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Cardiology Billing Challenges Forcing Physicians to Merge with Hospitals

May 29, 2014

Due to massive CMS cuts and stringent healthcare reforms, pace of cardiology practices merging with hospitals and integrated delivery networks (IDNs) has quickened. Rather than operating independently, providers are finding hospital employment appealing due to financial stability.

With integration, practices are shifting risk to hospitals, without having to worry about practice expenses that was the top concern for 87% of doctors who opted for employment with hospitals in 2013. It is also giving them an opportunity to manage and create cardiology programs on a bigger stage.

  • According to a cardiology practice census carried out by the American College of Cardiology (ACC), the trend of hospital integration is growing. Compared to the census in 2007, hospital employment of cardiologists almost tripled by 2012
  • Medicare cuts, workflow management, health IT implementation, reimbursement, hospital/practice alignment were among the challenges that caused this integration
  • As per MedAxiom’s 2013 Annual Integration Report, compared to 32% in 2011, approximately 53% cardiology groups were full integrated with a hospital in 2013

There is a strong need for Congress to eliminate red tape or else physicians will end up focusing on patients rather than paperwork. The flawed SGR formula needs to be repealed and new payment models should be implemented. Transition is necessary from the current fee-for-service payment model to a more sustainable system to prevent cardiologists from selling or leasing their private practice.

Is hospital integration the right decision?

With bundled procedure codes and reduced reimbursements, maintaining financial stability has been the top concern for cardiologists. They are taking a tough decision to sell their private practice just in order to maintain a stable personal and financial situation. But Irrespective of the benefits associated with hospital integration, providers should think twice before making a final decision.

There is no doubt that reforms and payment cuts have caused cardiologists to spend more time worrying about paying bills rather than offering quality patient care but these issues can be solved through outsourcing.

  • By outsourcing cardiology billing requirements, providers can eliminate the headache of hiring and training skilled billers and coders and become assured of timely, error-free claim submission
  • A reputed cardiology billing partner can help them strengthen their RCM by ensuring timely reimbursements
  • They can also handle challenges related to HIPAA compliance, implementation of electronic health records and so on
  • Providers can take advantage of increased revenue and invest money in latest equipment for offering quality patient care
  • Since worries related to running a private practice will be eliminated, they can make optimum use of their time to focus on documentation and serve patients in a better manner

Medicalbillersandcoders.com is the largest consortium of coders and billers in the US, helping cardiologists run a smooth business. Our expert team can handle your billing requirements and ensure timely reimbursements. From claim submission, follow-ups to solutions related to EMR implementation and HIPAA compliance, we do it all. MBC can strengthen your revenue cycle management, offering you ample time to concentrate on patient care.


Category : Practice Administration