Reaping Benefits of Pay-for-Performance through Outsourced Billing and Coding Services


Idea of paying medical providers for their performance has found many backers in the US. According to the supporters, pay-for-performance will remove bad incentives from the current system and stop doctors from performing unnecessary tests and hospitalization of patients.

This payment system rewards hospitals, doctors and other healthcare providers for attaining the targeted service goals. They can become eligible for incentives if they happen to meet efficiency standards or healthcare quality. It will give practices an edge over others and ensure steady flow of patients, adding to their income inoutsourcing medical coding and billing the long run.

Providers need to meet goals related to resource usage, care processes and patient experience to become eligible for payment under pay-for-performance. Irrespective of the benefits, do providers have enough time and resources to obtain the rewards?

Challenges related to implementation of P4P:

  • P4P will surely provide encouragement to doctors and better services to patients but to become eligible for this program, providers will be required to bring down variation in their clinical practice
  • Practices will have to reduce errors through promotion of medical safety practice. Efforts will have to be made to offer best care for chronically-ill patients
  • Factors such as reduction in glycohemoglobin for diabetic patients is also one of the scales on which performance of physicians will be measured
  • Hospital stay of your patients and emergency room visits will also be assessed to ensure whether or not you become eligible for P4P. Chronic disease patients and their care co-ordination between office, hospital and home is also a criteria for incentives
  • If you want to enjoy the rewards under these programs, you will have to show the usage of latest health IT for treating chronically-ill Medicare patients
  • Providers will also have to devote sufficient time and energy for ensuring that patients coming to their clinic or hospital are empowered and well-informed
  • Providers who plan to stay out of P4P programs will be losing out on market share as well as patients, affecting cash flow in the long run

Currently, rise in number of patients and workload is leaving practices financially vulnerable. Due to lack of skilled staff, time and money, providers are facing difficulties in offering quality services at attractive costs. If you are concentrating more on billing and account receivables rather than patient care, you cannot become eligible for P4P program.

How can outsourcing medical coding and billing help?

Billing, coding and tasks related to account receivables can eat your precious time that can be otherwise used for offering enhanced medical care. This is why many practices are outsourcing medical billing and coding services and using the spare time for P4P programs. has been helping physicians across 50 states in the US with effective outsourced billing and AR management services. We have the largest consortium of billers and coders who make use of the latest technology to strengthen revenue cycle management for small as well as large practices. The team at MBC is also expert at providing consultancy to doctors so that they can enhance their healthcare services.

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