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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

Having 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

Becoming the Practice of the Future Today: 10 Steps to Transform Your Practice and Provide Individualized Care

Posted by Matthew Smith on Oct 6, 2015 11:23:51 AM

By Susan Corneliuson, MHS, FACHE, Senior Manager, GE Healthcare Camden Group

Current business and care delivery models, even if combined with innovative or sustainable technologies, will not lead to future success. Practices must create new care delivery and business models while incorporating technological advances to effectively compete today and in the future. New payment models, disruptive technology, and care delivery vehicles (e.g., e-visits, home monitoring, retail clinics), along with changing consumer demands for immediate access and transparency, require medical practice transformation. Here are the top 10 steps you should be taking now to transform your medical practice in order to succeed now and in the future.

1. Create a profile of your current and potential patients

Who are they (e.g., age, sex, payer mix)? What is their health status? What are their priorities for their healthcare (e.g., convenience, access, relationship, continuity of care)? How do they want their care delivered? Perhaps through e-visits, urgent care, face-to-face visits, telemedicine, or e-mail? How do they want to communicate (e.g., e-mail, texting, phone, patient portal, face-to-face encounters)? Identifying who your patients are will allow you to tailor your practice to meet their needs.

2. Assess your market

What are the demographics (e.g., ages, sex, income, health status) of your service area, and how fast is it growing? What do consumers want from their physicians? What do employers want from providers? Where are payers going with their payment models? What are your competitors doing to position themselves for the future? Who else might come into your market? Market knowledge should inform your practice redesign efforts as you move to meet the needs of patients and payers.

3. Examine your practice from your patients’ perspective

Assess your practice from top to bottom as if you were a patient. Use patient shoppers and patient focus groups to understand their perspective and expectations. Scrutinize your patient satisfaction surveys for useful data on patient needs and wants. Identify the amount of value-added time (the amount of visit time spent in actual interaction about the patient’s care) versus non-value added time, and perform cycle time studies to identify reasons for long wait times. Target patient cycle time at 30 to 40 minutes for a routine visit, and value added time at 75 to 80 percent of the visit total. By examining your practice from the patient’s perspective, you will be able to identify the gaps and develop a roadmap to transform your practice.

4. Create process excellence to drive patient, provider, and staff satisfaction

Document and analyze your work flows for all key operational areas, including patient scheduling, check-in, vitaling, exam, check-out, and patient follow-up. Identify waste, duplication, and barriers in each operational function and develop revised workflows that reduce process variability. Focus on process excellence, ensuring that every step in the process is meaningful and leads to better care. This not only will improve patient satisfaction but motivates providers and staff because it eliminates unnecessary steps and increases direct patient care time.

5. Develop patient-directed, convenient access points to your practice

Based on your patient profile, develop the access points your practice requires to meet the needs of your patient population. Be able to offer same day patients appointments so they do not go elsewhere. Implement a robust patient portal with interactive email and scheduling capabilities. Offer e-visits, text messaging, expanded hours, and/or develop relationships with urgent cares. Create an environment that allows the patient to choose the method in which they will access care with convenience and ease.

6. Change your care delivery model to facilitate population health management

With the move to fee-for-value reimbursement and the new demands of patients in this technological age, providers need to use teams more effectively to meet patient needs. Based on your patient’s needs, determine what type of team will be most successful in managing your population of patients. Consider the use of medical assistants, care managers, social workers, and health coaches to create the support network required. For example, if your practice has a high volume of chronic care patients, consider a high-touch, high-contact delivery model with the use of care managers and health coaches to continuously engage patients in their care. For panels with high commercial, healthy populations, increase the use of advanced practice clinicians, offer e-visits, and expand hours to provide easy, convenient access. Ensure that all team members are working to the top of their license and skill sets to maximize efficiency and physician support.

7. Assess your current business model based on what is necessary to succeed in a fee-for-value world

Assess your capabilities to provide high quality, effective, affordable care not only today, but three to five years from now. Analyze your practice’s cost structure, and identify the profit formula that will allow you to compete. Based on the needs of your patients and resources required to manage your population, identify the profit margins, reimbursement, and volumes required to meet your business goals. Analyze your payer contracts and explore fee-for-value payment model options with your payers that build on your strengths as a practice. Understand the total cost of care for your patients so you can be part of the solution in bringing them the care they deserve in a cost-efficient manner. Ensure that your compensation models effectively align with practice goals and critical success factors.

