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SELLING THE PRACTICE

Due diligence in practice acquistions and physician employment

By John W. McDaniel Many hospitals and healthcare organizations are being approached by private practice physicians and physician groups seeking refuge from the unstable state of the healthcare economy and what lies ahead. While many healthcare organizations are employing physicians in order to solidify their market position, others (particularly in rural areas) find this method of physician recruitment most effective in terms of their overall medical staff development plans. Regardless of the reasons why hospitals and/or physicians are seeking to affiliate with one another, one of the most critical components to ensure that a successful transition occurs is performing a Due Diligence Analysis of prospective medical practices. Some of the most critical due diligence components which are a part of any medical practice acquisition are as follows: Rights to Payment… . . . read more.

WORKING WITH DOCTORS

Nearly 7 in 10 physicians now employed by hospitals and corporations, says report

Once upon a time, a medical degree was a ticket to life-time self-employment. That no longer seems to be the case—at least not the “self” part of the phrase. For years, hospitals and health networks have been gobbling up physician practices at increasing rates. And now a new study from the Physicians Advocacy Institute (PAI) finds that, as of the beginning of 2021, just 30 percent of all physicians in the U.S. are practicing medicine independently. The remaining 70 percent are employed by hospitals, private equity firms, health insurers or other corporate entities. Whither the independent physician? In addition to being a fixture of the U.S. health care system, the independent physician has been a part of Americana itself perhaps best captured in the paintings of Norman Rockwell. But now… . . . read more.

5 action steps for regaining staff trust

By Lynne Curry bio  When employees or colleagues no longer trust you, they don’t tell you. Why would they? They don’t trust how you might react to what they say. Their distrust descends below the surface, though it shows up in them keeping their distance from you. Distrustful employees or coworkers protect their backsides. They withhold information. Their morale and productivity lowers. According to the Edelman Trust Barometer, one in three of the 33,000 employees surveyed don’t trust their employers1 and as a result provide their employers lower levels of engagement, productivity and loyalty.2,3 According to recent surveys, 25 to 50 percent of employees plan to leave their employers in 2021,4,5 with distrust ranking among the top reasons for this talent exodus. What created this distrust? Some describe it as collateral damage resulting from… . . . read more.

MANAGING PATIENTS

Putting patients first is the best way of enhancing the doctor-patient relationship

By Dr. Neil Baum bio There is nothing in my practice of medicine that equals the joy of focusing on my patients and making every effort to ensure each encounter fosters a positive experience. Well, maybe one thing: positive outcomes. In my experience, the patients with whom I’ve developed close and trusting relationships seem to be better at following treatment plans, which helps improve positive outcomes. For decades, research has found strong indicators that the quality of the doctor-patient relationship impacts health outcomes. One significant finding is that the physician’s knowledge of the patient’s disorders and emotional state is associated positively with whether the physical ailments get resolved. Evidence shows that patients who feel they are not heard or are not respected by their doctors suffer poorer outcomes. A study from Massachusetts General Hospital… . . . read more.

MANAGING STAFF

How to prevent the spread of nurse burnout in your healthcare organization

When COVID-19 hit, healthcare teams were called upon to save the world. And they did. But what healthcare leaders didn’t realize was that the battle has just begun for healthcare heroes suffering a severe mental and emotional toll. As COVID-19 cases rise and fall and rise again, so do physician and nurse burnout. “Executive leaders are cutting back on their resources to the point where they have stopped investing in their people. They’ve stopped offering the very same programs that could help their teams protect their physical, emotional, and mental energy to ride this additional wave,” says Dr. Renee Thompson, founder of the Healthy Workforce Initiative,  a global leader in addressing disruptive behavior in healthcare. Dr. Thompson says when things get tough financially, administrators cut back on education and development… . . . read more.

INCREASING PROFITS

The physician enterprise model: a non-employment alternative

By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a part of their long‐range plans, but because physicians employed by hospitals lose approximately $190,000 per year, hospitals and health systems must explore alternatives to physician affiliation aside from the traditional employment model. Beyond employment Affiliation is sought for various reasons. Large hospitals seek a wider reach into communities, while small and rural hospitals seek help with physician recruitment, which has been troublesome over the past years due to 84% of senior medical residents desiring to practice in… . . . read more.

HUMAN RESOURCES

5 people problems and how to solve them

By Lynne Curry bio We can’t guess all the challenges facing us as office managers in this new year, but we can assume that we will be dealing with an old one: people and their personalities. Whether working together virtually or in-person, chances are good you will be dealing with people problems. Here are five common problems and strategies for dealing with them. Stopping a bully senior manager without losing your job Question: I face a situation that has no easy answer and no easy solution. As the office manager and human resources director, I supposedly enforce our corporation’s code of conduct and oversee the human resource issues. I report to the report to the chief operating officer, a bully who runs roughshod over any employee unlucky enough to cross… . . . read more.

KICKBACKS

OIG issues fraud alert on pharmaceutical company in-person speaker programs

Before the pandemic put the chill on live conference events, it was fairly common for pharmaceutical companies, device makers and diagnostics companies to offer healthcare professionals fees for in-person speaking appearances. Such practices raise red flags under the federal Anti-Kickback Statute (AKS) when those speakers recommend the products of those companies to their patients. So, on Nov. 16, the OIG issued a Special Fraud Alert warning companies about restarting in-person paid healthcare professional speaker programs when COVID-19 restrictions lift. OIG Skepticism of Speaker Fees Program Federal government suspicion of paid speaker programs, especially by pharmaceutical companies, is nothing new. For example, Novartis recently agreed to pay $678 million to settle a seven-year-long legal battle with the OIG over allegations of using its speaker programs as a way to disguise bribes to… . . . read more.

CODING

Impact of 2021 evaluation and management coding changes to WRVU based physician compensation

By John McDaniel bio As you may know, all physician contracts which include any form of WRVU based compensation will need to be reviewed and probably amended due to the increase in WRVUs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. We recently conducted an assessment for one of our hospital clients which showed the ʺunintended consequencesʺ of increased compensation to the physicians/providers and the resultant impact to fair market value standards. This has been necessitated by CMS whereby the final decision involved eliminating CPT Code 99201 and leaving CPT Code 99211 unchanged. The changes for CPT Codes 99202‐99205 and 99212‐99215 have resulted in increased reimbursement since the WRVUʹs for these codes have increased. Indeed, the increase in the WRVU component will certainly affect physician compensation… . . . read more.

CODING ALERT

Physicians should consider these overlooked codes

By Lisa Eramo bio It’s a common complaint heard among primary care physicians: Evaluation and management (E/M) codes don’t adequately capture the time, skill, and resources necessary to plan and coordinate care for patients with complex medical needs. Although new, streamlined E/M guidelines for 2021 may help, several existing remedies can enable physicians to capture additional revenue for the services they provide. More specifically, the U.S. Government Accountability Office (GAO) has published a list of 58 CPT codes that fall under the category of “longitudinal comprehensive care planning” (LCCP) for Medicare beneficiaries diagnosed with a serious or life-threatening illness. These codes include elements of shared decision-making through interdisciplinary care as well as development of a care plan to address the following: Progression of the disease and treatment options Beneficiary’s goals,… . . . read more.


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