Happy patients mean healthy practices
Nearly 80 percent of the better- performing practices surveyed by MGMA assess patient satisfaction. Some did so once a year, some monthly. But most of the surveys looked at various practice elements, including:
• Professionalism of the staff, • Overall experience, • Appointment availability, • Quality of care, • Recommendation of practice to oth- ers, and
• Bedside manner. Practices also put the survey results to
use, primarily to educate physicians and staff about behavior and to evaluate and improve practice operations.
ville Clinic conduct regular meetings with physicians to review financial data and make decisions on larger purchases or long- term planning.
Physicians also can join staff on committees to address spe- cific practice needs they are interested in, such as ICD-10 or EHR updates. “That keeps physician engagement in the practice and al- lows for everyone to know what the practice pressures are and what long-term plans are being made to address those,” Dr. McMillion said.
Cash is king One of those pressures is making sure practices have adequate
Mr. Evenson recognizes that not all physician practices can
afford to hire a robust staff. But he says the MGMA survey shows having a certain number of staff does not matter as much as having the right staff to support physicians and allow them to be as productive as possible.
Good training and support for staff also should be consid-
ered an essential investment, says Donna Kinney, director of health care research and data analysis for TMA’s Division of Medical Economics. “Proper training means that practice staff can help physicians solve practice problems.” Stephenville Clinic, for example, recently adapted to the loss of some employees it could not afford to replace by cross- training existing staff to take on additional roles. “Of course, there is some overhead to pay for the salaries of the people who help you take care of the business. But we accept that as the price of doing business,” so the practice runs smoothly and so physicians can put most of their focus on patient care, Dr. McMillion said.
That does not mean individual physicians aren’t involved in or aware of the practice’s overall financial health and goals. For example, ABCD Pediatrics, Thomas Spann, and Stephen-
20 TEXAS MEDICINE February 2014
cash flow to keep their doors open, which means getting claims out in a timely manner and following up on collections. That process has become more important as practices report having to cope with an increase in high-deductible health plans and brace for unexpected recoupments by insurance companies — two trends that are likely to continue with the launch of the federal health insurance exchanges. (See “Un- tested Waters,” December 2013 Texas Medicine, pages 37–42.) The MGMA survey showed that among the better-perform- ing practices, most payments were collected within 30 days; only 9 percent to 14 percent of claims were outstanding for more than 120 days; and only 3 percent were denied on the first submission. Nearly all of the practices — 95 percent — billed claims electronically. At ABCD, “we do a good job of getting our claims out the door within 24 hours of service and getting our cash in some- times in a week,” Practice Administrator Victoria Waltemath said. In the past, claims filing had lagged by as much as two weeks, “and we can see by the quicker turnaround that we can increase income by about 20 percent. So practices don’t have to do anything other than get things done in a timely manner because the later claims go out, the later payment comes in.” Making sure claims go out correctly also is key to a quick turnaround on claims.
As a first step, Thomas Spann staff and physicians work as a team to make sure everyone is educated on correctly coding claims. Chief Financial Officer (CFO) Belinda Chism says a good practice management system also comes in handy, which “allows us to ‘scrub’ claims for inaccuracies before they reach the clearinghouse and payers.” As another level of protection, the clearinghouse Thomas Spann uses scrubs the claims a second time for more-detailed items like new drug codes or updates to existing ones. “Our claims are not sent to payers until they are corrected, so the denials we get are true denials and not for minor items like missing a number. It keeps cash flow up, and our mailbox is no longer full of minor denials, which are very time-con- suming,” she said. All three practices Texas Medicine spoke to said they’ve seen an uptick in high-deductible plans in recent years. That means patients must pay a certain amount out of their own pocket before their insurance kicks in, an amount that physician prac- tices must collect up front in order to get paid. Those deduct-
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