8. Optimize your use of data to enhance care, ensure accountability, and achieve your goals

Create your practice’s value proposition for the future, and use it to guide your practice metrics and dashboard reports. Apply integrated technology and automated dashboards to track and report on practice performance, including quality measures to maximize pay for performance dollars. Use the electronic medical records (“EMR”) to proactively prompt you about a patient’s care needs. Utilize real time prompts to remind physicians of needed preventive and chronic care during the patient visit so needs can be immediately addressed. Implement a patient registry to manage patients with chronic diseases and consider the integration of home monitoring and diagnostic equipment in your care model. Gather data on your use of ancillaries, and assess if you are following best practices and only performing tests and procedures when necessary.

9. Implement strategies to foster patient “stickiness” to your practice

Focus on creating patient loyalty. Use texting, email, and social media to maintain contact outside of the face-to-face visit. Provide your patients with the information they need to stay healthy on a regular basis through texting, email, and phone calls. Develop your patient portal as the “go-to” site when they have questions by making patient education materials readily available on the portal, including the provision of links to reputable internet sites. Explore the creation of a phone application that can provide patients with a ready source to answer their immediate health concerns so they don’t have to go outside the practice’s sphere of influence. For example, the application could be linked to a branded call center which could provide an immediate response to health questions and concerns.

10. Optimize the use of technology

Utilize technology purposefully to allow providers more touch time with patients and make sure your technology works for you, not against you. Assess EMR efficiency by counting the number of clicks, screens, and typing required per task; observe physician and staff as they use the EMR and record extra steps. Work with your EMR vendor to decrease extra steps and streamline the data entry process. Note variations in the use of the system and train providers and staff in the most effective and efficient processes. Implement other technology such as automated appointment reminders and easy payment tools through the use of text, email, and phone. Use your patient portal to decrease call volume by activating patient scheduling, referral management, prescription refills, lab notifications, and pre-registration and check-in features. Consider the cost benefit of each technological feature and ensure that, once the feature is enabled, it is optimized to work for the practice.

Start now: make transformation a priority to ensure you successfully achieve your practice’s value proposition. Do not wait until your payers change how they pay, retail clinics proliferate in your community, your practice is losing patients or physicians, or you are losing money. Practice transformation does not occur over night. It takes time and hard work. To succeed in the future, you need to lay the foundation now.


Ms. Corneliuson is a senior manager with GE Healthcare Camden Group and has over 13 years of healthcare management experience. She specializes in physician integration strategies, practice assessments, operational improvement, care and workflow redesign, and compensation arrangements. She is the co-author of The Governance Institute’s signature publication for 2012, Payment Reform, Care Redesign, and the New Healthcare Delivery Organization. She has a strong background in physician practice management with experience in medical foundations, provider-based clinics, and specialty hospital settings. She may be reached at susan.corneliuson@ge.com

Topics: Mary Witt, Medical Group, Susan Corneliuson, Medical Group Efficiency, Medical Group Transformation

The Latest Thought Leadership from The Camden Group

Posted by Matthew Smith on Feb 11, 2015 3:57:00 PM

The Camden Group, Thought Leadership, Population Health, Clinical IntegrationEach month, thought leaders from The Camden Group share their expertise through original posts, articles, speaking engagements, and interviews.

Below are links to the top thought leadership shared recently by The Camden Group. 

 

Email Newsletters

►“Top 10 Trends and Implications for Medical Groups in 2015” by Mary Witt

►“Prevent 2017 Medicare Penalties Now” by Lucy Zielinski

►“Improving the Financial Performance of Your Newly Acquired Medical Group” by       Tawnya Bosko

Bylined Articles

In the News

Upcoming Speaking Engagements

To request more information about scheduling a thought leader from The Camden Group to speak at your organization's next event, please click the button below.

The Camden Group, Speaking Opportunity

Topics: Value-Based Care, Medicare, Medical Group, Deirdre Baggot, Daniel J. Marino, The Camden Group, Steve Valentine, Physician Services.

