SGR Bill Passed House of Representatives Now On to Senate

Well we have dodged the first bullet, but there is still a whole war to be won concerning H.R. 3630, known as theMiddle Class Tax relief and Job Creation Act that was passed on December 13th by the U.S. House of Representatives.  The Act prevents a further 27% cut to Medicare physician reimbursement and provides physicians with a 1% increase in Medicare payments for 2012 and 2013. So far, there have been no additional medical imaging cuts, so kiss your babies but keep your fingers crossed folks, because we still have to make it through to the Senate.

There is still the concern that this act does not contain information from the Diagnostic Imaging Services Access Protection Act (H.R. 3269), which protects against the implementation of a 25% payment reduction on professional fees for multiple MRI, CT and ultrasound procedures.  Fortunately, there are 127 supporters of H.R. 3269 in the House of Representatives and the ACR has announced that they will continue on their plight to add the language from H.R. 3269 as the SGR legislation heads to the Senate.

This SGR adjustment means good things but since it still does not address the proposed rule from CMS that would severely cut the Medicare reimbursement rate for radiologists who interpret multiple images, we have to hope that pressure from all concerned, including the ACR, pushes the Bill through. Although this is certainly a step in the right direction, this could just be a “quick fix” and the proposed cuts to radiologists would be the 8^th cut in the past six years to Medicare funding for Diagnostic Imaging.  The seven cuts that have occurred over these past six years have totaled more than $5 Billion and with imaging growth at less than 2% annually, additional cuts would end up limiting American’s access to quality diagnostic imaging due to the facilities that would suffer and end up closing their doors if the cuts went through. Republican representative James Renacci did introduce a legislation that would allow for a six-month grace period for new diagnostic imaging centers, so that those certain suppliers of Medicare imaging services could bypass the MIPPA accreditation requirement to receive reimbursements during that period of time.  The grace period begins when a new physician or facility submits images to the accreditation process and ends either with the approval or denial of their request, or after 6 months have commenced.  The center will be able to receive reimbursements during this time, however if they are unable to get accredited by the end of the period, any reimbursements they received would need to be paid back.

It can be assumed that due to the Senate’s Democratic leadership, they will attempt to create their own version of the legislation that will include a one to two year “doc fix,” which equates to questionable Senate action timing.  TheRBMA estimates that a package will be put together by the end of the week and voting will take place Monday or Tuesday, dependent upon the ability to create a package that gains some Republican Senate support.  This brings a whole new meaning to the term, a house divided sports fans, and we could end up waiting on a decision until well into 2012.

Tags: health care reform, diagnostic imaging, affordable health care, DSO, reimbursements, ACR, RBMA,Medicare, imaging cuts, SGR

Culture of Quality Care and Service: The Impact on Patient Experience

The health care community has seen a number of significant changes in the past year, which has opened the doors for many discussions, and one of the most talked about topics is the high cost of health care. Whether you are a patient or a physician, the cost of health care has most likely impacted you.  For patients, they have started to require pricing transparency, so that they know what they are truly paying for, which places a heavier weight on the overall patient experience.  Practices are essentially going back to the drawing board to reevaluate how to instill a culture of exceptional service, reassessing their “brand” and overcoming the plateau-effect.

The first step in re-instilling a culture of care in your practice is to reevaluate the core of your practice’s belief system.  What is the most important factor of your services? Is it that you have the most up-to-date technology; your impressive turn-around time or maybe it’s your low prices?  Once you have a focus, a campaign can be built around your mission.  Your entire staff should adopt the culture of service in order to succeed and everyone should have a hand in improving the patient experience, so that they recognize your facility for that focus that sets you apart from the competition.

                 

The practice’s new mission will encompass the facility’s “brand.”  No you’re not selling cars or vacuum cleaners, but even when people do, they are selling their brand, which encompasses not only the product, but also the feeling consumers get from that product.  If what you and all of your competition are selling is health care, you have to sell a better “feeling.”  This will require a number of things, including:

-       Getting to know your patients to understand what they want

-       Leaders with service-focused visions and values

-       Consistent delivery of the message

-       Effective ways to measure success of your initiative

-       Useful development, training and coaching to achieve success

-       Constant improvement and growth

These steps will assist your practice to encompass the concept of culture you are attempting to represent, and will lead to successfully overcoming the plateau effect your practice might be experiencing in this time of health care crisis.  Often times practices think the solution is to throw money at a worthless ad campaign or try some innovative marketing technique, however sometimes it just takes going back to the basics.  

Are You In Control of Your Practice's Medical Billing Collections?

The weight of the challenges currently on the shoulders of our nation’s health care professionals has grown increasingly debilitating in the past year and it appears that 2012 will be the same old song.  Physicians are starting to recognize their lack of recoveries and collections due to shrinking reimbursements, and a solution is needed. The feeling that your revenue is spinning out of control, is not only daunting, but also nerve-racking. So how do we combat this? It is time to re-evaluate the billing process and look for new medical billing solutions. To help mend this issue, we have created a checklist for you to use in determining where your process can be altered to improve practice revenue and so that your practice can achieve overall success.

Our goal when working with new clients is to help them overcome any hesitations they might have with outsourcing their billing by keeping them in control of the process.  It seems that the concerns are usually similar from practice to practice.  Physicians want to improve process time and increase revenue, but they also want to maintain control over their payments, personnel and data.  

By giving our clients complete access to our live database to produce reports, we keep the lines of communication open and operating in real time.  Physicians can see patient accounts and track them on their own, without the behind the scenes hassle. Also, many external billing companies have an inefficient collection process, which includes the company scraping a fee off the top of each service. We don’t work like that.

