GE Healthcare Camden Group Insights Blog

Primary Care at a Crossroads

Posted by Matthew Smith on Jul 25, 2016 2:42:30 PM

By Marc Mertz, MHA, FACMPE, Vice President, GE Healthcare Camden Group

Most primary care practices still operate based on a model developed decades ago: the hours of operation, appointment scheduling rules, staffing, patient flow, and office design were all determined based on physician preference. In an attempt to provide physicians with a more convenient practice model, we created a system that forced patients to accept long waits for appointments, inefficient office flow, and limited ability to communicate with their physicians outside of the exam room.

Yet physicians hardly fared any better in these offices that were actually designed with them at the center. Complex appointment scheduling rules and templates inherently led to mistakes and double booking, phone messages piled up, administrative work increased, patient appointments ran behind, and physicians inevitably spent hours working in the clinic long after patients had left.

While the typcial primary care practice doesn't really work for patients or physicians, in the absence of alternatives, we came to accept this model for what it was. But times are changing. A plethora of new providers are entering the primary care marketplace, and their growing popularity is as much an indictment on traditional physician-centric primary care practices as it is a reflection of new reimbursement models and rising consumerism.

To contunue reading "Primary Care at a Crossroads," please click the button below. You will instantly be directed to the online article published in CAPG Health's Summer 2016 issue.

Primary Care, Practice Management, Practice Transformation


MertzM.jpgMr. Mertz is a vice president with GE Healthcare Camden Group and has 18 years of healthcare management experience. He has 15 years of experience in medical group development and management, physician-hospital alignment strategies, physician practice operational improvement, practice mergers and acquisitions, medical group governance and organizational design, clinical integration, and physician compensation plan design. He may be reached at marc.mertz@ge.com.  

Topics: Practice Management, Primary Care, Primary Care Providers, Primary Care Access, Marc Mertz, Practice Transformation

Quick Tips for Improved Patient Access

Posted by Matthew Smith on Jun 9, 2015 12:27:34 PM

By Marc Mertz, MHA, FACMPE, Vice President, GE Healthcare Camden Group

It is hard to have a conversation about healthcare today without mentioning quality. Government and commercial payers are putting increasingly larger portions of providers’ reimbursement at risk for performance on quality measures. Employers are seeking high-quality providers to help maintain a healthy work force. Patients assume that their physicians are high quality. Public reporting sites are introducing a new level of transparency regarding physicians’ quality scores. All of this increased emphasis on quality is justified, and an organization should strive to provide and demonstrate high-quality care. But if patients cannot access your services, it is all for naught.

The Importance of Patient Access

Not only does a lack of patient access impact the ability to provide quality care, but it also impacts your financial performance.

In a fee-for-service environment, poor access means lower volume and lower revenue. In a fee-for-value environment, groups must demonstrate high-quality care and high patient satisfaction--a lack of access will impact both. Regardless of the reimbursement model, a lack of access will drive patients to find other providers. Those other providers are no longer limited to medical groups, as new providers of care are entering the market. Retail providers are rapidly expanding their number of locations and the services that they provide. These locations offer immediate access and low costs, and are often affiliated with health systems or networks. Once patients visit one of these locations they might not return to their original provider.

Getting Started

Evaluate Current Wait Times

Start to address access by evaluating current wait times for appointments in existing care locations. The third next available appointment is a commonly used metric to measure access in a medical group. Best practice is within 24 hours for primary care and three days for specialty services (although some specialties like oncology are increasingly offering same or next-day appointments). Calculate the practice’s patient demand versus practice capacity and implement strategies to increase capacity as needed.

Add Providers and/or Access Points

If access is poor and your physicians are highly productive, then consider expanding the group by adding providers or new access points. If your access is poor and productivity is low, consider evaluating processes: are appointment schedule templates structured correctly, are appointments the correct length, and are staff trained appropriately?

Allow Patient Self-Scheduling

Consider allowing patients to schedule their own visits through a patient portal, providing evening and weekend hours, offering e-visits, and communicating by e-mail and text.

Review Office Operations

Inefficient office operations will also create waste and reduce access. Assess the workflows in the office, and redesign processes so that patient flow is efficient.