Top 10 Trends and Implications for Medical Groups in 2015

Posted by Matthew Smith on Jan 27, 2015 2:23:00 PM
By Mary Witt, MSW
Senior Vice President, The Camden Group


016_healthcare_consultant.juSuccess in 2015 requires clear thinking and decisive action. Whether independent or hospital/system-owned, medical groups cannot continue to do business as usual and expect to succeed in 2015. Increasing financial pressures, the move to fee-for-value, and increased expectations for quality require new ways of doing business. Here are the top 10 trends for 2015 that can provide direction and focus as medical groups plan for the year ahead.

1. A focus on performance optimization is necessary for success. Medical groups can no longer be satisfied with median performance. Medical groups that are not pushing themselves to excel will find themselves left behind as top performers emerge and gain market dominance. Also, as financial pressures increase for hospitals and health systems, they will no longer be able to sustain the high losses experienced by many hospital-owned medical groups. It is critical that medical groups assess their performance as compared to industry best practices and implement a performance improvement plan to address any deficits. To sustain forward momentum, medical groups should establish clear accountabilities for performance throughout the medical group by creating measurable performance standards, continually measuring performance against targets through the use of dashboard reports, developing action plans to address variances, and incorporating performance expectations into job descriptions.

2. Patient collections cannot be ignored. With the increase in high deductible plans and patient copays, medical groups are seeing a significant increase in the dollars owed by patients. Therefore, an effective patient collection process that starts when the appointment is scheduled is critical to ensuring that all revenue owed is collected. When the appointment is scheduled, patients should be informed of copay and deductible amounts as well as outstanding balances, and the expectation that payment is due at the time of the visit should be established. Time of service collections should include collection of all monies owed for the services provided that day as well as any outstanding balances.

3. 2015 brings increasing competition from nontraditional organizations. New, non-traditional competitors are entering the outpatient medical care market. Retail firms such as WalMart, Walgreen’s, CVS, and RiteAid have created primary care clinics; while some have partnered with local providers, more often they have created their own clinics or partnered with national firms. Target and Kaiser Permanente have developed a partnership to provide primary and specialty care in clinics in Target stores that will be open to nonKaiser enrollees. Payers such as Anthem California are marketing e-visits directly to their enrollees bypassing the traditional in person physicianpatient relationship. Partnering with non-traditional organizations is an option that should be assessed as well as considering non-traditional practice locations. It is important to understand what patients want and expect of the practice to retain them. Regularly survey patients about their experience with the practice; consider the use of focus groups to gather more in-depth data on what is important to them.

4. Physician compensation models require redesign. As medical groups prepare for fee-for-value payment, increasing competition, and a focus on quality, there is likely a need to redesign their compensation model to better align incentives with the new environmental realities. What worked in the past is unlikely to work in the future. It is important to understand how quickly the market is shifting from fee-for-service to value-based payment in order to determine what needs to be changed and how quickly it needs to happen. Medical groups will want to develop a road map to broaden compensation incentives to prepare for fee-for-value payments. Consider adding incentives for care coordination, quality, and efficiency in addition to productivity. Initially, it may make sense to devote a small percentage of compensation to these new metrics to prepare for the future if the market is not demanding immediate change.

5. Transparency is becoming increasingly important. The era of transparency in cost and quality is here. Payers are publishing provider charges by Current Procedural Terminology (“CPT”) code; CMS has published Medicare payments made to physicians. Employers are demanding price transparency, especially as they move to high deductible plans and pass more cost on to their employees. States are creating multipayer pricing databases based on payer claims data and providing access to consumers. Many new websites enable consumers to shop price and quality. Quality is being tracked more vigilantly, and quality scores are readily available to the consumer through a variety of websites. With all of this data available, it is important that medical groups understand how their pricing and quality compare to their competitors and take action to ensure that high prices and poor quality do not cost them patients.

