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    Site-neutral payments: What does it all really mean?

    Posted by Stephanie Boim on Dec 18, 2015 1:27:00 PM

    Experts agree that the days of payment differential are fading. The new and revised place of service codes become effective January 1, 2016. What are your considerations for developing strategies in a site-neutral environment?

     

    As a revenue cycle leader, one of my most challenging moments was trying to explain to an eighty-six-year-old patient why she had to pay more for her doctor visit. The patient had a great understanding of her deductible and coinsurance. She also had been seeing the same internal medicine physician for more than thirty years, as she reminded me frequently throughout our conversation.

    But things had changed. Her internal medicine physician’s practice had been acquired by the local hospital system. What was once a private practice, owned and operated by the doctors within the group, was now an off-campus hospital outpatient department.

    I asked the patient if she had seen the new signage and if she’d received the written notice describing her potential financial liability with the change in practice ownership. She informed me that she’d had to fill out new paperwork and had been given plenty of documents in return—but in her opinion, it was all a big waste of time. Nothing had changed for her in years. She lived in the same home and carried the same red, white, and blue Medicare card she’d always had. Why, she wanted to know, did she have to pay more money to receive the same care she’d been receiving for years?

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    Topics: Revenue Cycle

    Hospital-Owned Medical Practices: Managing for Performance

    Posted by Marc D. Halley, MBA on Dec 15, 2015 8:30:00 AM

    This post originally appeared on the MedCity News website on December 6, 2015.

    On a recent assignment, we encountered a hospital client who had built up a bureaucratic maze of medical directors and executives tasked with steering both the business and clinical sides of the hospital’s owned medical practice network. Unfortunately, rather than facilitating smooth operations, the additional layers of management slowed the decision-making process, created confusion for providers and support staff, and produced inconsistent operating performance from clinic to clinic.

    At the client’s request, we provided training on operational governance and introduced our council model to the physician network. As they began to implement our training, the physicians and other providers became engaged as peers and as partners, providing the positive peer pressure and clinical direction necessary for day-to-day operations within each individual practice and across the entire medical group.

    In implementing this new system of operational governance, our hospital client noted that many of their traditional medical director roles had become superfluous. As a consequence, they asked for our help in creating a streamlined and effective implementation management infrastructure that would support the new operational governance model and perhaps even allow for the elimination of these unnecessary director roles.

    Such a request is not uncommon; we have interim managers out in the field who are seeing similar situations on a regular basis. What we’ve learned from being on the ground is that, as we mentioned in the previous article, hospital-owned physician networks can benefit greatly from studying successful independent practices and applying what they learn to their own infrastructure.

    Let’s take a look at some of the principles of management that work well for independent practices and examine how those principles can apply in a medical practice network setting.

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    Topics: Operational Governance, Interim Management, Physician Practice Management, Engaging Employed Physicians

    Are PCPs the Foundation of Your Growth Strategy? They should be.

    Posted by Sarah Montijo, MHA on Nov 10, 2015 10:00:00 AM

    The following post was written by Sarah Montijo, MHA, Director of Business Analytics and Consulting Executive for Halley Consulting Group.

     

    Sit in almost any hospital leadership meeting focused on growth or strategy, and you will likely hear the phrase market share—the percentage of admissions the hospital captured relative to the market basket, or total admissions for a given area. The competitive landscape of healthcare makes monitoring your market share trends, and understanding what and who is impacting those trends, a must.

    Gone are the days when hospital CEOs could focus strictly on managing the hospital. Now they must also manage their market. These hospital CEOs, whom we often refer to as market managers, have to appreciate what drives their market share by understanding the relationships and affiliations that exist with physician practices in their community, and by forging relationships where they are currently absent. Market managers should consistently ask themselves three questions:

    • Where is my market share?
    • Who holds my market share?
    • What are they doing with it?
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    Topics: Primary Care Retail Strategy

    Engaging Employed Physicians in Your Hospital's Success - Part II

    Posted by Marc D. Halley, MBA on Oct 5, 2015 10:00:00 AM

    In Part I of our post on engaging employed physicians in your hospital's success, we discussed engaging with physicians as business partners. In this post, we explore a successful model for decision-making, performance improvement and accountability.
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    Topics: Operational Governance, Physician Practice Management, Engaging Employed Physicians

    Engaging Employed Physicians in Your Hospital's Success - Part I

    Posted by Marc D. Halley, MBA on Sep 21, 2015 10:00:00 AM

    A few years ago, a client engaged us to conduct an evaluation of their multi-specialty, multi-site group practice, which was organized as an integrated component of a local health system. This multi-site network suffered from high physician turnover and annual financial losses in the millions. As we began to delve into the everyday workings of the practices, we found that the physician CEO who managed this network had an autocratic leadership style, and the providers had little input into decisions that affected their daily lives. The practice management team gave inadequate attention to clinical or service quality. Performance expectations were unclear. Provider productivity varied dramatically, and no one was held accountable for performance improvement. As a consequence, the individual providers felt no concern for practice or enterprise performance.

    We’d seen this scenario many times, and we quickly zeroed in on the fact that the providers’ indifference to the success of the organization was hindering performance improvement for the entire network.

     

    In fact, this lack of physician engagement
    had become one of the most critical barriers
    keeping the practices from reaching
    individual, network, and organizational goals. 

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    Topics: Operational Governance, Interim Management, Physician Practice Management, Engaging Employed Physicians

    Improving Front Desk Operations

    Posted by Charlene Mooney on Aug 26, 2015 10:00:00 AM

    Thinking of hiring more staff for your busy office? Before you do, take a good look at your front desk operations. There may be significant opportunities to improve workflow without increasing staff. 

    When examining office workflow, it helps to ask who, what, and how—or, more specifically:

    • Who is performing the job?
    • What does the job require?
    • How is the job being performed?

    Here are some ideas that I’ve found helpful in working with clients to improve front desk operations:

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    Topics: Front Desk Operations, Physician Practice Management

    Are You Maximizing the Value of Your Physician Network?

    Posted by Marie Debs and Luanne Yeley on Aug 3, 2015 10:00:00 AM

    In this post, Marie Debs and Luanne Yeley, consulting executives with Halley Consulting Group, offer insight on effective approaches to optimize revenue cycle management for physician networks.

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    Topics: Interim Management, Physician Practice Management, Revenue Cycle

    Halley Consulting Builds High Performing Medical Groups

    Insights from Thought Leaders at Halley Consulting Group

    Halley Consulting Group has a proven track record of building high performing medical practices. We can show you how to continue to benefit from the downstream revenue provided by your owned physician network, while at the same time, diminishing the losses. If this type of measurable performance improvement would be of interest to you, please contact us! We would be delighted to visit with you. 

    Check our blog regularly for industry insights on many topics, such as:

    • Enhancing physician-hospital relationships
    • Improving performance through operational governance
    • Managing medical groups
    • Evaluating revenue cycle
    • Planning physician compensation
    • Facing changes in the healthcare industry

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