The Pyramid of Success

The Pyramid of Success (below) identifies the access points that are the highest priority. Health systems and hospitals are adding hospitals, clinics, health plans, direct contracts with employers, physician practices, and ambulatory sites to their continuum of care delivery system/network. Increasing the number of access points listed at the bottom of the pyramid will help a hospital or health system reach a broader population and support the services listed higher up in the pyramid.

Pyramid_of_Success_Gray.png


mertz_headshot

Mr. Mertz is a vice president with GE Healthcare Camden Group and has 20 years of healthcare management experience. He has 17 years of experience in medical group development and management, physician-hospital alignment strategies, physician practice operational improvement, practice mergers and acquisitions, medical group governance and organizational design, clinical integration, and physician compensation plan design. Mr. Mertz has managed private practices, hospital-affiliated practices, and academic physician practices. The Medical Group Management Association (“MGMA”) has identified practices under his management as “Best Performing.” He may be reached at 310-320-3990.    

Topics: Patient Access, Practice Management, Patient Engagement, Marc Mertz, Medical Practice Workflow

Patient Access is the New Quality

Posted by Matthew Smith on Mar 25, 2015 12:26:00 PM
By Marc Mertz, Vice President, GE Healthcare Camden Group
 
It is hard to have a conversation about healthcare today without mentioning quality. Government and commercial payers are putting increasingly larger portions of providers’ reimbursement at risk for performance on quality measures. Employers are seeking high quality providers to help maintain a healthy work force. Patients assume that their physicians are high quality. Public reporting sites are introducing a new level of transparency regarding physicians’ quality scores. All of this increased emphasis on quality is justified, and an organization should strive to provide and demonstrate high quality care. But if patients cannot access your services, it is all for naught.

The Importance of Patient Access

Not only does a lack of patient access impact the ability to provide quality care, but it also impacts your financial performance. In a fee-for-service environment, poor access means lower volume and lower revenue. In a fee-for-value environment groups must demonstrate high quality care and high patient satisfaction; a lack of access will impact both. Regardless of the reimbursement model, a lack of access will drive patients to find other providers. Those other providers are no longer limited to medical groups, as new providers of care are entering the market. Retail providers are rapidly expanding their number of locations and the services that they provide. These locations offer immediate access and low costs, and are often affiliated with health systems or networks. Once patients visit one of these locations they might not return to their original provider.

Getting Started

Start to address access by evaluating current wait times for appointments in existing care locations. The third next available appointment is a commonly used metric to measure access in a medical group. Best practice is within 24 hours for primary care and three days for specialty services (although some specialties like oncology are increasingly offering same or next-day appointments). Calculate the practice’s patient demand versus practice capacity and implement strategies to increase capacity as needed. If access is poor and your physicians are highly productive, then consider expanding the group by adding providers or new access points. If your access is poor and productivity is low, consider evaluating processes: Population_Health_Pyramid_of_Success1are appointment schedule templates structured correctly, are appointments the correct length, and are staff trained appropriately? Consider allowing patients to schedule their own visits through a patient portal, providing evening and weekend hours, offering e-visits, and communicating by e-mail and text. Inefficient office operations will also create waste and reduce access. Assess the work flows in the office, and redesign processes so that patient flow is efficient.

Figure 1: Pyramid of Success (left) identifies the access points that are the highest priority. Health systems and hospitals are adding hospitals, clinics, health plans, direct contracts with employers, physician practices, and ambulatory sites to their continuum of care delivery system/network. Increasing the number of access points listed at the bottom of the pyramid will help a hospital or health system reach a broader population and support the services listed higher up in the pyramid.

Medical Groups, Trends, Access, The Camden Group


mertz_headshotMr. Mertz is a vice president with GE Healthcare Camden Group with more than 20 years of healthcare management experience. He has 17 years of experience in medical group development and management, physician-hospital alignment strategies, physician practice operational improvement, practice mergers and acquisitions, medical group governance and organizational design, clinical integration, and physician compensation plan design. Mr. Mertz has managed private practices, hospital-affiliated practices, and academic physician practices. The Medical Group Management Association (“MGMA”) has identified practices under his management as “Best Performing.” 