6. Mastery of technology cannot be ignored. Medicare demands that medical groups report on quality or face penalties, and payers increasingly link payments to quality reporting or results. Therefore, medical practices need to be able to collect, analyze, and exchange data. Also, as expenses increase, and operational demands become increasingly complex, the ability to automate work is critical to improving efficiency. New care models increasingly rely on real-time access to patient clinical data as well as access to tools such as telemedicine or health monitoring devices. Effective use of technology to improve results is a necessary element for future success. Evaluating current work flows and looking for inefficiencies (e.g., duplicate data entry, multiple handoffs) can lead to identifying opportunities for automation. Explore the use of telephone technology to automate tasks such as appointment and payment balance reminders. Participate in a health information exchange that provides two-way communication and clinical results with hospitals, referring physicians, and other health providers. Use an electronic health record to assist clinicians in the care of their patients; the use of real-time prompts assists physicians in performing preventive services and informs them when test results are outside of normal.

7. Managing a population of patients requires new care delivery models. Managing a population of patients requires a change in how care is delivered. The focus is no longer on episodic care, but instead focuses on managing the total healthcare needs of a population of patients. The emphasis shifts to “providing the right care at the right time in the right place.” Redesigning care involves transforming both how care is delivered and who delivers the care. Re-examine roles within the practice to ensure that everyone is working to the top of their license/expertise. Successful management of a population of patients requires an expanded team approach to care. New care team members can include advanced practice clinicians, care managers, social workers, pharmacists, nutritionists, and health coaches with leadership and direction provided by the physician. Reexamine the workflow in the office to assure that as the care model evolves, the work flow is adapted to facilitate efficient use of space and staff. Explore the feasibility of using e-visits, tele-health, and group visits to improve access, responsiveness, and maximize patient engagement. Consider the operational and financial feasibility of implementing Medicare’s newly reimbursed chronic care management.

8. Patient engagement leads to better outcomes. Patients actively engaged in their care have better outcomes and utilize fewer health resources. In order to maximize patient engagement, medical practices must move from telling patients what to do to assisting them to develop the knowledge, skills, and confidence necessary to be an active partner in their care. Train physicians and staff on communication skills and motivational interviewing and integrate expectations into physician and staff performance expectations. Ensure that patients are actively engaged in discussing their health and developing their care plan. The use of patient portals can be an effective means of maintaining communication with patients and monitoring their adherence to care plans.

9. Patient demand for access is not going away. Thus, ensuring timely patient access has to be a medical group priority if the practice is to have satisfied patients. To understand patient access, routinely monitor third next appointment availability. Calculate the practice’s patient demand versus practice capacity, and implement strategies to increase capacity as needed. Consider allowing patients to schedule their own visits through a patient portal, providing evening and weekend hours, offering e-visits, and communicating by email and text. Practices should also employ strategies to facilitate regular communication with their patients through e-mail blasts, texting, and social media.

10. Physicians will continue to move toward the employment model. As the complexity of medical practice and economic pressures increases, and the demand for capital for practice infrastructure (e.g., electronic health record, care team staffing) grows, more physicians are choosing to become employed, and that trend is likely to accelerate over the next few years. This provides opportunities for existing medical groups and hospitals/health systems to add physicians to their practices as they seek to capture a greater population. To ensure a successful employment relationship, medical groups and physicians both need to clearly define their goals and expected outcomes and then develop a set of criteria to guide decisions as opportunities are considered.

As medical groups grapple with the many challenges of 2015, it is important to focus on optimizing performance and preparing for value-based reimbursement by meeting the needs of patients efficiently and effectively. Concentrate on how to create a strategic advantage by establishing capabilities or attributes that will distinguish your group from competitors. In difficult times like these, superior, nimble, focused performance will lead to success.

Mary Witt, The Camden Group, Physician ServicesMs. Witt is a senior vice president with The Camden Group and has over 25 years of healthcare experience. She has held management positions in hospitals, health systems, and management services organizations (MSOs). She has extensive experience in medical group and integrated delivery system development and management. This includes developing patient-centered medical homes, practice management, performance improvement, physician compensation, managed care, strategic planning, healthcare marketing, and physician recruitment. She may be reached at mwitt@thecamdengroup.com or 424-201-3971.

 

Topics: Clinical Integration, Population Health, HIT, HealthIT, Mary Witt, Medical Group, Medical Groups, Clinically Integrated Networks, Physician Compensation, Patient Engagement, The Camden Group, Trends

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