Several years ago, a colleague and I were presenting market research to a large audience of employed physicians and administrators. A few minutes into the presentation, a physician in the middle of the hotel ballroom raised his hand and said, rather adamantly, “Don’t call my patients customers! They are not customers, they are patients!”
Healthcare organization decision-makers often struggle with the question of whether or not to bring in an interim executive (often referred to in more general terms as an interim manager). One of the major barriers to this decision is cost.
This concern about cost makes sense, particularly if management views an interim as nothing more than a warm body to serve as a placeholder during the search for a permanent executive.
However, if you bring in the right interim manager—a seasoned executive with a proven record of improving performance and driving change—the benefits of engaging an interim manager can far outweigh the costs involved. In fact, the right interim executive can provide a return on investment that exceeds the associated fees and expenses several times over.
One of our clients, a large hospital-owned physician practice network, needed to quickly improve their financial performance. Their Rapid Improvement Plan included goals designed to speed up the cash collection process, maximize opportunities for reimbursement, improve coding and documentation at the clinics, and increase provider productivity. Sound familiar?
With these goals in mind, we convened in a conference room with about a dozen key players, including practice managers as well as representatives from information systems, finance, revenue cycle, and managed care. The two of us from Halley—a revenue cycle expert and an operations expert—began engaging the group in a conversation regarding the overall performance of the physician practice network. In our passion and enthusiasm for the topic, we seamlessly worked together throughout the discussion, even to the point of finishing each other’s sentences. This was just a normal day for us, supporting one another in our roles, and we didn’t give any thought to the impact of what we were modeling. But for the leaders sitting around the conference table, our synergy was a revelation: This is how it should work. This is the partnership of operations and revenue cycle in action.
As hospital CEOs take on more of a market manager role, it is crucial for them to build and sustain relationships with employed and private practice physicians in the community. We all know that referrals follow relationships—and that all relationships atrophy over time—so hospital executives need a coordinated way to proactively visit with physicians on an ongoing basis.
One way you can assist your CEO to stay focused on physician relationships is by creating an executive rounding program, where hospital or healthcare system executives meet with targeted physicians on regularly scheduled visits.The following steps will help you on your way to building an executive rounding program that is both meaningful and effective.
As a consultant in physician network management, I regularly recommend that healthcare systems contract with an external expert to perform quarterly audits on coding and revenue cycle metrics for their providers.
Because if you’re not monitoring metrics, you’re leaving money on the table. And not just a few hundred dollars.
One example of a revealing metric is the adjusted fee-for-service collection percentage. When we find that a client has not been monitoring this metric, we perform the calculation and often discover that they are leaving hundreds of thousands of dollars on the table.
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.
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.
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.
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:
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.