Private practices withstanding healthcare reforms: Revenue Management


Private practices are facing many challenges and gone are the days when physicians could easily start their own practice in a small office. The complexities in the form of changing policies, added administrative work and changes in Healthcare IT has made it very difficult for physicians to start or maintain a small or solo practice. Policy changes in the form of EMR/EHR implementation, the need for demonstration of ‘Meaningful Use’ and numerous changes in various departmental processes has made solo or private practice enormously cumbersome to handle and to sustain in terms of profitability. There are numerous other reasons that are forcing private practitioners to turn towards hospitals or form larger groups in order to bring sustainability to the practice.

A survey by Accenture has shed more light on the matter and has revealed that small practices are in the decline. Physicians are packing up their practices due to the uncertain business environment, better access to Healthcare IT in bigger institutions, and for a better manageable workweek. The survey also shows that individual practitioners are in decline at the rate of two percent annually and would decline by five percent annually by the year 2013. Another white paper by The Physicians Foundation examines the effect of the Patient Protection and Affordable Care Act on physician practices in the United States. The report clarifies the attitude of physicians when it comes to reforms and the effect it is having on the way physician practices operate. The survey finds that the majority of physicians plan to alter their practice patterns where the full-time, independent practitioner accepting third party payment would largely be replaced by part-time, locum-tenens, and concierge practitioners.

Small private practices are finding it more difficult to comply with all the guidelines in the reform and upgrade their systems and staff to a level where they can be qualified for the incentives. However, some practices are able to survive this change by employing the services of specialists in various departmental processes. Better EMR/EHR implementation, professional revenue cycle management, better denial management, and error-free medical billing and coding can give an edge to physicians who have decided to continue with their private practice. Optimization of these processes can ensure that physicians reap the financial benefits of the reform even as they provide better health care delivery through a complex process. is the largest consortium of medical billers and coders in the United States which provides these services for physicians in addition to consultancy and other value added services.

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