The Future of Independent Practices Becomes Clear

“The most reliable way to predict the future is to create it.”

~ Abraham Lincoln

How hard is it to predict the future with any great degree of accuracy? Ask any meteorologist, fortune-teller, or stock analyst how accurate their predictions are, and they might say something to the effect of, “The accuracy of my predictions is based only on the evidence I have at hand.” But that is not what Abraham Lincoln seems to imply in his quotation about predicting the future. He says that we do have a role in what our future will be.

Perhaps the answer lies somewhere between these two seemingly divergent views. We can take what we know, and use it to predict what might happen, but we can also use our actions to make our predictions come to fruition. When it comes to predicting the future of independent practices, the prognosis can sometimes seem quite murky.

The COVID-19 pandemic has certainly clouded the waters, but it has also given more impetus to the goal of maintaining the private practice as a vital part of the healthcare system. This article peers into the crystal ball of the future to make some reasoned predictions, which can then be fortified by action.

Predictions About the Future of Independent Practices

“I think one of the most important benefits of private practice is that all the decisions affecting the practice are made by clinicians, those who understand what it means to be a physician and what it takes to provide care to patients.”

~Dr. Peter Rippey, board-certified family physician who practices in private practice in rural Missouri.

Prediction: Virtual health will transform the healthcare system

Analysis: Between November 2019 and January 2020, the Deloitte Center for Health Solutions, in conjunction with the American Telemedicine Association, conducted a survey of health care executives to obtain their opinions regarding how virtual health will shape the health care landscape for the next two decades. At that time, fifty percent of the respondents thought at least a quarter of all preventive care, outpatient care, well-care and long-term care would move to virtual delivery in twenty years.

Rapid implementation and acceptance of remote care during the pandemic may now serve as the tipping point to accelerate that timeframe even further. Benefits cited for the bright future of virtual care include:

• Providers and patients have the ability to share data and remotely engage in personal interactions.
• Patients have access to convenient, high-quality care that can help them take charge of their personal health choices.

• Virtual health care enhancements, such as a Virtual Preventative Care Assistant can relieve providers of mundane, repetitive tasks and enable them to focus of providing higher levels of personalized care. Amazing Charts offers the capability to add external remote care services to your patient care kit by adding remote staff, or contracting out existing staff, to reduce labor costs while maintaining patient continuity.
• Rapidly-emerging advances in telehealth and remote monitoring are increasing the ability of private practices to deliver in-home patient care that is comparable to an in-office visit.
• Virtual health has the ability to fulfill the “Four Cs” of improved patient care delivery: continuity, connectivity, coordination and interoperability, and continuing care after emergency room visits and hospital stays.
• Improved clinical outcomes, especially in areas of chronic care management.

Prediction: Independent practices will find new and more creative ways to fortify their income

Analysis: In July and August 2021, Forbes released two articles which focused on the future of the independent medical practice. Due to continuing pressures from COVID and reimbursement rates, increasing emphasis must be placed on accurate coding, billing and revenue stream management. CMS also recognized the importance of telehealth as a care delivery mechanism by adjusting reimbursement rates.

As part of the imperative for the survival of independent practices in the overall health system, it is crucial to fortify current patient income and attract new patients. Amazing Charts Medical Billing Service is a fully integrated Revenue Cycle Management service that handles the hassle of billing in order to deliver an increase in collections, a higher rate of claims paid on first submission, and a quicker time to payment with your payers and patients. Other suggestions for securing revenue include:

• Join buying groups to increase purchasing power.
• Creatively extend office hours through virtual care and remote care to provide access to medical providers outside routine office hours. Keeping patients out of ambulatory care, emergency and emergent care facilities can lead to more income for the independent practice.
• Better utilize office hours. Time and money can be lost when patients forget an appointment or show up late. Reinforce appointment times through multiple means and have a fast-track system in place to fill slots made available through last-minute cancellations.

Once these mechanisms are routine mechanisms to maximize revenue, the practice can then look to expand through patient acquisition. Suggestions to promote growth include:

• Maximize online visibility and findability. More patients use mobile devices and social media to find a private practice near them which can address their medical needs. According to Software Advice, in fact, patients begin a new doctor search 71% of the time by reading reviews. In addition to asking patients to provide reviews, your independent practice can improve online visibility through organic and paid avenues to increase the likelihood of being seen at the exact moment of opportunity.
• Focus on increasing patient satisfaction. One of the biggest advantages of a private practice is its ability to establish long-term relationships with patients. Delivering high levels of patient care and satisfaction leads to repeat appointments, better reviews, and honest feedback for improvements.

