Erie County's attempt to force New York state to close either Buffalo General Hospital or Erie County Medical Center has been dismissed in the state Supreme Court. Judge John Curran ended the effort in a decision that indicated the June 23 settlement between the health systems averted any action to shutter a facility.
The U.S. House has voted to postpone a planned cut in payments to physicians who treat Medicare patients by approving a reduction in payouts to private insurers. The legislation would forestall a 10.6% cut in Medicare payments to doctors and hospitals for 18 months. Democrats warned that such a decrease would lead to many physicians opting out of treating Medicare patients.
A study by the School of Population Health, University of Queensland, published in The Lancet Infectious Diseases journal shows that 25% of healthcare-acquired infections could have been prevented with proper hospital staff-to-patient ratios. The Australian researchers also found that an increase in MRSA infections specifically is causing a reduction in the number of available hospital beds, despite decreasing staff levels.
In the healthcare industry, physicians run tests and analyze results to help diagnose a patient. An A/R analysis can work the same way by offering ways to identify and ultimately repair the billing processes in your practice.
Practices often see the following A/R problems:
Failure to adequately use technology. Whether it’s an EMR or a practice management system, staff members often fail to get the most out of their computerized technology.
For example, practices might not load managed care reimbursement rates or fee schedules by CPT code into the system. Many also fail to load payer-specific edits.
As a solution, practices should research vendors that provide an electronic interface to access the practice’s payers and download updates. This gives practices the convenience to send out a request to the payer providing the most current insurance information before the patient arrives at the office, helping to avoid a denied claim and saving time.
Failure to bill the correct insurance company. For example, a patient has two insurance companies: a primary and a secondary. The staff member makes the mistake of billing the private company first and then sends a bill to Medicare, which means both bills are in the mail at the same time. Now the office will have to resubmit the claim after receiving a denial statement in the mail.
Failure to track and collect patient payments. Often, the billing department does not give patients a specific time to submit their payment to the office. They do not send out notices in the mail that explain the practice’s collections policy. This may cause confusion regarding what services a patient’s insurance provider will cover and may prevent patients from paying altogether.
These common pitfalls can result in lost time, increased A/R days, and reduced cash flow, says Frank Cohen, a senior analyst at MIT Solutions, Inc., in Clearwater, FL. But establishing an A/R analysis at your practice as a standard task not only can reduce billing mistakes, it can also help staff members recognize and avoid these problems altogether.
This story was adapted from one that first appeared in the June edition of The Doctor's Office, a publication by HealthLeaders Media.
Australian researchers report that the control of MRSA in hospitals can depend on overcrowding and understaffing. The team at the School of Population Health, University of Queensland also found that while the number of available beds in hospitals has decreased, the number of outpatients seeking care continues to rise. This problem is further complicated by a decreasing healthcare workforce.
Every time I open a newspaper or visit a major Web site lately, I see another article about the emergence of online portals that allow patients to rate their physicians. And the recent barrage of media coverage seems to have left many doctors skeptical of the unregulated sites and worried about their potential consequences.
Although perhaps overhyped in the media, many of their concerns are real. A few patients have already used negative online ratings as a form of "vigilante justice" when a malpractice lawsuit or complaint to the medical board didn't do the trick. And the anonymous format of many sites raises questions about whether patients will be honest (and whether it will only be patients leaving feedback).
Facing this reality, physicians have three options.
They can ignore the emerging trend and hope it doesn't affect their practices. This is feasible for now, but new companies are getting into the physician-rating business every day (Angie's List and Zagat, for example), and the influence of the sites is growing. Twenty-two percent of respondents to a recent poll by the California HealthCare Foundation reported looking at physician rating sites in 2007, up from 14% in 2004.
Eventually, physicians will have to accept online ratings as a normal part of practicing medicine.
The second option is resistance. Some practices are considering requiring patients to sign a contract in which they promise not to post any comments online without their physician's approval. The concept was developed by Medical Justice, a group dedicated to preventing frivolous malpractice lawsuits.
Not only is the legality of this approach questionable, but it can't be good for patient satisfaction. I agree that frivolous lawsuits are a major problem for physicians, but as a healthcare consumer, I wouldn't return to a physician who presented a gag order before the visit.
The third option—and best, in my opinion—is to use online ratings to improve your practice, to take the potential bag of lemons presented by physician rating Web sites and make lemonade.
For example, Jeanine Brailey, a practice administrator with Queen City ENT Associates in Cincinnati, was able to use online patient ratings to negotiate a 3% discount in each physician's malpractice fees.
The office had initially evaluated a number of paper surveys to measure patient satisfaction, but it decided instead to direct patients to Cincinnati.md—a physician rating Web site operated by YourCity.md—and monitor the feedback. When the group's malpractice carrier offered a discount if the group could show that, among other things, it was soliciting patient feedback and complaints, Brailey was able to point to the online rating system to negotiate a better rate.
Mark Deutsch, MD, an otolaryngologist with the group, says actively monitoring patient comments on the site has also led to improvements around the office, as well as a few new patients who first read about his service online.
Rating Web sites are still a long way from becoming an integral part of the healthcare process—only about 2% of patients have actually changed physicians based on information from an online rating, according to the California poll.
But most practices want and need patient feedback, and online rating sites provide that. Although there are certain risks involved, savvy practices will see them not as a threat, but as a new tool for managing the practice and improving patient care.
Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.Note: You can sign up to receive HealthLeaders Media PhysicianLeaders, a free weekly e-newsletter that features the top physician business headlines of the week from leading news sources.