Forecast for Healthcare Finance 2015

“Cheers to a new year and another chance for us to get it right.”

– Oprah Winfrey

2015 is forecasted to be another year of tremendous change in healthcare.  Looking back at my long career, I realize that every year has been a year filled with change.  Often, adjusting to change requires greater mastery of the basics.

For example, let’s look at revenue and financial management.

• A recent Health Leaders Media article identified high-deductible health plans as the top revenue challenge in 2015:  It states: “Healthcare financial leaders say high-deductible health plans, whether pushed by employers or offered through health exchanges, are rapidly expanding the risk of non-payment.  Many consumers choose plans with the smallest upfront cost and largest deductibles…”
• One-third of American were enrolled in a health plan with a deductible of $1,000 or more in 2012 and 14% had a deductible of at least $2,000 in 2012 according to a Kaiser Family Foundation study.
• The Camden Group recently published “Top 10 Trends and Implications for Medical Groups in 2015”.  Trend #3 states “Patient Collections cannot be ignored…”
• An Aon Hewett analysis states employee premiums and out-of-pocket healthcare expenses doubled since 2009, will increase 8% from 2014 to 2015, and out-of-pocket costs will be $2487.

Yes, more self-pay can result in more financial risk, but this risk can be effectively managed by going back to the basics.

The following 9 questions are a solid starting-point:

1. Are our Review Financial Policies current and do they reflect the new payment paradigm?  Are we clear in our expectations on patient financial responsibility?  Do we ask for payment at the time of service and provide patients the opportunity to pay by cash, check, PayPal or credit card?
2. Is our technology current?  Are we prepared for ICD – 10?
3. Does our team provide a clear, consistent message on Patient Financial Responsibility?  Have we trained them adequately to collect at the time of service?
4. Do we verify insurance coverage and do we know who is financially responsible?  For example, do we know the patient’s financial responsibility (copays, deductibles, exclusions, etc.)?
5. Are we collecting the patient’s financial responsibility at the time of service?  If payment arrangements are needed, do we have a system for monthly payments?
6. Are bills accurate and timely?  Some experts recommend a 24 to 48 hour standard for charge posting, check posting, rejected claims, and responding to correspondence.  Daily submission of claims and monthly review of unpaid claims are also frequently recommended.
7. Are our coding practices current and acceptable?
8. Are payers reimbursing at our contracted rates?  Are our payer contracts acceptable?
9. Is our monthly review process meaningful and do we have goals?    Do we have the ability and are we routinely reviewing key numeric indicators?

I was impressed by the simplicity of a program that focused on only 4 numbers:

Yes, 2015 will be a year of changes and challenges.  As shown in the above, mastery of patient collections can yield major results.  Achieving these results is realistic with good systems, effective staff, and straight-forward goals.  In 2015, Physician Partners and the Physician Resource Center will continue to offer our members the advantages of a large medical group while respecting the autonomy of the individual practice.

We’re here to help!  Happy New Year!

Office Supply Savings & More with our Latest Vendor Partner!

We are excited to announce that The Physician Resource Center has negotiated an exclusive type of business contract through the MedAssets GPO with Office Depot®.

Effective immediately, you’ll be able to start saving on office supplies, equipment, and more with customized pricing. A recent analysis indicates a 15% average savings on common items.

Our program includes:

Facilities and safety
Hand soap, paper products and floor equipment, even safety supplies, including first aid, personal protective equipment and more.

Office products
All the essentials, including pens, paper, ink and toner from top brands, as well as Office Depot® brand products for even more cost savings.

Furniture
Business Interiors by Office Depot® offers everything from a new chair or replacement cabinet to a full office redesign.

Technology
PCs, laptops, peripherals and tech accessories, even servers and multifunctional printers to accommodate larger workspaces.

Print and promotional products
Business cards and letterhead, marketing materials, forms and more, plus branded promo products to make customer connections.

We worked closely with Office Depot® to create a program that is the perfect fit for our business. Not only will we significantly reduce our spending but also consolidate our vendors and simplify orders as well. And with their experience and expert recommendations, our program will only get better.

Please look for more communications in the coming weeks, including introductions to the team and training, as we smoothly transition to our new program with Office Depot®.

Cleaning and breakroom
Coffee, water, energy drinks, sweets and healthy snacks as well as cleaning products and even sustainable options.

Success in Medicine despite Intolerance – Dr. Prabaker’s Story

“Here in the medical community, I am proud to say that while cases of discrimination do occasionally exist, they are usually outweighed by the idea that people should be valued for their knowledge and experience rather than their skin color.” — Venu Prabaker

Dr. Venu Prabaker is opening up about his personal experience with discrimination in the September 2014 edition of San Diego Physician Magazine, an official publication by the San Diego County Medical Society. Dr. Prabaker stresses that while intolerance does exist, he has never let it prevent him from building a successful practice or hold him back from reaching for his career goals.

Discrimination, My Perspective

By Venu Prabaker, MD | September 2014

Having been born in India, a country with a long tradition of having a strong caste systems, I am no stranger to discrimination. The Indian government has tried to change this negative aspect of their culture in recent years, and Gandhi drew worldwide attention to the problem by speaking out against oppressing the constantly downtrodden “Untouchables.” But judging people by their social class, color, or profession continues to be a persistent issue in India. Unfortunately, this mentality expands past the borders of a single country.

The reasons I came to America are intriguing and involved, but, for the sake of brevity, I’ll skip them for now. Though I had completed training as a doctor in India, the American medical system demanded that I restart my residency upon coming to this country. Consequently, I lived in poverty for eight months, often on just one meal a day. My first place of employment was in Paintsville, Kentucky, a very small town. So small, in fact, that a classmate and I were the only people in the entire town who weren’t Caucasian. He was faring better than I financially, so one night he offered to take me to dinner. We sat and talked at a table in the restaurant for over an hour before noticing that other patrons had come and gone, but the two of us hadn’t been acknowledged by the staff.

Click here to read more…

Original Article from: San Diego Physician Magazine, September 2014 Edition