Surviving as an Independent Medical Practice

Let’s face it, the hard reality is that it is harder than ever these days to run a successful independent medical practice. As insurance payers change to value-based vs. fee-for-service reimbursements, solo and/or small practices will be on the hook to struggle through the changes in clinical care and administrative coordination to receive payment. Staying independent can happen and thrive in the current abyss of changes. How? A national healthcare advocate advised on the following capabilities to stay independent:

  • Strong Financial Performance
  • Connectivity and Clinical Integration
  • Ability to thrive in a risk-based environment
  • Competitive Edge
  • Adaptability to change

Essentials for Surviving and Thriving as an Independent Medical Practice.

Independent practices need to review, plan and maximize their efficiencies to outperform the reduction of insurance reimbursements. Audit and controls are essential for the Independent practice, such as AuditGuard™ or CodeRite™, to ensure coding and fee schedules remain error free. Also, a complete revenue cycle management workflow ensures data is captured and provides the practice owner the strong financial performance indicators required to keep the practice on the right path.

Independent practices have great options for getting providers the right patient data at the right time, allowing for independence among affiliated entities. Connectivity reliability and clinical integration with cloud-based solutions, such as, EMRx™ and iClaim™, meet the requirements for HIPAA, MU2, ICD-10 and more.

Independent practices can compete in the world of the hospital-led ACO or physician-led ACO risk-based contracts. To do so, independent practices must focus on improving quality and efficiencies to stay competitive. Independent practices must have the right staffing and tools in place to outperform, be quality-focused and low cost providers verses a risk-based contract.

Independent practices must take the competitive edge from their counterparts, hands-down. Focusing on patient engagement, patient communication and patient involvement is critical to staying ahead of the alternative enterprise/hospital practices. For example: optional payment choices for the patient financial responsibilities, such as ChoicePay™ or QuickCollect™, allows the patient to choose how to pay their deductible, co-pay or co-insurance. Independent practices maintain a strong financial performance when there are minimal bad-debt patients and/or aged receivables.

Change, the never-ending story. Independent practices must be on the alert and ready to adapt to changes within the healthcare industry. The alternative is delay in reimbursements, even denied claims, due to not meeting guidelines. If your practice has started down this slippery slope, STOP NOW. A static Independent practice that is not paying attention to the industry will not survive. Seek out cloud-based, revenue cycle management partner(s) that are at the ready to help Independent practices change course, to capture new revenue, implement best practices, obtain better visibility with provider referrals, and improve the practices cash flow.

True or False?

True independence is not a viable option in the current health care environment.

False. We know that independent practices are under more pressure to conform, to demonstrate clinical/business outcomes or SELL to survive. However, there are very successful alternatives. Cloud-based EMR/PM solutions, partnering with experts in the revenue cycle management industry, become a stronger practice with the right support, right tools and connectivity plan in place to keep the independence practice and yet adapt to the change.

It will cost too much to make the changes necessary to remain independent.

False. With a cloud-based solution there is no need for large startup costs, such as installing servers or complex networks. To get started now, all the Independent practice is required to have is a computer and an internet connection. It’s really that simple.

Our practice is required to join a hospital’s EHR system to meet data exchange and care coordination requirements

False. Transferring of data today is widely done on and named the ‘technology superhighway’ for good reason. The millions of miles of the global technology superhighway allow for transferring of data not only in real time, but to and from multiple organizations. The security behind the technology is just as impressive. Cloud-based solutions can seamlessly connect to an independent practice, a lab, a hospital or a patients’ home all due to the internet connectivity. The Independent practice does not have to join a hospital just to make a connection to transfer data, it’s all completed “in the cloud”, as they say these days!