“How can I increase the profitability of my medical practice?”

 It’s a question that every practice manager, every provider, has running through her mind on a constant loop. The challenge of providing the best possible patient care while keeping the lights on and ensuring full regulatory compliance is an endless juggling act. Changes in the reimbursement landscape and increased patient volume due to the Affordable Care Act have added complexity to maintaining a profitable practice. As a result, the need to find creative ways to maintain (or increase) margins without compromising patient care has only become more acutely felt in recent years.

There are, of course, only two ways to do this: cut costs and/or increase revenue. If you cut costs too much, you run the risk of alienating patients and/or staff. Everything in life can be measured on a bell curve. If you cut too deep, you’ll fall from peak profitability due to inefficiencies, poor morale, and reduced volume. So, the key is to save where possible but perhaps look more towards adding revenue. What does that look like in practice? We have compiled a few ideas for you to think about over this upcoming holiday season.

­­Last week, one of us here at BeckonCall grabbed the phone to get in touch with a physician’s office to clarify a question about insurance coverage for a recent minor procedure. Instead of the usual recorded message directing him to “press 1 for appointments, press 2 for billing,” etc., the machine clicked on after one ring and announced that the practice was closed for the day. And then, the office manager’s voice said, “if you are an existing patient and are calling with an urgent medical question, please call Dr. Smith’s pager at 555-123-4567, pager number 89.”

Make no mistake, we at BeckonCall are well aware of the prevalence of pagers in medical practices. Finding better ways to get in touch with physicians is literally our reason for existence. And indeed, we spend a lot of time talking about the use of legacy technology - like fax machines and pagers - in medical practices. Even so, it was a jolt for our colleague to hear, in the context of being a patient, that he was supposed to set off an irritating alarm screamed from a box on “Dr. Smith’s” hip. This is 2016, after all.

Pager use may be on the decline, but they’re not gone yet. Why? A Slate article published earlier this year by Dr. Allison Bond reviews some of the reasons. It’s a good read, so be sure to check it out. Briefly, though, Bond points to the simplicity of pagers (battery life, for example) and their reliability when receiving messages. She also notes that there is some pride when physicians and other providers are first given a pager, although she’s quick to point out that the novelty wears off in a hurry.

There are a number of other concerns medical providers and practices express when talking about switching away from pagers. Below are a few, as well as responses that might help break the inertia of technological stagnation.

Remember when it seemed exciting to find a communications tool that touted HIPAA compliance at the top of its feature list? “Is it secure?” was one of the first questions asked when evaluating medical communication technology. Now, 20 years after the Kennedy-Kassebaum Act was first passed, compliance is generally assumed. Of course, HIPAA compliance is critically important. It’s the law. But it now sits in the background, almost as part of the scenery, instead of prominently featuring in discussions about how a system works. It’s like airbags in your car; they’re legally mandated and you spend no more than a few seconds thinking about them when shopping for a new ride.

“Oh, I thought you said…” is a common refrain heard by parents, teachers, and TV police captains when their idealistic subordinates pretend to have misunderstood a command. Unfortunately, it is also a paraphrase of conversations heard far too often in clinical settings among healthcare providers, and it has severe consequences.

Miscommunication in healthcare causes quantifiable breakdowns in, and added cost to, delivery of care. Earlier this year, CRICO published a study that looked at medical malpractice lawsuits from the previous five years. The researchers found that more than 1,700 deaths in that timespan could be attributed to communication problems. In addition to the loss of life, the suits cost approximately $1.7 billion. That’s bad enough, but the CRICO stats only reflect part of the problem, as those numbers were pulled only from malpractice cases - i.e. where legal action occurred. Additional data has suggested almost two-thirds of sentinel events are caused by miscommunication within and between careteams, and that this problem costs over $100 billion a year in lost revenue and avoidable operating expenses.

Clearly, hiccups and outright failures in care team collaboration are enormously detrimental to all aspects of the healthcare system. Breakdowns in communication can and do occur between any two participants in delivery of care: nurse-nurse, nurse-physician, patient-staff, patient-nurse, etc. Some of these failures arise from in-person interactions, such as when a verbal message is not relayed from patient to staff to physician within the clinic. In many other cases, physical distance creates a literal game of telephone where humorous phrases are replaced by negative patient outcomes.

