Steer­ing in trou­bled wa­ters

Med­i­cal group man­agers face raft of tricky is­sues in down econ­omy

Modern Healthcare - - OPINIONS COMMENTARY -

Is­tarted my work as the new pres­i­dent and CEO of Med­i­cal Group Man­age­ment As­so­ci­a­tion and the Amer­i­can Col­lege of Med­i­cal Prac­tice Ex­ec­u­tives about a week ago. What bet­ter way to hit the ground run­ning than by at­tend­ing the MGMA’s an­nual con­fer­ence in Las Ve­gas this week. I feel for­tu­nate as I take the helm of the as­so­ci­a­tions to see our mem­bers in per­son in my first weeks of em­ploy­ment.

As I’ve been con­nect­ing with mem­bers, I’ve sensed the pres­sure they are feel­ing from the chang­ing health­care environment. They de­scribe their plates as al­ready full as they are tasked to adopt new in­for­ma­tion tech­nolo­gies and im­ple­ment new busi­ness pro­cesses to ac­com­mo­date health re­form, all the while en­sur­ing that their prac­tices run in the most ef­fi­cient and ef­fec­tive man­ner pos­si­ble. This stress also was present in 2005 when I was the chair of the MGMA board of di­rec­tors. Then, too, our mem­bers faced cuts to Medi­care physi­cian pay­ments, but I would have never imag­ined our mem­bers would be fac­ing an al­most 30% cut to­day. Our mem­bers look to the MGMA and ACMPE to act as a light­house amid all the bur­dens they must over­come to run an ef­fi­cient med­i­cal prac­tice. We’ve been dili­gent about let­ting them know what they can be do­ing to­day to help en­sure their prac­tices are as healthy as pos­si­ble to­mor­row. Here are a few of our rec­om­men­da­tions:

Cre­ate a con­tin­gency plan for po­ten­tial Medi­care physi­cian pay­ment cuts. Many prac­tices are brac­ing for these po­ten­tial cuts and are try­ing to quan­tify the im­pact. Prac­tices also need to scru­ti­nize com­mer­cial con­tracts where re­im­burse­ment is di­rectly tied to Medi­care rates. Many prac­tices al­ready have cut their op­er­at­ing ex­penses as closely as they can. Ac­cord­ing to the MGMA’s Cost Sur­vey, med­i­cal prac­tices cut op­er­at­ing ex­pen­di­tures 2.2% in 2010 as they an­tic­i­pate a po­ten­tial cut to pay­ments.

Cre­ate a strate­gic plan for your or­ga­ni­za­tion. Many prac­tice lead­ers are fac­ing crit­i­cal strate­gic de­ci­sions: Join an ac­count­able care or­ga­ni­za­tion? Sell to a hos­pi­tal? Merge with other prac­tices? Go it alone? A plan­ning process can pro­vide di­rec­tion even though the con­clu­sion may be, “We’re com­fort­able stay­ing as we are for now.” Plan­ning will re­quire some ef­fort, in­clud­ing po­ten­tially hir­ing an out­side fa­cil­i­ta­tor and us­ing ev­i­dence and data to drive these de­ci­sions. The plan should con- records un­der the stim­u­lus act.

Cre­ate or up­date your dis­as­ter plans. This past year’s hor­ri­fy­ing tor­nado in Jo­plin, Mo., and other nat­u­ral dis­as­ters re­mind prac­tice lead­ers that we need to be vig­i­lant. Prac­tices must un­der­stand their role fol­low­ing a nat­u­ral dis­as­ter and how to pro­tect their busi­nesses as well as care for and pro­tect their com­mu­ni­ties.

Pre­pare for a value-based ap­proach to con­tract­ing. Although we have some idea of what value-based con­tract­ing looks like, there re­main many un­knowns. As these wa­ters be­come less murky, we are work­ing dili­gently along­side our mem­bers to help lead this mas­sive change. You can start pre­par­ing your staff to track and re­port on a va­ri­ety of qual­ity and uti­liza­tion met­rics. Be pre­pared to deal with a va­ri­ety of both fee-for-ser­vice and value con­tract com­bi­na­tions.

Hire a cre­den­tialed, pro­fes­sional med­i­cal prac­tice leader to help the prac­tice have the best chance in this tough econ­omy. Med­i­cal groups must con­tend with over­whelm­ing ad­min­is­tra­tive com­plex­ity and reg­u­la­tion with the end goal of pro­vid­ing a safe, sat­is­fy­ing pa­tient ex­pe­ri­ence and help­ing the prac­tice to suc­ceed. A cer­ti­fied prac­tice leader with rep­utable cre­den­tials, such as the cer­ti­fi­ca­tion and fel­low­ship pro­gram by the Amer­i­can Col­lege of Med­i­cal Prac­tice Ex­ec­u­tives, can give a prac­tice the best chance of suc­cess in this dif­fi­cult mar­ket­place.

Mea­sure your prac­tice against in­dus­try stan­dards and know what in­di­ca­tors to watch. Fre­quent bench­mark­ing to ap­pro­pri­ate and mean­ing­ful stan­dards takes on greater im­por­tance as re­im­burse­ments stag­nate or de­cline. The suc­cess­ful prac­tices will rec­og­nize and re­act quickly to ad­verse fi­nan­cial trends.

I look for­ward to work­ing with our mem­bers and in­dus­try col­leagues to face down these chal­lenges, and to take ad­van­tage of all the op­por­tu­nity for growth and in­no­va­tion to help im­prove our health­care de­liv­ery sys­tems.

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