Prediction: Practices can thrive by instituting policies to maximize the benefits of Electronic Health Records

Analysis: Although initial efforts at incorporating EHRs into practice routines were somewhat uneven, great advances have been made since then. Today’s sleek, intuitive EHR software systems have made great leaps in efficiency and usability. However, decisions made by the independent practice as to which EHR to rely on, how to implement its use, and how to ensure active participation by staff members can contribute greatly to the benefits to be realized. AMA outlines nine crucial steps to maximize EHR efficiency:

1. Align Leadership and Clinician EHR Users
2. Stop Doing Unnecessary EHR Work
3. Optimize Hardware and Built-Environment Solutions
4. Optimize Software Solutions
5. Reduce the Burden of Order Entry and Documentation
6. Optimize Teamwork
7. Optimize Clinician User Skills with the EHR
8. Optimize Information Flow Throughout the Health System
9. Leverage Data from EHR Use

Of course, it is also important to align your practice with an EHR provider that is an expert in the field. Look for a top-rated company with an EHR that enables clinicians to chart faster, with the least number of clicks, while also keeping the cost affordable.

Although some patients do adapt quickly, most will need to be educated as to their options and shown how to use telehealth. Steps your practice can take to introduce patients to the new world of telehealth include:

Prediction: Effective revenue cycle management strategy will help reduce provider burnout

Analysis: Although it seems like an unlikely stretch from revenue cycle management to burnout, in August 2021, Medical Economics published an article to just that effect. The article cited pre-pandemic stressors on healthcare providers such as healthcare reform, changing payment policies, and increased administrative tasks. Pandemic pressures exacerbated these tensions even further by dramatically reducing patient volume and practice revenue. The federal government did implement some stop-gap measures, but there is concern about what happens after these support mechanisms disappear.

To ensure a healthy future and reduce burnout issues, the article stressed that private practice physicians must take a hard look at internal operations and make changes to stay on solid financial footing, including optimizing the revenue cycle. It is estimated that better practices throughout the cycle could have saved significant amounts of money that would have diminished some of the pandemic’s harshest financial impacts. Recommended steps to improve revenue cycle management include:

• Analyze your Key Performance Indicators (KPIs) for current revenue management. Answer questions such as how many days do accounts remain in accounts receivable, claim submission and payment rates, and collections per visit. Gather this data on a regular basis, so you can note trends within your practice, and take appropriate steps to improve performance.
• Evaluate all areas that impact the revenue cycle, from front desk and appointment procedures, to billing and collections.
• Collect current patient data during the scheduling process. Keep up-to-date on requirements for each payer, and gather appropriate information to support claims submissions. If appointments are set online, be sure to gather the necessary information as part of that process.
• Clearly communicate your financial policies online, in writing, and at the front desk. Shorten the patient check-in process by checking eligibility in seconds. See exactly what patients owe with easy-to-read benefits statements. If patient financial circumstances are a concern, have an option for a payment plan in place.
• Clearly document all interactions and details of care provided for billing purposes. Update coding for telehealth, online communications, and chronic care management to ensure full reimbursement for services provided.
• Identify coding inconsistencies prior to claims submission, electronically confirm eligibility and claim status, and easily identify unpaid claims.
• Reconcile payments daily to catch and correct any coding or billing errors before they become bigger issues or lead to claim denials.

Work with an experienced Revenue Cycle Management vendor that offers real-time reporting, timely submissions, claim analysis and extensive follow-up.

Prediction: Advanced primary care practices will be well-positioned to pivot during a crisis like this

In a variation of the usual approach to private practice, advanced primary care practices do not rely on volume and fee-for-service models to keep the doors open. Instead, they offer a value-based contract portfolio of services, concentrating on specific areas such as behavioral health, triage calls, remote patient monitoring, or mental health. This enables the practice to either streamline its offerings or add a supplemental service line focused on one particular treatment area.

Practices considering this model will need to carefully extrapolate the number and type of patients they will take on and provide sufficient staffing and training to meet any increased needs. It will also require strong documentation and may require the latest in Electronic Health Record (EHR) capabilities to keep up with the flow. Components of the most comprehensive EHR systems include easy charting capabilities and templates to maximize provider time, e-Prescribing, better scheduling capabilities, and a patient portal for enhanced communication purposes.

The importance of increasing efficiencies, improving patient care, and enhancing professional satisfaction are deemed as essential by the American Medical Association. Its work in practice transformation aims to create practice conditions where joy, purpose and meaning are entirely possible for physicians and other health professionals moving forward. The Association has created a five-step process of research, measure, act, recognize, and convene to identify and field-test targeted solutions that can help guide physicians, care teams and health system leaders in developing and implementing strategies to optimize their practice efficiencies, reduce personal burnout, and improve professional well-being. 

Perhaps Lincoln was right. The only sure way to predict the future is to create it yourself. Looking for trends about where the industry is heading is a good first step. Thinking about what those directions might mean for your private practice is the second step, and taking action is the final piece of the puzzle. To increase effectiveness at spotting and adapting to trends, work with a reputable vendor dedicated to helping independent practices survive and thrive by providing easy-to-use solutions for delivering patient care that make healthcare more accessible, and more effective.