload.

The survey data is based on responses from 1,527 physicians gathered between April 18 and June 5, 2014.

Practice Environments

Here is a breakdown of participants' employment and ownership status:

    • Hospital Employee (21 percent)
    • Solo Practice Owner (21 percent)
    • Ownership Stake in Single-Specialty Practice (17 percent)
    • Single or Multi-Specialty Practice Owned by Hospital/Health System (14 percent)
    • Employed by Privately Owned Single or Multi-Specialty Practice (14 percent)
    • Independent Contractor or Locums (9 percent)
    • Ownership Stake in Multi-Specialty Practice (4 percent)

    Specialists most likely to own a solo practice include:

    • Dermatologists (55 percent)
    • Ophthalmologists (43 percent)
    • Behavioral Health (34 percent)
    • Women's Health (29 percent)
    • Primary Care (28 percent)
    • Musculoskeletal (27 percent)
    • Surgery Subspecialists (22 percent)

    Primary Care Statistics

    The number of hospital-employed primary care physicians increased from 10 percent in 2012 to 20 percent in 2014. And the number of primary care physicians with an ownership stake in a single-specialty practice decreased from 12 percent in 2012 to 7 percent in 2014.

    When asked why they chose hospital employment over private practice, 37 percent of physicians said they did not want to deal with the administrative hassles of owning a practice. Thirty-three percent said they wanted to be a doctor, not a businessperson. Overall, the lifestyle that employment offers is the underlying factor driving physician preference.

    For physicians who left private practice, the majority attributed their decision to high overhead costs. Reimbursement cuts, lack of resources to comply with ACA requirements and the administrative hassles of ownership were other significant reasons cited.

    Practice Capacity & Workload

    When asked if their medical practice was at capacity, half said yes and half said no. This has remained unchanged since 2012.

    The medical practices of behavioral health and internal medicine subspecialists were more likely to be at full capacity. General surgeons, pediatricians and surgery subspecialists were least likely to be at full capacity.

    The majority of physicians surveyed (61 percent) work between nine and twelve hours per day. Eighteen percent reported working eight-hour days.

    The following are mean numbers from this year's survey:

    • Patients seen per day: 22
    • Minutes spent with each patient: 20
    • Patients seen/rounded on during hospital shift: 13
    • Surgeries on surgery day: 5

    Topics: Employed Physicians, Survey, Physician Employment, Practice Environments

    New Report Lists Physician Pros and Cons of Hospital Employment

    Posted by Matthew Smith on Mar 19, 2014 4:53:00 PM

    Physician Employment, Employed PhysiciansAccording to the Medscape Employed Physicians Report 2014, most hospital-employed physicians are content with not running the day-to-day business of running and operating a medical practice, but 45% say that they miss having some input in the decision-making process. 

    Physicians were asked to list the top three disadvantages and the top three benefits they find in hospital employment. The findings are as follows:

    10 Top Disadvantages

    Limited influence in decision-making — 45%
    More limited income potential — 44%
    Too many rules — 34%
    Less control over work/schedule — 32%
    Being "bossed around" by management — 30%
    Less/lack of autonomy — 27%
    Too much administrative work — 16%
    Burdensome productivity formula — 14% 
    Unpleasant office culture — 11%
    Less interesting work — 5%
    Other — 6 percent

    10 Top Benefits 

    Not having to deal with the business of running a practice — 58%
    Not having to deal with insurers and billing — 45%
    Guaranteed income and/or even cash flow — 42% 
    Good benefits package — 28%
    Malpractice coverage — 25%
    More regular hours — 23%
    Limited or no night call duties — 17%
    Collegiality — 16%
    Staff provided by employer — 15%
    Signing bonus — 2%
    Other — 4%

    Medscape surveyed more than 4,600 physicians for the 2014 report.
     
    Employed Physicians, Employed Physician Practices

    Topics: Employed Physicians, Hospital Employment, Hospital Physician Employment, Hospital-Physician Collaboration

    Physician Employment Continues to Grow | Up 33% Since 2000

    Posted by Matthew Smith on Jan 21, 2014 4:39:00 PM
    Via Kansas City Star

    Independent Physicians, Employed PhysiciansQuickly and quietly, hospitals across the country have been buying up hundreds of doctors’ medical practices and hiring thousands of formerly independent physicians.

    Since 2000, the number of doctors on hospital payrolls nationwide has risen by one-third, according to the American Hospital Association.

    The future solvency of the nation’s health care system may rest on how doctors adapt to a corporate style of medicine and on whether hospitals put the doctors to work improving patient care or fattening the hospitals’ bottom lines.

    The hope of the Obama administration, as well as many independent health care experts, is that hospital systems will use their new employee-doctors both to keep people healthier and save money by preventing unnecessary trips to emergency rooms.

    It’s far from clear whether those goals will be realized.

