Practice Management Improvement Strategies

As deductibles and co-insurances remain high, patients continue to shoulder more of their medical bills than ever. When it comes to paying for surgery, physical therapy and injections, many patients can’t afford to pay their portion of an orthopedic surgery bill all at once.

As more orthopedic practices are approached for potential acquisition, our firm is engaged by buyers and sellers to evaluate the accuracy of coding and documentation, and the efficiency of the revenue cycle.

When was the last time you ran your referral report? If you are contemplating a merger or acquisition, your referral report is a valuable asset. If you’d prefer to stay independent, it may be one of the most valuable tools you have for practice growth and profitability.

With ever-increasing amounts of private equity flowing into health care, orthopedic surgeons are being approached by firms offering capital infusion or partnership arrangements. If your group is considering going this route, ensuring your “house” is in good order will better position you for success. “Success” in this context means a premium offer. If your practice is not in optimal order, you risk a less than top tier offer or worse yet, you may cost yourself the deal in total. If the transaction does not happen, the internal evaluation process will improve the bottom line and practice efficiency, but that is not the goal. The goal is to close the deal and ensure the practice gets a maximum return. Do not let this window of opportunity close because you did not want to tackle subjects that might be unpleasant. Be clear eyed and ready to show the true value of your practice.

The shift toward hospital or health system ownership of physician group practice has been on a steady pace of growth for several decades. From July 2012 to July 2016, the number of physician practices employed by hospitals increased an astounding 100% according to data from Physicians Advocacy Institute.

More than half of the orthopedic practices that responded to the KarenZupko & Associates Inc. 2018 American Academy of Orthopaedic Surgeons coding and reimbursement workshop pre-course survey (54%) said that no-shows are a “problem” in their offices. That is up from 38% in 2017 and 43% in 2016.

The top two things that can trigger a payer audit are computer algorithms and coding outliers, according to attorney Patricia Hofstra, a partner at Duane Morris LLC.

If you have you been thinking about hiring a scribe to handle your electronic health record data entry, then you are not alone.

Whether you’re an employed physician or in private practice, no doubt you’ve pondered ways to boost payments for your services. After all, your compensation is either directly or indirectly tied to collections. Reimbursement from payers isn’t increasing, you’re likely at maximum productivity and expenses aren’t declining. So how does one boost their bottom line? The strategy is simple. Collect for the services you are already performing.

I was approached by an orthopedic client at a recent conference. Our firm had conducted a revenue cycle assessment for his solo practice. He told me we had issued a good report with lots of practical ideas for improvement. The problem was he couldn’t get the staff to implement any of them. They would not/could not/did not want to do anything differently and were unreceptive to his requests for new technologies and billing process changes. As the physician did not want to upset the staff, he didn’t push things, but he told me it was like being tethered to a ball and chain. Still, the staff wouldn’t budge. Ultimately, cash flow crumbled and managing the practice became too frustrating, so he took an employment offer from a large group and everyone in the practice lost their jobs.