It’s often the simplest things that cause the worst headaches. Maybe this is because we expect big tasks to cause big problems and are therefore mentally prepared for them. Maybe it’s because when small things break, the cascade of subsequent issues is anything but small. Whatever the psychology, as a medical practice manager you know how difficult it can be to keep up with all of the daily minutiae of running a medical office even under the best of circumstances. You are always looking for ways to streamline back office operations, save money on equipment and services, and coordinate staff and providers, all while keeping a steady flow of happy patients moving through your doors.

One seemingly small area that encompasses all of these challenges is your inter-practice communications. First you have to ensure your team is on the same page. Then comes coordinating outside your practice with patients and hospital staff, directing their questions and concerns to the proper physician. Should be simple, but in reality hiccups are not uncommon.

You know the drill: a disgruntled physician calls after she was erroneously paged while on vacation. Or your on-call doctor failed to respond to a page because he never received it. Even worse, details in a patient’s complaint get scrambled en route to the on-call physician, leading to confusion and delays in care.

Medical answering services are supposed to help with these problems. However, you may still have to do a lot of manual work to keep up with scheduling changes and coordinating on-call duties among your providers. Without the right set of tools mistakes are inevitable, both from your office and from your answering service.

Fortunately, there are solutions to help busy group practices, including technology such as HIPAA-compliant communications and scheduling platforms. And medical answering services can play an invaluable role in helping you coordinate your practice’s communication.

While both classic medical answering services and newer on-call management platforms are designed to help simplify the business of healthcare so your team can stay organized and efficient, they are not created equal.

With that in mind, we have selected 14 critical points to consider when evaluating a medical answering service. The list below will help you more easily assess your unique needs and priorities against the capabilities of each provider.

Your time as a medical practice manager is precious. You want - and need - to be spending your effort making life better for your staff, your providers, and your patients. Your daily goal is to smooth the way towards better medical care and increasing the profitability of your practice. So if your goal is to move forward, why live in the technological past?

The Medicare Access and CHIP Reauthorization Act (MACRA) is a landmark legislation that alters how Medicare reimburses physicians. The ultimate goal of MACRA is to navigate away from the traditional fee-for-a-service model, to a quality-based reimbursement model.

The initial rule, proposed in 2015, was met with criticism from much of the medical community for its stringent requirements and hasty preparation period. However, the final ruling, released October 14, 2016, has expanded flexibility and exemptions.

Healthcare is staring down the barrel of the largest changes to the industry since Medicare was introduced by Lyndon B. Johnson in 1965. The recently proposed Medicare Access and CHIP Reauthorization Act (MACRA) has sweeping implications for the way healthcare providers are paid for their services. The ultimate goal of MACRA is to navigate away from the traditional fee-for-a-service model, to a quality-based reimbursement model.

Although MACRA is sure to be an initial headache for clinicians, medical practices need to understand and prepare for the new legislation or suffer significant financial penalties.

Let’s break it down.

• So, what is MACRA? 
• Am I Eligible? If so, what track is right for me? 
• How am I reimbursed? 
• When do I start implementing MACRA? 
• What will MACRA cost me? 
• Who will know my score? 
• What are the actions I can take to prepare? 

Running a profitable medical practice is is more challenging than it has ever been.  Driven by new regulations like the Affordable Care Act (ACA) and the Medicare and CHIP Reauthorization Act (MACRA), administrators have to spend more of their time dealing with new tools, reporting requirements and practice guidelines that take away from the time they would otherwise spend focused on running the business of the practice.

Since those regulatory burdens are unlikely to go away anytime in the foreseeable future, practices have to develop new disciplines to ensure they can not only continue to grow, but grow profitably as well.

Here are 6 tips to do just that: 

Text messaging is rampant in hospitals. Instead of relying on pagers, clinical staff are now using their mobile devices to communicate in real-time. As time is of the essence in patient care, this makes sense. Nurses are frustrated with delays from third-party answering services. Doctors are tired of roundabout communication channels to give a simple, one-word approval. Unfortunately, text messaging in hospitals is not without risks.

Here are the 5 biggest risks of text messaging in hospitals: