It’s no secret that the healthcare reform is changing the way medical providers operate. Patient responsibility is higher than ever, and consumers are having a difficult time understanding their new policies. This leads to higher patient balances, which often go unpaid. In addition, with co-pays, deductibles and co-insurances on the rise, patients are beginning to shop around for care. In order to compete, the emphasis in medical practices must shift from volume to value.
In the face of these changes, medical office staff is playing a much bigger role in patient experience and has a significant impact on how well the office functions. Practices must focus on process efficiencies to reduce increasing costs and to reassess patient collection policies to increase declining revenue while still maintaining patient relationships. According to the presenters at this year’s Maryland MGMA State Conference, making these necessary changes starts with empowering and educating medical office staff.
According to Owen Dahl, Medical Practice Management Consultant and keynote speaker at this year’s conference, quality is the key to the future. Patients are now shopping price, which to a provider could be high deductibles, but could also be long wait times, inconvenient appointment hours or less than friendly staff.
Dahl said in order to improve quality and lower costs, practices must begin to function leaner. In order for a practice to be lean, it must “consider the expenditure of resources for any goal other than the creation of value for the end customer to be wasteful and thus a target for elimination.”
The most important consideration in running a lean practice is to focus on the customer, but the practice must also reduce waste and downtime. Examples of downtime include long wait times, excess processing and failure to utilize and empower medical office staff.
Maureen West McCarthy, a CPA with Medical Business Advisors and another presenter at the conference, agreed with Dahl that in order to provide a quality patient experience the front desk staff must be properly trained and empowered. She also spoke to the new management techniques that are required due to new payment methods and revenue struggles under the reform.
According to McCarthy, five to seven years ago the average patient balance was approximately 10% of the total fees. Today it is nearly 30%. Failing to reassess collection efforts could mean a loss of 20% of a practice’s revenue. Increasing at-time-of-service collections begins with authorizing and training staff to collect patient responsibilities and past-due balances. Additionally, higher patient balances are more costly to recover. It now costs twice as much to collect from a patient than from an insurance company.
Some of her suggestions for meeting new challenges included not only authorizing and requiring staff to collect patient balances, but also providing them with the right tools for the job. Make sure they have access to accurate patient balance and eligibility information, train them on what your financial policy states you will do when patient cannot pay, and decide upon a strict in-house and/or third-party collection policy.
The healthcare reform is bringing about various changes in medical practices and as a result medical office staff positions are becoming increasingly important and difficult. Not only are those members of your organization charged with being the face of the practice, but they also must understand the ever-changing eligibilities and coverages of new insurance plans. Most importantly, they need to be able to educate patients about their coverage and to execute stringent collection policies.
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Written by Ali Bechtel, Public Relations Coordinator
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