11. “Dr. Sanders thinks he’s part of the solution.That’s part of the problem.” 11
12. Shortages will make recruitment of new partners challenging. “We don’t have enough doctors in primary care or in any specialty.” Rep. Shelley Berkley (D-Nevada) To cope with the growing shortage, suggested proposals include: “One would increase enrollment in medical schools and residency training programs. Another would encourage greater use of nurse practitioners and physician assistants.” “The Association of American Medical Colleges is advocating a 30 percent increase in medical school enrollment, which would produce 5,000 additional doctors each year.” Source: Shortage of Doctors an Obstacle to Obama Goals, by Robert Pear; The New York Times, April 27, 2009 12
13. The urge to merge among independent practices will continue to accelerate. 13
14. Flawed Decision-Making:Ready! Fire! Aim! Examples: “We’re quitting all health plans!” “Spending money on marketing with no predictable ROI or ROE” “Hire her! Fire him!” “Buy the laser!” “Install the EMR – next week!”“We need an aesthetician.” 14
16. Confusing Control, Deligationand Abdication Examples: “I can’t let anyone else do ________, I have to maintain control.” “Here you do this even though you don’t have the skills or training” “We told the nurse/manager to do it.” 16
17. How Do You Measure Up? Our Practice Management Reporting Visits Procedures, Surgeries, Treatments Collections Staff to Revenue Ration 17
30. The Fraud Buster’s are out in force. Expect an audit. 60 Minute Rule Careless Coders Beware! 22
31. 2011 OIG Work Plan Excerpt Coding or Evaluation and Management Services Medicare paid $25 billion for E&M services Payments for Evaluation and Management Services Medical records with identical documentation across services Evaluation and Management Services During Global Surgery Periods The number of E&M services provided by physicians and reimbursed as part of the global surgery fee 23
32. What Does This Look Like? 24 2008 National 2008 NE State Dr. C
35. Supervision and Scope of Practice: State and Payor Variations Matter Tech MD NP RN PA 27 27
36. “This board has to implement a compliance program. Please … we don’t need the visual aid.” 28
37. Trusting and Not Verifying “Background checks – nope we don’t do that unless, well you know, they look like we should.” “Sure I cleaned up the AR.” “Yep, we are appealing accounts.” “How would I know they weren’t sending patients statements?” “Well, I though we were _______.” “She told me we were ______.” 29
56. 48 “Instead of my resume, I’ve printed out my daily horoscope for the past year. You’ll see that I’m a special person who is destined for great things!”
59. Litmus Test for New Technologies Save Time Boost Efficiency Reduce Costs Improve Patient Experience Leverage Knowledge 51 If it doesn’t, don’t buy it!
60. More Common Than You Think 52 You Bought This… You Drive It Like This...
61. Race Car vs. Station Wagon Appointment Schedule Integrated with encounter form generator? Set-up templates by condition, MD? Integrated with batch eligibility processing? Billing & Collections Are you leveraging custom message on statements? Do staff use work queue features? Is anyone using the payment plan follow up tool? Flags & Account Alerts Reporting! 53
72. The Rise of Networks and Social Media 35% of online adults have social network profiles. Facebook reports ‘several million’ accounts of users older than 65. Source: Pew Internet and American Life 64
73. MGMA Survey Results Do you currently have a group practice web site? Yes - 81% Do you see the internet as an effective communication medium for basic information between you and your patients (office information, insurance information, downloadable forms etc)? Yes - 93% Assuming security is not an issue, do you see the internet as an effective communication medium for personal information between you and your patients for: 65
75. Does Your Website Do This? New patient packet/pre-registration Referring physician section Digital forms and policies Appointment scheduling options Post-op instructions Patient stories Videos of surgeons and what to expect in the office Email staff and surgeons 67 See KZA’s Minimum Website Requirements–2009
89. Use Key Features 69 Out of Office Reply Greetings! I am out of the office returning on August 24th. My phone access is limited and none to email. Call my office at 312.642.5616 x. 15 and ask for Mary if you need something or to schedule an appointment. Karen Custom Signature
90. 70 I don’t skate to where the puck is; I skate to where I think the puck is going to be.” -Wayne Gretzky
