Successful Medical Practice Management: Beyond the Beans

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Milo Conley
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1 Successful Medical Practice Management: Beyond the Beans Susan Turney, MD, MS, FACMPE, FACP President and CEO MGMA-ACMPE

2 About MGMA-ACMPE The largest, oldest and most respected professional association for practice managers Our (NEW) mission To elevate the performance of medical practice leaders and their organizations by: connecting members, building partnerships, setting the standards for certification, advocating for physician practice, and providing innovative solutions.

leaders and their organizations by: connecting members, building partnerships, setting

3 About MGMA-ACMPE Members Our members are among the leading experts in the business of medicine. Members in practices of all sizes, types, structures, specialties Practice managers of all levels from students to CEOs We leverage the power of our affiliate and local chapters to extend our reach and build on our collective voice

Members in practices of all sizes, types, structures, specialties Practice

4 Like medicine, practice management is both an art and a science mgma.com

5 Today s Reality 80.0% 60.0% MGMA-ACMPE Cumulative Percent Change Since 2001 for the Medicare Physician Payments, Not Hospital/IDS-Owned Multispecialty Group Operating Cost, and the Consumer Price Index 44.5% 50.2% 53.1% 60.5% 62.5% 65.6% 67.4% 40.0% 20.0% 0.0% -20.0% -40.0% 13.8% 0.0% 1.6% 16.6% 3.9% 20.6% 6.7% 30.0% 10.3% 34.0% 13.8% 17.1% -0.9% -0.9% -0.9% -0.4% 21.6% 21.1% 0.6% 2.9% 3.9% 4.9% % -3.8% -2.4% 23.1% 27% reduction due to implementation of the SGR * 2012, and 2013 median operating cost values are three year moving average projections of previous years'data. * CPI is the June 30 semiannual figure. 27.6% 29.8% 30.9% -23.4% Medicare Conversion Factor CPI Total Operating Cost per FTE Physician

1% 60.5% 62.5% 65.6% 67.4% 40.0% 20.0% 0.0% -20.0% -40.0% 13.8% 0.0% 1.6% 16.6% 3.9% 20.6% 6.7% 30.0% 10.3% 34.0% 13.8% 17.1% -0.9% -0.9% -0.9% -0.4% 21.6% 21.1% 0.6% 2.9% 3.9% 4.

6 Performance Today Is Production, Tomorrow Is Value Fee For Service Value Transition to Value-based Payment Strategy strives to maintain trajectory -Quality -Satisfaction -Outcomes -Shared Savings Time

7 Topics for Key Performance Indicators (KPI) Financial and nonfinancial metrics that define and measure progress toward organizational goals Business Practices Satisfaction Revenue Quantifiable measurements that reflect the critical success factors of an organization

organizational goals Business Practices Satisfaction Revenue

8 Regardless of location of service... Successful Healthcare Organizations will have: Skilled leaders Comparative data Actionable information Alignment with the community Patients that come first

9 Internal Data Sources Standard financial statements Income statement and balance sheet Payroll Special and ad hoc reports Appointment schedules Patient billing Claims clearinghouse Electronic Health Record Surveys, inventories, or assessments Staffing Patient satisfaction surveys Patient flow and time-motion (waiting time, lab turnaround)

Claims clearinghouse Electronic Health Record Surveys, inventories, or assessments

10 Practice performance insights Time to new appointment scheduling Change access model; add midlevels? Referrals to ancillary departments by service line Admissions, Radiology, Procedures, Outpatient surgeries Referrals outside of network (ie patient admissions from non hospital-affiliated specialists) Ease of scheduling with ancillary departments Staffing coverage (temp usage) Uniformity/cost of staff benefits Physician productivity periodically Care coordination use of nonphysician providers and services (physical and occupational therapy, home health, infusion services ) Cost effectiveness and ease of entry into hospital system

from non hospital-affiliated specialists) Ease of scheduling with ancillary departments Staffing coverage (temp usage) Uniformity/cost of staff benefits

11 External Data Sources MGMA Benchmarking Reports Broadest spectrum of sample data Primary areas of research Provider compensation and production Practice financials (cost, revenue, staffing, revenue cycle) Best practices Suggested revenue cycles indicators to watch: Gross charges Collections Accounts receivable Total medical revenue

(cost, revenue, staffing, revenue cycle) Best practices Suggested revenue cycles

12 Actionable Information- Defined Actionable Information Having the necessary information immediately available in order to deal with the situation at hand or be acted upon Information Logistics The right information for the right people Actionable Information Logistics The right information for the right people at the right time so that action may be taken

Information Logistics The right information for the right people Actionable Information

13 Generate Reports that Guide Colleagues To Making Better Decisions Organization WISDOM KNOWLEDGE INFORMATION DATA

14 Soft indicators. Beyond the beans mgma.com

15 Other factors for success Clinical integration Big Data Effective use of technology Exchanging Information Information at site of service Continuum of care Physician engagement

16 Patient-Centered Care More than just marketing copy Improved access Hours of operation; wait times; online scheduling? Higher quality Outcomes Safety Improved communication Patient engagement Measurements

17 Physician engagement best practices Participation - Committees, events, speaker s bureaus, open houses, community education Medical staff (non clinical) liaison - establish the relationship with physicians, office manager, etc. Constant communication (beyond your medical records are late ) Show up - Attend meetings, congregate where physicians congregate. Have a vested interest in success of the people and practice. Co-marketing - opportunities to improve community engagement, consider practices in planning with plenty of lead time to participate

Constant communication (beyond your medical records are late ) Show up - Attend meetings, congregate where physicians congregate.

18 Physician engagement measures Intrinsic Quality measures Patient satisfaction Good citizenship Accessibility to new patients Extrinsic Chart completion Call coverage EHR adoption/use Coding and compliance Administrative adherence Expense control Targeted cost savings Referral patterns

Chart completion Call coverage EHR adoption/use Coding and compliance

19 Challenges and Considerations Ability to capture data Accuracy of underlying data Objectivity of target measures Applicability to practice goals Ability to measure impact Accountability

20 Free DataDive A/R Tool:

21 Questions? mgma.com

MGMA Cost Survey: 2014 Report Based on 2013 Data. Key Findings Summary Report

MGMA Cost Survey: 2014 Report Based on 2013 Data % MGMA Cost Survey: 2014 Report Based on 2013 Data Each year, MGMA surveys its members and nonmembers to obtain the most recent cost and revenue data. This