    What is certain:

    • Hired doctors already are bringing hospitals billions of dollars in revenue by funneling patients to their services. There’s enough money at stake, and a great enough concern about monopoly power over health care markets, to draw the attention of federal government watchdogs.
    • As they buy out independent doctors and acquire their clinics, many hospitals are tacking “facility fees” onto those employee-physicians’ bills. For Medicare patients, these fees can bump up costs by 70 percent compared to the bills for basic office visits to independent doctors.
    • Young physicians are embracing hospital employment for a variety of personal and financial reasons, while older doctors are selling their practices out of frustration over declining payments for their services. Some observers say we’re seeing the death of independent medical practices.

    The trend is playing out across the country, particularly in growing suburbs with well-insured residents like Overland Park, KS, Spartanburg, SC, and Phoenix, AZ,where hospitals have been buying up large independent practices.

    Other hospitals, like the Cleveland Clinic and Heartland Regional Medical Center in St. Joseph, have been hiring physicians to staff new outpatient facilities in direct competition with independent doctors.

    “No one wants to be left out,” said Joy Grossman, a senior health researcher with the Center for Studying Health System Change, a Washington think tank. “It becomes a war between hospitals to acquire practices.”

    Fueled by Referrals

    For hospitals, the spoils of that war begin with referrals.

    It’s a business model adopted by hospitals across the country: Hospital-employed primary care doctors refer patients to the hospital’s employed specialists, who admit the patients to the hospitals that employ them.

    As those patients make their way through, the employed doctors order their tests, lab work, MRIs, surgeries and other lucrative services through their hospital system. By one estimate, these revenues average $1.5 million a year per physician.

    Hospitals with strong exclusive networks of doctors have far greater leverage than independent doctors to negotiate higher payments from insurance companies. Costs can soar where hospitals command large shares of the market.

    “We see it every day in hospitals across the country. They use their clout to increase prices for physicians,” said Robert Zirkelbach, vice president of America’s Health Insurance Plans, the industry’s trade association.

    “When a hospital buys a practice, its rates will increase in the following year’s contract. Increases of 20, 30 or 40 percent are not uncommon. It’s not 3 or 4 percent, that is for sure.”

    Hospitals Doing Most Recruiting of Physicians

    Each year, the physician search company Merritt Hawkins tracks efforts to recruit physicians into different types of medical settings, including hospitals, group practices, physician partnerships and community health centers. Increasingly, it’s hospitals that are doing the most recruiting.

    Hospitals’ percentage of all physician search assignments

    2004: 11%

    2005: 19%

    2006: 23%

    2007: 43%

    2008: 45%

    2009: 45%

    2010: 51%

    2011: 56%

    2012: 63%

    2013: 64%

    Source: Merritt Hawkins

    Independent Practice, Independent Physician, Physician Practice, Allied Physician

    Topics: Employed Physicians, employed physician practices, Employed Medical Practices, Independent Physicians, Affordable Care Act, Independent Physician Practice

    Discount Available for HFMA's Chicago Seminar Featuring Health Directions

    Posted by Matthew Smith on Nov 27, 2013 9:56:00 AM

    Health Directions, Speaking, Clinical IntegrationHealth Directions is excited to present two sessions at this year's Healthcare Financial Management Association's (HFMA) Chicago Seminars. Attendees may choose between 1, 2, and 3-day options for the Seminar held December 10-12 at Chicago's Swissôtel Chicago (323 E. Wacker Drive, Chicago, IL 60601).

    Health Directions clients and blog readers/subscribers are entitled to a 20% registration discount. If you are interested in attending the Fall Session in Chicago and would like to obtain the discount code, please email Matt Smith at msmith@healthdirections.com. Discounted registrations may only be made via phone with HFMA. 

    These popular sessions provide timely strategies and metrics to help you keep pace with the changes reshaping American health care, while enhancing your professional development. Seminars are offered in three categories:

    • Revenue Cycle, Reimbursement, Compliance

    • Business Intelligence & Performance Improvement

    • Clinical Alignment & Delivering Accountable Care  

    All seminars take place from 8:00 a.m. to 3:15 p.m. each day. Fees include a workbook for each seminar you attend, a continental breakfast, lunch, and break refreshments.

    Health Directions' seminars are listed below.

    Building the Infrastructure to Deliver Accountable Care and Clinical Integration

    Learn about effective governance, payer contracting strategies, physician engagement, e-health strategies (including EHR and HIE components), clinical quality measures—such as value-based purchasing—and how to develop a program infrastructure and team to succeed in your organization and market.

    Health Directions Speakers: Daniel J. Marino, President/CEO

    Organization: Healthcare Financial Management Association

    Dates: December 12, 2013; Chicago, Illinois

    _______________________________________________________________

    Maximizing Financial Performance of Employed Physicians

    With physician employment as a strong trend, it’s key to understand how to address distinct challenges to onboarding and maximizing performance of employed physicians as they transition from independence to employed medical groups. This seminar provides a comprehensive checklist of key requirements, essential processes, and opportunities for successfully onboarding and maximizing the performance of employed physicians.