Topics: Patient Access, Practice Management, Healthcare Quality, Marc Mertz, Access, Quality

Healthcare Reform: The Impact on the Medical Practice Today and in the Future

Posted by Matthew Smith on Sep 8, 2014 10:00:00 AM

Independent Physician Advisors, Healthcare Reform, Medical Practice, Health DirectionsChicagoland independent practices are invited to join the Independent Physician Advisors this Thursday, September 11 at 7:30 am in Oakbrook Terrace for their complimentary monthly breakfast seminar: Healthcare Reform: The Impact on the Medical Practice Today and in the Future

  

Learn About:

  • What is the impact of Healthcare Reform on your practice's income/revenue?
  • What the primary Tax Implications are for your practice AND what you should do and not do in response to them
  • How the mandate will affect your medical practice?
  • How to deal with insurance exchanges
  • Understanding the tax breaks available for your practice
  • 5 things you must do this year and more!

Know someone else who could benefit from these seminars and workshops? 

Those who should attend include:

  • Physician Owners
  • Practice Managers & Administrators 
  • Office Managers
  • Billing Managers 
  • Key Administrative Personnel who aid with practice financial management 

Presenter:

Laura S. Goodman

Laura S. Goodman, CPA, CHBC, of FGMK, LLC.

Schedule:

7:30am    Hot Breakfast & Networking
8:00am    Presentation 
9:30am    Q&A and open networking

Location:

Redstone American Grill
13 Lincoln Center
Oakbrook Terrace, IL 60181
(630) 268-0313

Sponsor:

Logo for Allscripts

 

Registration:

This event is complimentary, however advanced registration is required. We ask that attendance be limited to independent physicians and their office staff.

To register for this event, please click the button, below:

Independent Physician Advisors,

Topics: Healthcare Reform, Independent Physician Advisors, Practice Management

Five Reasons for Providers to Embrace Social Media

Posted by Matthew Smith on Jul 22, 2014 12:23:00 PM

Social Media, Physicians, Physicians today often find themselves asking, "Who has time for social media?" Since most providers are focused on the chaos of reimbursements, busy practices and healthcare reform, it's no wonder that social media time is not a high priority.

But if you’ve been paying attention to society, business, and commerce over the last few years, you would know that social media has developed a very effective purpose in helping professionals communicate, engage in professional development and build meaningful reputations in their fields.

Social media is also a very effective way for physicians to manage their online reputations, which has become more and more important in today’s competitive healthcare marketplace.

Many physicians will argue that engaging in social media could be beneficial, but also brings about a certain amount of risk. Dr. John Mandrola negates this argument in his MedCity News article titled, Doctors and Social Media: It’s Time To Embrace Change

Dr. Mandrola writes, “But I ask: What medical intervention, what shot at making things better, comes free of risk? A rule of doctoring is that to do good a doctor must risk doing harm. A distinguished heart surgeon once consoled me—after I had caused a procedural complication—that if I didn’t want complications, I shouldn’t do anything.”

Dr. Mandrola sees the “risk” argument as a confining attitude that many physicians often take – keeping them trapped in the same outdated rituals that have perpetuated the healthcare industry for years.

“In the hyper-connected world of 2014, medical professionals have reached a fork in the road. One path is a road well traveled. On this familiar route, we continue to keep our heads down, stay in the weeds, out of trouble. Don’t wiggle; don’t rock the boat; check the boxes; fill out the forms and accept what comes. Don’t dare engage in the online conversation. Choosing this path is like not treating a disease: less ownership confers less personal risk.”

Dr. Russel Faust provides five great reasons in his Whitepaper, Social Media Guide for Docs, 12 Tips For Beginners.  

