Management strategies aim to help allergy practices evolve, expand, succeed

PHOENIX — With new treatments, technologies and billing policies, providers may feel like they are falling behind their competition and failing their patients and their practices. Strategies and resources, however, are available.

“The practice of allergy is completely changing,” Priya Bansal, MD, FAAAI, chair of the American Academy of Allergy, Asthma & Immunology Practice Management Committee and member of the AAAAI Board of Directors, told Healio.

Bansal led a session tackling how providers can use clinical, administrative and reimbursement strategies to respond to the evolution of the specialty and expand their practices during the AAAAI Annual Meeting.

“We wanted to talk about how the allergist incorporates all these different changes. Maybe you don’t have to do everything, but what are the different ways that the traditional model of an allergy practice is changing?” said Bansal, who also is an allergist and immunologist at the Asthma and Allergy Wellness Center in Saint Charles, Illinois.

Accommodating new therapies

One practice concern involves the “explosion” of biologics and different ways to treat food allergy, Bansal said.

She noted that subcutaneous immunotherapy, or allergy shots, have been available for years. But more allergists now are using sublingual immunotherapy tablets or drops.

Priya Bansal

“Part of it is recognizing what these options mean for your practice and your patients. Maybe your patient is not willing to come every week for an allergy shot. What are the options that exist out there, FDA and non-FDA approved, that an allergist may wish to pursue?” she said.

Bansal also cautioned that practices need to keep track of the many different biologics on the market as well as which patients are taking which therapies. Strategies are available to help offices streamline these courses of treatment as well, such as having a dedicated biologics team on staff.

“You can verify benefits that morning, make sure that the biologic is available and ready to go for the patient, and get approvals done quickly and more efficiently,” she said.

Scheduling can play a role too, Bansal said. For example, some clinics see oral immunotherapy patients in the morning because those patients may need to be observed for several hours. The clinic can then be structured around such needs.

Remote monitoring

Digital tools such as remote monitoring and telemedicine also are having an impact.

“You’re connecting with the patient to try to help improve their adherence to therapeutic medicine utilizing technology,” Bansal said. “We use these technologies to monitor asthma control because the patient’s perception of control isn’t 100% accurate.”

The use of telemedicine significantly expanded in the wake of the COVID-19 pandemic, and it also helps doctors ensure their patients are compliant with care.

“When you’re doing telemedicine, patients can say that they don’t remember how they use their inhaler. But then they go and get that inhaler, you can see how they use it, and you can make adjustments,” she continued. “Telemedicine has given me that opportunity to make that connection so I can provide better continuity of care.”

In January, billing codes for remote therapeutic monitoring became available so practices can be reimbursed by insurance companies for its use. Yet doctors need to ensure that their staff is available and able to understand how to use the billing codes, and changes in what patients will be responsible for covering will need to be communicated to them as well.

“Especially with the No Surprises Act, you don’t want the patient to be shocked,” Bansal said. “You need to have discussions with families so they’re well aware of the costs of their procedures, especially if they have high-deductible plans.”

Sources of new strategies

The session on strategies is the result of discussions with the AAAAI Practice Management Committee and courses held during its annual workshop last July.

“The workshop is completely devoted to the practicing allergist — basically, the day-to-day clinical practice. How do you buy a practice? How do you sell? What about cyber-security? How do we figure out how much our RVUs or relative value units are worth? What struggles do providers and managers have in academic practice vs. community-based practice?” Bansal said.

“It’s fully devoted to the practicing allergist, no matter what the setting of the practice, and supporting staff. At the AAAAI Annual Meeting, we take some of the best sessions, the best ideas, and we expand on them” she said.

This year’s Practice Management Workshop is scheduled for July 22-24 in Washington, D.C. Topics will include conflict resolution and improving practice communication, coding and billing, negotiating physician contracts, post-pandemic rebuilding, patient-centered practices and staffing efficiencies and effectiveness.

Recordings from last year’s workshop and webinars from 2020 are available online as well, in addition to tips and other resources. Bansal encouraged clinicians to participate in this year’s workshop, access the committee’s materials, and take advantage of whatever education they can.

“For me, even if I come out learning one thing, I win,” she said. “Some of the people who attended this year’s session said, ‘I never thought about doing this. And now I’m going to figure out a way to make this work for my practice.’”

Bansal also acknowledged the difficulties that clinicians have in keeping up with the many ways that the practice is changing, but she said that the effort is worth it.

“Let’s say you have a full practice, and you feel like you can’t take on one more thing. But the landscape may change,” she said. “Maybe it’s not something that you’re going to use right now. But learning about it will help you get confident so maybe you can in the future.”

Reference:

• Bansal P, et al. Expanding your practice: Clinical, administrative and reimbursement strategies for success. Presented at: AAAAI Annual Meeting; Feb. 25-28, 2022; Phoenix (hybrid meeting).