The economic downturn has affected everyone including the medical practice. High unemployment rates have increased the number of patients not covered by insurance. This in turn means there are less premium revenues available from Private Payers. Stock market declines have resulted in insurance companies making less on investments. To preserve profits, Insurance companies are “cost-shifting” to physicians by placing downward pressure on reimbursements. From 2008 to 2009 the average payment for office visits for new patients, established patients, and consults decreased by almost 8 percent.
Healthcare reforms are projected to lower the overall cost of healthcare in part by decreasing physician compensation. A recent PricewaterhouseCoopers (PWC) report estimates that $1.2 trillion of the total $2.2 trillion spent on healthcare in the United States is wasted due to Ineffective IT, non-optimized claims processing and defensive medicine. The President’s recommendation to adjust payments so that health care providers are encouraged to increase productivity in how they deliver health care is a call to focus on efficiencies.
For the traditional medical practice these external forces necessitate the need to examine the five major practice components of IT expenses, work flow, labor intensive administrative operations, revenue management and compliance.
1. IT services need be examined for cost of deployment, technical staffing and training and software compliance across multiple office locations.
2. Complex and rigid processes and work flows are non-intuitive and require highly specialized training for staff. Over time this can result in a practice not agile enough to meet the ever changing needs of todays and tomorrows practice.
3. Labor Intensive daily tasks like claim management, patient follow-ups and insurance authorizations require intense office staff focus, tying up valuable resources that could be utilized on other value added activities.
4. Optimizing revenue may be difficult for a traditional practices due to a lack of time and tools required to identify and act on areas of the business and process management, as they relate revenue.
5. Compliance to HIPAA, Insurance Providers, and coding standards have regularly updated regulations that must be continually addressed.
Solutions lie in breaking down the silos built up within the practice for optimized work flow, outsourcing IT and software, implementing proven fortune 500 revenue and cost management techniques to increase practice profitability, perform internal audits for compliance assurance and free up physicians and staff to have more time for patients, family and self. For more information, check out our medical factoring and billing solutions.
Dan Conrad
Compound Profit Medical of Virginia
4870 Sadler Rd. Suite 300
Glen Allen, VA 23060
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medical billing, medical factoring
medical factoring, medical billing