Small Practices: Adapting to the Challenges of Healthcare Reforms for Better Revenue

The major challenges faced by physicians who run a small practice or clinics that have less than four or five physicians are expanding exponentially. Many physicians find themselves worrying and spending time on administrative processes and interacting with payers rather than spending some quality time with their patients. The recent health reforms including the HITECH Act, implementation of EMR and EHR, the overhaul in medical coding and billing procedures, Medicare cuts, and the added burden of incorporating new technology in the face of increased patient volumes have brought single physicians and small clinics to the end of their tethers.

However, the challenges are difficult but not insurmountable and health providers who work as a small group or on their own or are Individual Practice Associations (IPAs) are finding solutions to these myriad hurdles. Here are some simple steps that you can take as a single physician, an IPA or a small group of physicians in order to increase the revenue without sacrificing the quality of services provided.

Technology

The use of Electronic Medical Records and Electronic Health Records has become a feature of the recent health reforms. However, many physicians and clinics are struggling to understand and use the healthcare technology, either because it seems too cumbersome or due to the inevitable resistance to new technology. This problem can be circumvented by partially or completely outsourcing your healthcare IT-related requirements to an entity that understands the changes and has had hands-on experience in using the latest technology for such processes. These experts can also support your staff in up grading the relevant skills for routine usage of these processes.

Medicare

Small practices and clinics usually find it difficult to balance the administrative processes and patient care without either dropping some insurance providers or putting in more time and effort that is not justified. Moreover, the looming Medicare cuts that seem inevitable along with increasing number of baby boomers have made many physicians and clinics consider dropping Medicare patients as well. The time and effort put into interaction with payers and delays in reimbursements cannot be justified if quality of patient care drops along with the revenue. An alternative would be to outsource such processes to medical billers and coders experienced in latest Medicare regulations, who can save time and effort for the physicians and their staff and ensure minimum losses by utilizing their experience and skills in this area.

Rural Physicians

IPAs or physicians practicing in rural areas are the ones who are going to be most challenged by the reforms since these are either nurse practitioners or single doctors with a small staff. The burden of implementing and testing the new technology according to CMS and HHS guidelines and handling claims denial, interacting with payers while providing patient care in relatively poor localities can take a toll on the revenue. Moreover, since there is a dearth of health care providers in rural areas it becomes difficult to just drop patients because of delayed claims or due to Medicare cuts since this would put patients’ health in jeopardy and lead to decreased revenues for physicians as well. The need for dedicated medical billers and coders who can also handle claims denial along with other tasks such as charge entry and payment posting can be felt in such times. These medical billers and coders would ensure that you as a health care provider dedicate most of the time to patient care instead of interacting with insurance companies and worrying about various guidelines to be followed.

The Solutions

There is no question that small practices and solo physicians would need to adapt to the reforms in the health care system. There are many ways of doing this and some small practices have joined bigger health care providers for training as far as the new technology is concerned. Other practices are grouping together in order to share knowledge about the changes and search for solutions. Another solution is to form a medical group so that you as a physician receive better benefits and pay by without worrying overmuch about routine administrative hassles all by yourself. These mergers can help solo or IPA physicians in understanding and sharing the risks and benefits of the health reforms, share resource expenses and also improve the quality of care for their patients.

Another feasible alternative is to tie up with a standard healthcare consultancy provider such as medicalbillersandcoders.com, for effective and customized solutions in healthcare IT, Revenue Management and strategic operational areas for small practices. This consortium is preferred by smaller practices due to its reach in all 50 states across

Visit medicalbillersandcoders.com for more information.

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