Another concern is that a billing acquisition will end up serving as an Exodus for the personnel that have been with a practice for so long.  Many offices fear that their dedicated staff will be removed and replaced with newbies, which is not true with us.  We always vow to retain key individuals at practices, because we don’t believe in fixing something that isn’t broken. 

The final concern is that the practice will no longer be in control of its own data.  People in “the biz” call this unfortunate side-effect of a poorly operating billing department, “black hole syndrome.’ This is when no one can really be sure what exactly is happening within their own company because they are no longer able to monitor success, progress and inefficiencies.  We eliminate that lack of knowledge and replace it with participation so that the staff is a part of the change.

Tags: medical billing, medical billing collections, ICD-10 codes, DSO, SCRUBS, EHR, PCT codes, revenue cycle management, improve practice revenue, practice revenue

The Self-Pay Solution: Benefitting Providers & Patients

Whether you are recently unemployed, a college graduate, or a hard-working professional with a family to provide for, the prices for health care services are enough to make your heart stop.  Americans are trained to think that without insurance, they simply can’t afford good health care.  The Complete Idiot’s Guide to Medical Care for the Uninsured even states, “Americans without insurance don’t get the health care that those with insurance do.” Well we’re here to ask who the idiots are now, because readers, that is just simply not true anymore.

The quagmire of cost variations and the questions they bring, have built up in the minds of patients and providers alike as a result of the utter disrepair our health care system has found itself in, and now it needs a solution. That solution is self-pay, or cash-pay, whatever you want to call it.  In the past, physicians have shied away from promoting self-pay pricing within their facilities due to a myriad of reasons that usually relate back to low collections. However, with insurance companies cutting reimbursement, those physicians have found themselves trapped in quite the Catch-22. 

                 

Hospital systems have suffered the most when it comes to cash-pay collections, which is one of the many reasons the list prices for services like MRIs are so high there. They are having to cover-up for the patients that never pay-up.

What patients often don’t realize, is that their medical decisions are 100% up to them and they should price shopfor their services in the same way that they shop for cars.  Thanks to a new trend of pricing transparency, patients are seeing the light. The Pueblo, Colorado newspaper, The Pueblo Chieftain, wrote an article about the wide-ranging prices for MRIs in their area, showing the disparities between the hospital system and the independent diagnostic imaging facilities.  “Cash-paying patients in Colorado can shell out as much as $3,460 for a basic shoulder MRI, but a little shopping around can cut that cost to $450.” If you could save over $3,000 on an MRI, and still receive the same level of service and care, why wouldn’t you?

So, patients are obviously at a pricing advantage when you look at it this way, but we like win-win situations, so we found a solution that benefits both patients and providers.  That solution is Save On Medical.  For physicians, Save On Medical ensures that chasing after collections is a thing of the past, by collecting the previously agreed upon service cost ahead of time. Patients have the ability to price shop for services in their area in one place, without having to call around to 20 different facilities and question whether or not they are paying for quality care because the Docometer grades each option.  Studies show that on average, families end up paying upwards of $4,000 a year out-of-pocket for medical services, or they could just go to Save On Medical first.

Marketing: Improve Volume, Increase Revenue & Return-On-Investment

Today, I attended a free webinar that discussed some of the things that Marketing Professionals for Hospitals should be focusing their attention on, and while we do marketing for a myriad of different healthcare facilities from independent diagnostic facilities to specified radiation oncology centers at university hospital systems, I found the message very informative.  The speaker, CEO at The Heavyweights, John Luginbill discusses 9 ways to improve volume and revenue, and while they are geared towards facilities with larger budgets typical of a successful hospital system, independent facilities can utilize the same knowledge.

He discusses the following actions for Hospital Marketers:

1. Spend Money to Make Money: stating that an average hospital should be spending 1% of their gross revenue on paid media.
2. Choose DRG’s Wisely: Don’t spend money on something unless there is a high capacity for action and a high level of profitability.
3. Integrate Your Efforts: Meaning plan out how you will coordinate your promotions, advertisements and marketing efforts in each aspect of your business.
4. Target “Healthy” Patients: You aren’t going to convince a patient to leave their physician, rather focus on those that aren’t already in need.
5. Master Media Mix: Make sure that your media is effective and inspires an action, this is called a Call to Action.
6. Opt-In Marketing Not Optional: Utilize forms that require potential leads to provide their information so that you can help them.
7. Distribution of Patients: Be a resource to help them, even if it does not seem directly relatable to your practice.
8. Capitalize on Co-Risks: Analyze your community and determine how, for example, if an individual is at risk for multiple things, you can help “all of the above.”
9. Follow Downstream Revenue: Track with your financial people.

Some of the most important things to take away from this message lie in #2, #3, #4 and #5.

For Independent Facilities:

2. Consider what will work in your community that will not only improve your visibility but create an actual profit.  For example: Social Media is essentially free, if you dedicate time to a marketing campaign on Twitter and Facebook and it brings in just THREE people, that return-on-investment is HUGE, because you didn’t spend any money marketing to them.

3. Integrating your marketing efforts by layering and timing your plan well will enable you to set realistic goals and prove success. We do this for each of our centers and our company overall.  This will help determine what works and what doesn’t for improved future plans.

4. It is true that marketing is easier when you are targeting someone who is already in need, but when it comes to healthcare that might not be the best approach, because like John said, a patient isn’t going to leave their physician.  Consider the way that Susan G. Komen promotes Early Detection; they are not selling a product, rather awareness, which eventually targets someone in need.  Independent facilities can do the same thing.

5. Always use a call-to-action in marketing because you want to make capturing leads as easy on the potential client as possible.  You do not want these un-captured leads running around, unsure of what to do next.  With a clear, clever and HELPFUL call-to-action, you will create a mutually beneficial next step in your relationship with that lead or patient or referring physician, really whoever it is that you are targeting.