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GE Healthcare Camden Group Insights Blog

Five Focus Areas for Medical Groups in 2017

Posted by Matthew Smith on Jan 26, 2017 12:59:09 PM

For medical groups, the last few years have been tumultuous with the shift to value-based care. In 2017, medical groups will continue to experience change on all fronts, including payment, care delivery, and interaction and communication with patients. Medical groups must contend with new payment models, fierce competition in their markets, increased regulatory requirements, clinical advances, digital and information technology changes, and population health management implementation.

In response to these shifts, medical groups should focus on five key areas to position themselves for the future. As Socrates said, “The secret of change is to focus all of your energy not on fighting the old but on building the new.” And that is what medical groups need to do in 2017: build the new by transforming the old ways of practice management.

To read this article in its entirely, please click the button below to be taken directly to the HFMA website.

Medical Groups, 2017 Trends

Topics: Population Health, Medical Groups, Patient Access, Trends, Medical Group Transformation

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

Advanced Access: a Winning Approach for Patients, Providers, and Staff

Posted by Matthew Smith on Oct 5, 2015 3:14:13 PM

Access to the right medical care at the right time in the right setting improves patient satisfaction. It also attracts new patients, retains existing patients, supports safety, improves outcomes, and reduces cost. So why do so many medical practices still struggle to provide adequate access to achieve these goals?

Traditional approaches to improving access have focused on:

  • Recruitment--which may be costly, impossible, or too much of a long-term challenge
  • Partnering with urgent care centers or retail clinics which do not facilitate continuity or an ongoing relationship with your medical practice
  • Managing demand through triage, which has only led to greater patient dis-satisfaction
  • Holding a fixed number of appointments for patients (which are never the right number) needing to be seen the day they call, often called "carve-out scheduling"

Under any of these approaches, physicians and staff struggle to meet the needs of today, as well as those of patients who have waited days or weeks for appointment.

Access may be improved significantly through practice optimization, and by employing the principles of advanced access. Advanced access is appointment availability that reflects the real-time demand of patients and, therefore, reduces or eliminates queuing. It is a philosophy that focuses on “doing today’s work today.” However, it is more than just changing the schedule. It is an innovative way of thinking about patient care. It emphasizes improvement of the total care experience, from the initial telephone call to follow-up care. Advanced access works because it predicts demand and then focuses on maximizing daily capacity so that daily demand can be met. It also does not occur in a vacuum. It requires that the processes in a practice be reviewed and often modified. 

Here are five tried and true principles:

1. Understand Your Demand and Capacity

It is well known that Monday is always the day of highest demand for primary care providers (or Tuesday after a three-day weekend). Tuesday often has the second greatest demand, and demand on Wednesday through Friday is about equal. Most patients would appreciate some early evening and weekend availability too. We also know that winter flu season is the busiest time of year and that if a practice performs school physicals, July and August will have greater demand.

Does your provider capacity match patient demand?  Do you maximize provider availability for your high-demand hours?  You may find that you have too many physicians working mid-day Thursday and not enough on Monday morning. Talk with your providers about the mismatch of appointment availability to the known hours of patient demand. Let them work out a fair distribution within the parameters you give them. Most of the redistribution can often be accomplished voluntarily. Provider vacations can be managed to minimize coverage holes at times of greatest demand.

2. Decrease Appointment Types

Much inefficiency and unnecessary queuing results from the creation of too many appointment types. Many systems try to handle demand by creating more appointment types to “manage” the schedule, but that has only created additional complexity and limited appointment availability. Best practice is to reduce appoint types to two: a short and a long (with the long being twice the length of a short). You may decide to have 15 and 30-minute appointments or 20 and 40-minute appointments for instance. Relegate all patient needs to one of the two. This gives your scheduler much more flexibility to get patients in. Also, if you know that a certain patient always runs over, give them a longer appointment.

3. Manage Your Daily Appointment Inventory

Many providers clog up all their future appointment availability for those who are acutely ill by unnecessarily scheduling follow-up appointments. A protocol change, for instance, of seeing patients for blood pressure checks every quarter instead of every other month immediately creates capacity. The same is true for diabetics or anyone with a chronic disease. Of course, different patients need to be seen on different intervals due to the severity of their disease or their compliance with treatment. The point is to be mindful of that need rather than rescheduling routinely in a pattern that limits future availability.

Use a morning and afternoon huddle with your medical assistant to review the schedule and plan for the day. Identify patients whose needs could be met by a phone call to free up space on the schedule. If someone being seen today has a future appointment, take care of both issues during the first appointment if possible.

4. Create Contingency Plans

Create provider care teams to ensure that vacations, sick time and temporary absences do not significantly impact same-day appointments. Proactively develop plans to handle peak demand such as flu season and school physicals.

5. Measure and Monitor Access on an Ongoing Basis

Unless access is routinely measured (third available appointment), it is easy to fall into old habits and slip into postponing work until tomorrow. When contingency plans are implemented, they need to be monitored to identify what is working and what is not so that problems can be quickly identified and resolved before backlog creep occurs.

Advanced Access Is Win-Win

Everyone wins with advanced access: patients, physicians, staff, and management by:

  • Increasing patient satisfaction
  • Improving clinical outcomes for patients through better continuity of care (patients now see their own doctor) and greater emphasis on prevention
  • Enhancing quality of practice life for physicians and staff
  • Increasing efficiency in patient flow
    • Fewer no shows
    • Less phone calls
    • Minimizes re-work
  • Decreasing costs through decline in ER and urgent care visits
  • Potentially increasing in net revenue
    • More new patients
    • Ability to do more for patient through max-packing
AccuTracker, Workflows

Topics: Medical Group Efficiency, AccuTracker, Advanced Access, Medical Group Transformation

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