  1. You will gain market share– yes, it will help grow your practice!
  2. You will be recognized as an authority in your area of practice (which will also growyour practice).
  3. You will be better connected with your patients: compliance with your diagnostic and treatment regimens will improve (healthier patients, reduced readmissions).
  4. Your patients will arrive to appointments better- educated, and take less time: it will streamline your work flow!
  5. Your patients will be less needy outside of your clinic: they will require less time on the phone with you and your nurses.
Social Media, Twitter, LinkedIn, Health Directions

Topics: twitter, facebook, linkedin, Practice Management, Practice Marketing, Matthew Smith, Social media

Complimentary Breakfast Seminar (Chicagoland Area): The Social Business Of Healthcare

Posted by Matthew Smith on Oct 15, 2013 3:15:00 PM

The Social Business Of HealthcareJoin the Independent Physician Advisors on Thursday, October 17th at 7:30 am in Oakbrook Terrace for a complimentary breakfast and seminar:

The Social Business Of Healthcare: The role of digital and social in managing and growing your practice

The goal of the Independent Physician Advisors is to improve core business operations for independent healthcare providers through shared learning and support. 

Members--including Health Directions--provide key strategy and operational services that foster sustainable growth and enable the physician and practice owners to focus on patient care.

Gain keen insight into this issue by learning:

  • The role of social media and digital marketing in patients’ healthcare decision making
  • Building a digital presence for your practice
  • Proper use of social media to acquire and engage patients
  • Tips on developing a strategic digital & social media plan for your practice

Presented by

Jamey Shiels, Founder, Exploring Digital
Maureen Uy, Managing Partner, Uy Creative Communications, LLC

Schedule:

7:30am    Hot Breakfast & Networking
8:00am    Presentation 
9:30am    Q&A and open networking

Location:

Redstone American Grill
13 Lincoln Center
Oakbrook Terrace, IL 60181
(630) 268-0313

Registration:

This event is complimentary, however advanced registration is required. To register for this event, please click the button, below:

Topics: Independent Physician Advisors, Practice Management, Seminars, Social media

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

7 Simple Tips for Marketing Your Medical Practice

Posted by Matthew Smith on Apr 21, 2013 9:01:00 PM

Medical Practice MarketingBuilding a medical practice is harder than ever. Many specialists face a crowded market, and primary care groups are getting direct competition from retail clinics. A phone book listing and a hospital affiliation are no longer enough to establish a strong patient base.

Physicians today must take an entrepreneurial approach to marketing—actively seeking out new patients and referral sources. Entrepreneurial marketing does not need to be expensive. Practices can achieve good results with a few effective techniques.

1. Differentiate your practice

Healthcare consumers today have many choices. To compete, physicians must focus on something unique about their practice that captures the attention of patients and referring physicians.

For example, a Chicago-area otolaryngologist has built a strong practice by emphasizing his unique approach to managing allergies. His distinctive care philosophy and good patient outcomes help him stand out from “generic” ENTs.

Primary care physicians can also differentiate their practice. Focus on diabetic care, excellent management of hypertension, teen health—wherever your special interest lies.

2. Reach out for referrals

Physicians are much more likely to make a referral when they know a specialist personally and understand his or her care approach. Specialists can clear both hurdles through low-cost networking.

Lunch presentations are a great opportunity. Contact local family practices and offer to bring a sandwich platter to a lunchtime meeting. During the gathering, spend 20 minutes explaining your services and care approach to physicians and staff.

Other options include going to CME talks, attending hospital fundraisers or simply visiting the physician lounge. Any opportunity to meet physicians or office managers is a chance to develop referrals.

3. Get in front of potential patients

Health fairs, charity runs and fitness events can draw large crowds, but medical doctors are usually under-represented. Entrepreneurial practices can create strong market awareness by volunteering at these events.

Draw people to your booth by offering health screenings that align with your care approach. For example, if your practice’s focus is caring for hypertensive patients, provide a simple stroke risk evaluation.

What if a physician is uncomfortable meeting the public in this way? Identify a capable “people person” within the office to handle health fairs and other marketing efforts. 

4. Provide “free samples”

Free introductory offers are effective in almost every industry. Medical practices can also use this approach with good results.

Consider offering a monthly flu clinic with free vaccines to the first ten patients. The cost is minimal and it can attract patients who might otherwise visit a pharmacy clinic. Another possibility: free blood pressure screenings every Wednesday. This could be especially effective for practices near retail traffic. Each strategy provides potential patients with a “taste” of your care approach.

