Practice Management—2nd in Series of 3, Top Line Responsibilities and Success in 2020

Practice Management – Top Line Responsibilities and Success in 2020

The “practice” of Medicine is an ongoing evolution that has adapted to HMOs, managed care plans, Obamacare, PPOs, concierge doctors, consolidation of hospitals, consolidation of medical groups, consolidation of insurance companies, and many other changes. It is undergoing rapid change because of Covid-19.

Fellow Health Partners, a highly respected Medical Billing and Solutions company based in Long Island, NY, has focused on Best Practices for enhanced Practice Management. This is the second in a series of articles. (The first can be found here)

Practice management is a broadly used term to describe the way in which a medical practice is organized, staffed, focused, and equipped to help optimize for the patient and provider.

A Practice Manager is responsible for the administrative responsibilities of daily operations and, often, development of a business strategy. In many cases, they are tasked with growing the practice as well which might include skills in marketing, customer service and management. The function of the practice manager is to allow the providers (physician, PA, nurse, NP, etc.) to remain focused on treating patients, without the burden of running the office.

Most Practice Managers are responsible for hiring and managing staff, negotiating benefits and personnel policies, ensuring that medical and office supplies are ordered, ensuring that equipment is maintained, overseeing regulatory compliance, as well as the development and marketing of services, among other things.

They are often responsible for billing (in-house or outsourced), integration of new technology, efficiency, and patient satisfaction.

James McCullagh, Associate Executive Director of Finance at Northwell Health, sums it up nicely when he says, “Effective practice management works to make things as efficient, as patient focused, and as profitable as possible.”

The Impossible Burden

Looking at those responsibilities, it’s clear that this is a HUGE job and we respect all those who are asked to do it. We admire their commitment, their desire to perform, and their willingness to work as hard and as long as the providers they serve.

Unfortunately, in the year 2020, it’s getting harder and harder for practices to do all the necessary jobs as well as they need to be done.

And, it will likely get even harder as we emerge from Covid-19 over the next few years.

For example, many patients are going to be pressed for money as they come out of the current situation. They may have lost their insurance or shifted to a policy with even higher deductibles and copays.

It will take a higher degree of “conscious” interpersonal skill on the part of staff to ask for payment and to collect it, while helping the patient feel OK, so that they leave the office with a positive feeling, happy to recommend the practice.

Increasingly, it’s becoming clear that management skills will have to be much sharper post Covid-19.

Nicola Hawkinson, RN, DP, and CEO of Spine Search, says that “Practice Managers will have to be more agile. They may be in the office half the time, at home half the time, on site, on Zoom”, juggling a new order of organization and management. She adds, “Receptionists might not want to be in the office. They may be replaced by telephone.”

The New World and How to Be Even More Successful in It

Because of these changes and others, the offerings that support the four pillars of successful practices will need updating. Here are some ways to prepare.

1. A More Satisfied Patient 
Because of changes in insurance and patient incomes, there is likely to be more competition for patients, which means improving “service”. Based on our experience, we expect the demand to increase for:

  • Online appointment scheduling
  • Streamlined paperwork
  • Short/no wait times & longer hours including Saturday
  • Replies to questions – quickly – no more than 24 hours via EHR
  • Nice waiting or exam room – Wi-fi, safe distancing, clean and sanitized surroundings
  • No waiting room – for some, it will mean efficient scheduling, remote monitoring for vitals
  • Transparent pricing – and help to pay it
  • The option for a telehealth visit, especially for follow-ups
  • Greater use of remote monitoring tools
  • “Visible safety” – this may include more handwashing stations, masks, gloves, wipes that reassure the patient that everything is being sanitized often, etc.

2. A More Satisfied Provider
As insurance companies come under pressure, hospitals compete more aggressively for the “best” providers, and private equity companies try to squeeze efficiencies out of already squeezed practices, providers might benefit from:

  • Software assisted diagnostics
  • Enhanced EHRs, relying less on QWERTY keyboards and more on touch and voice
  • Superior billing services to capture every dollar earned
  • Enhanced telehealth tools including remote monitoring, App based solutions
  • More patients with good insurance or who pay cash (which means better marketing and more referrals)
  • Practice Managers who can help alleviate concerns about reimbursement and the reimbursement environment

3. More Efficient Functionality
More than ever, an efficient practice will depend on an educated patient who is comfortable with using technology as part of their interaction with providers. At the same time, technology and outsourcing will become more important as skilled labor becomes scarcer and more expensive and patients shy away from crowded medical spaces. Practice Managers will have to learn more about competing technologies and learn how to choose the best one. They will have to improve their formal management skills. This might include:

  • Managing experts who can assist in choosing office software and systems
  • Managing experts who maintain systems
  • Outsourcing billing to stay ahead of increasingly technologically driven insurance companies
  • Greater understanding of management models, productivity measures, and use of data to help grow the practice, most likely gained by formal training
  • Gaining enhanced “people skills” to manage and grow staff, both remotely and in the office
  • Using “scenario planning” skills to prepare for resurgence as the Coronavirus pandemic whipsaws the country

4. Better Training, Customer Service, and Marketing
To gain an advantage and compete more effectively, Practice Management could benefit from:

  • Training staff and providers in “people skills”, including the skill of “versatility”, which means changing their behavior consciously and proactively to help each patient feel more comfortable
  • Enhanced management training for Practice Managers, especially the skill of “remote management” of staff
  • Patient satisfaction surveys (which requires using experts to design questionnaires and provide assistance in how to apply learnings)
  • Working with staff and providers collectively to make sure that mutual support turns into a better functioning practice
  • Clearer focus on marketing, including understanding how to improve the effectiveness of the practice website, how to get more strong online reviews, how to ask patients for referrals, how to enhance online search, among other tools

Practice Management is likely to become more “credentialed”, meaning more formal schooling, possibly certification, and possibly more specialized with Practice Managers who are responsible for growing the business (marketing, customer satisfaction, etc.) as well as those who specialize in areas such as Administration or technology. Although hospitals are leading the way here, they have a long way to go as they juggle politics, finances, sub-optimal management training, and the challenges of a Covid-19 world.