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Medical Practices Respond to Lower Payments by Cutting Waste

Posted by Tom Lombardo | Tue, Jul 29, 2014 @ 03:00 PM

According to recent resources published by Physician Practice magazine and by the Medical Group Management Association, the most common sources of waste in your medical practice fall into two broad categories: things you can improve through management, and one major thing you probably don't want to do at all.

Medical Reimbursement for Existing PatientsSince insurance company reimbursements for the most common procedures you provide to your existing patients have dropped significantly since 2012, addressing waste may be one of the most efficient ways for you to recoup those losses. But complicating that objective is the somewhat ironic fact that your compensation has been reduced at the same time it has been tied to patient satisfaction. Thus any effort you make to control waste needs to be executed in such a way that your patients perceive it as an enhancement in your quality of service – especially since patients now pay for 23.6% of their health care out-of-pocket.

Communication Can Reduce Waste and Increase Patient Satisfaction

The simplest methods begin with your communication and, according to a consultant who masquerades as a “mystery patient, they can be the most dramatic means to increasing treatment effectiveness and patient satisfaction.

Name TagNinety percent of doctors never call their patient by name. This tends to disorient them and cause them to withhold information you may need for a proper diagnosis -- which can lead directly to a major source of waste: overproduction, where you end up investing in “just in case” work that you might have avoided simply by beginning each examination with a friendly look in the eye and a complete name.

The end of the examination is just as important because the average patient has forgotten half of what you told him before he gets to his car, and by the time he gets home 86% of it is lost. To help your patients avoid disappointment and illness arising from the fact they can’t remember your diagnosis or instructions, end each exam with a brief, bulleted re-cap giving your patient a clear call-to-action.

And be sure to tell him what should happen immediately after you leave the room: Will a nurse come? Should he get dressed? Should he stay put or go to the front desk? Trivial confusion like this causes stress and embarrassment that negatively impacts his ability to remember what’s important, while clarity, on the other hand, improves his satisfaction with your practice.

How to Eliminate Waste by Using Something Wasted

Your staff causes waste as well, but usually not by wasting material things. Most of their waste has to do with time: multiple hand offs for approval, multiple trips back and forth with specimens, repeat form completion, re-entering data and searching for charts or other staff members top the list. Your patients may not know what your staff is doing but they will perceive if it is being done frenetically, which may translate to a negative impression of your clinic overall.

Wasting TimeFortunately, this source of waste can be addressed by using something else that’s also often wasted: employee creativity and potential. According to MGMA, asking your staff to solve procedural dysfunctions usually produces not only much better processes but also real employee buy-in.

That way your patients will sense that your office hums with colloquial efficiency, which can build their confidence.

Stop Avoiding Your Biggest Source of Waste

Every patient matters, but one commonly overlooked source of waste arises from keeping patients you ought to dismiss. You probably don’t want to think about it, but your business may depend upon it.

Your ability to work at the highest level while inspiring your staff to do the same can be negatively impacted by a patient who may bully you for drugs, refuse to follow your treatment, threaten to sue you, or repeatedly fail to pay his bills.

The patients that sprang to mind when you read that sentence need to be dealt with. One malpractice lawyer says that every time she counsels a doctor being sued, the doctor tells her “I knew this patient was bad news…” Patients like this cost you time and resources and they may negatively impact the care you provide to others simply because a problem patient can degrade your sense of well-being.

Dismissing a patient obviously thrusts you into a highly regulated legal situation, so your first step is to contact your insurance company and enlist their help to draw up a patient discharge policy or to hire a lawyer who can do so. With that in hand, select one employee who will work with you on dismissals and make sure everyone on staff knows that all communications regarding patients who are in the dismissal process must go through that particular employee.

As for the patient, simply letting him know that his behavior activated your dismissal policy may solve the problem altogether – most patients change their behavior to maintain the relationship. Those who don’t have no place in your practice.

Since lack of payment has the most obvious detrimental impact on your business, be sure that when you accept checks you know that revenue will drop to your bottom line by working with a check processing company that guarantees payment by check. And while you’re at it, give your staff a perfect example of eliminating wasted time and effort by opting for “remote deposit capture” which allows you to scan and deposit checks directly at the point of sale. Learn more about MED-RDC with check guarantee here.

Medical Remote Deposit Capture Insider's Guide

Topics: Medical

Written by Tom Lombardo