5. Rethink patient service

Retail clinics are a threat to traditional practices because they offer greater access and convenience. Medical practices can meet the challenge by making small changes that have a big impact on the patient experience:

  • E-mail forms to patients so they can spend less time in the waiting room.
  • Accommodate same-day appointments by leaving 50 to 65 percent of the schedule open.
  • Create a “fast track” for fasting patients (perform blood draws upon arrival, offer light snacks).
  • When running behind, have staff call patients to say they can come in later or reschedule.
  • Assign staff to contact patients the day after a sick appointment to see how they are feeling.

Remember that existing patients are your best source of referrals. Build patient satisfaction by listening carefully and communicating concern. Survey patients regularly and ask for referrals. Personally thank patients who refer friends and family to your practice.

6. Create electronic connections

Consumers increasingly expect to be able to manage their lives using digital tools. Medical practices that fulfill this expectation will succeed in forging powerful links with a strong patient base.

Start with your current Electronic Medical Record (EMR) system. Most systems can easily be configured to support a patient portal, allowing patients to access test results, receive clinical summaries and e-reminders, request appointments and download records to services like Google Health Vault and Microsoft Health.

Enhancing your website is another way to create electronic connections with patients. Provide content that keeps visitors coming back. Make patient forms available for download and update your site regularly with seasonal health information, “top ten” health habits or other useful content. You can also distribute content via Facebook, LinkedIn and Twitter or a simple e-newsletter.   

7. Work from a plan

The key to entrepreneurial marketing is steady progress. To turn a modest time investment into practice growth, create a solid marketing plan and work it consistently.

An effective plan will identify your unique selling point, target geography, competition and potential referral sources. List specific marketing initiatives, assign responsibilities and set monthly new-patient goals.

Whatever techniques you use, make sure to track referral sources. Continue marketing efforts that are working and drop those that are not.

Topics: healthcare marketing, Practice Management, Primary Care Physicians, marketing your medical practice, Medical Practice

Build a Field-Tested Diabetic Management Program

Posted by Matthew Smith on Feb 25, 2013 11:10:00 AM
Diabetes management, IAFP, Family PhysiciansThis presentation provides an up-to-date analysis of the status of diabetic care in the United States and its likely future, including the growing incidence of both Type I and Type II diabetes. Specific reference is made to quality of life issues pertaining to diabetic patients as well as to the avoidable problems, complications and ER or hospital admissions and their attendant costs which follow upon less-than-adequate management of diabetics.

Specific slides include:

  1. Resources for tracking patient care outcomes
  2. Diabetic care measure crosswalk table
  3. Diabetic care approach: Protocols, Models, Tools
  4. Sample measures by domain
  5. Comprehensive diabetic care outcomes: HEDIS 2012

Following this introduction, the presentation turns to an examination of the benefits of the family practice's conduct of a comprehensive diabetic management program for its patients. Such benefits include:

  • the improvement of a patient's overall health and longevity,
  • cost savings coming from reduction of unnecessary complications of care,
  • occasions to advance clinical integration,
  • and opportunities for physicians to expand the volume of their practices and incomes.

Next, the presentation turns to an extensive and detailed description of a model comprehensive diabetic management program. This description includes topics as its organization and operation; patient identification, contact, induction and orientation; and patient assessment, education, counseling and monitoring. 

The presentation concludes with a brief listing of a practical, "field-tested" procedures and techniques which can strengthen patient commitment to and compliance with the management programs expectations and requirements, thereby enhancing the prospect of achieving the program's main objective: the improvement of the diabetic patient's management and care. 

Health Directions' role within the diabetic management program:

To help physician practices:
  • Achieve CMS EHR “meaningful use” or NCQA PCMH recognition
  • Leverage “reportable” quality of care and outcomes for better reimbursement
  • Participate in pilot programs with local payers
  • Partner with local health systems to create electronic linkages
  • Increase patient satisfaction
  • Improve practice profitability
  • Strategically position themselves for the future 

Topics: EHR, Meaningful Use, Practice Management, Family Physicians, Diabetic Management Program, Physicians, Diabetes, Diabetic Cohort

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