    Health Directions Speakers: Lucy Zielinski, Vice President; Sabrina Burnett, Vice President

    Organization: Healthcare Financial Management Association

    Date: December 10, 2013; Chicago, Illinois

    _______________________________________________________________

    Discounted Rates:

    The following rates reflect the 20% discount for Health Directions clients and blog subscribers:

    1-Day Registration: ($592 members/$700 nonmembers)

    2-Day Registration ($947 members/$1162 nonmembers)

    3-Day registration ($1294 members/$1632 non-members)

     

    Questions? Please please email Matt Smith at msmith@healthdirections.com.


    Topics: Accountable Care, Clinical Integration, Employed Physicians, HFMA, Daniel J. Marino, Healthcare Financial Management Association

    Infographic: Highlights of Medscape's Physician Compensation Report

    Posted by Matthew Smith on Aug 2, 2013 10:00:00 AM

    Medscape Physician Compensation Report, Infographic, Physician CompensationThe 2013 Physician Compensation Report, published by Medscape, reveals physicians' most current salary and earnings trends by medical specialty.

    This comprehensive report, with new questions and insights this year, represents data from nearly 22,000 US physicians across 25 specialty areas. It provides rarely-shared information on personal income, patient load, time spent per patient, attitudes toward insurers, and much more.

    Key takeaways include:

    • 2012 compensation statistics
    • Compensation by geographic area
    • Compensation by practice setting
    • Participation in various payment models
    • Hours spent with patients per week
    • Number of patient visits per week
    • Satisfaction by speciality

    Click here to view the complete slideshow at medscape.com. 

    Highlights of the report are included in the infographic, below:

    Physician Compensation Report, Medscape, Employed Physicians

    Employed Physicians, Employed Physician Practices

    Topics: Employed Physicians, employed physician practices, Independent Physicians, Physician Compensation

    Download: Transitioning Employed Physicians--Maximizing Financial Performance

    Posted by Matthew Smith on Jul 31, 2013 4:30:00 PM

    Employed PhysiciansHow much money do hospitals lose on employed physicians? According to the New England Journal of Medicine,operating shortfalls range from $150,000 to $250,000 per provider during each of the first three years of employment. But for many hospitals, these initial losses are just the tip of the iceberg.

    Mistakes that occur early in the physician employment process can add to hospital costs while decreasing long-term revenue. For example, poor financial modeling can mask future problems with practice expenses. Missteps in contracting and billing can reduce practice payments. Misaligned incentives can permanently suppress practice revenue. All told, these early mistakes can swell the total cost of physician employment. Hospitals that pursue even a modest employment strategy can easily lose several million dollars per year.

    How can hospitals avoid excessive financial losses? 

    This new presentation from Health Directions provides a comprehensive overview of the key requirements, processes, and opportunities for successfully onboarding and maximizing the performance of employed physicians.

    Objectives include:

    • Provide an overview of the industry trends relating to physician employment
    • Introduce a “concierge approach” for successfully onboarding physicians
    • Review available incentive programs for employed physicians
    • Present key performance indicators for employed physicians

    Simply click the button, below and complete a short form, and you will be directed to the presentation that you may view or download by right-clicking and saving to your computer.

    Employed Physicians, Employed Physician Practices

    Topics: Employed Physicians, employed physician practices, Employed Medical Practices, Practice Management

    Infographic: Physicians Cite Challenges to Practice Profitability

    Posted by Matthew Smith on Jun 3, 2013 10:29:00 AM

    Infographic, Healthcare, Health DirectionsPhysicians are almost two-thirds more likely to foresee a negative profitability trend, rather than a positive one, in the year ahead according to recent research report by cloud-based health technology provider,CareCloud and QuantiaMD, online and collaboration physician platform. The findings gathered through online surveys and related discussion groups report an overall downtrend in profitability among US physician practices with reform requirements as the leading source of financial burden.

    Declining reimbursements, rising costs, ACA, coding/documentation changes including ICD-10, and EHR adoption were identified as having the most negative impact on practice profitability. Despite these challenges, the report concludes that most physician practice owners want to stay independent. Physicians also identified improved billing and technology as the greatest keys to improving the financial performance of their practices.

    Background

     The Practice Profitability Index (PPI) was created to provide a voice to US physicians practices about issues that impact their financial performance and operational health. 5,012 physicians contributed their insights to the PPI during April of 2013 and, functions as a barometer for the operational and financial health of private practices in 2013. The 2013 report identified a confluence of challenges that make staying profitable increasingly difficult for physician practices today.

    Key report findings include:

    • 1-in-3 physicians see overall profitability trending downward in 2013
    • 65% say declining reimbursements are the greatest threat to profitability
    • 59% spend at least one day per week on paperwork instead of treating patients
    • 48% say they lack the resources to accept any of the 30 million new patients from the ACA
    • Only 9% are very confident in their current processes for getting paid
    • Plus, profitability data is broken down by state, specialty and more…

    Some of key data points in the report have been highlighted in the infographic visualization shown below:

    Infographic, Practice Profitability, Practice Management

     

    Strategic Provider Planning, Specialty Mix

    Topics: ACA, Employed Physicians, employed physician practices, Employed Medical Practices, ICD-10, Coding, Practice Management

    Subscribe to Email Updates

    Value Model, Health Analytics

    Posts by Topic

    Follow Me