In Pursuit of the High Performing Medical Group

In Pursuit of the High Performing Medical Group

The reality for medical practices is constantly changing. Independent physicians are increasingly under financial strain due to the shifting reimbursement and regulatory landscape and seeing their margins shrink. At the same time, the migration of care from acute to ambulatory environments has prompted health systems, hospitals and large medical groups to acquire and consolidate clinics to expand their physician networks.

This new reality begs the question – how do you transform a collection of disparate practices into a high performing medical group?

While many practice leaders prefer a “hands-off” management approach, it can create future challenges because it fails to capture the benefits of running a truly integrated medical group. Such organizations are able to offer improved access, a stronger referral network, operational economies of scale, and ultimately, better care quality and outcomes.

To unlock the benefits of high performing medical groups, operations leadership must find new ways to optimize profitability and productivity across their practices. There are a number of scalable tactics that can help accomplish this, including: reducing no-shows, boosting volume through prevention, and automating processes.

Reducing No-Shows

While it might seem like a no-brainer, reducing no-shows is beneficial to your patients, providers and staff, and practices. When left unchecked, no-shows can have wide-ranging negative effects with potentially long-term consequences. That’s why high performing medical groups implement organization-wide tactics, such as appointment reminders, to proactively mitigate no-shows before they become a problem.

To help your leadership understand the value of a no-show reduction program, it’s important to convey the true costs of missed appointments. The low-hanging fruit is the short-term financial impact. Simply put, when your patients don’t show up for their appointments, your practices are missing out on revenue. In addition, higher-wage employees, such as physicians and advanced clinical practitioners (ACPs), are seeing fewer patients and are not utilized to their fullest potential.

Digging deeper, it’s also important to understand the extent to which no-shows compromise access and outcomes. When patients miss their scheduled appointments, it diminishes a practice’s ability to serve patients with more urgent needs because it reduces its effective capacity. When such patients are not receiving the care they require in a timely fashion, it increases the likelihood of negative outcomes and decreased payments-for-value.

Boosting Volume Through Prevention

Preventive health outreach is another tool in the high performing medical group’s toolkit that can drive growth. While most, if not all, physicians understand the value of prevention, not enough medical groups are making a concerted effort to promote it amongst their patient populations. The reality is staff are overworked and in many cases can only focus on the problems at hand during patient visits. While population health initiatives have gained momentum in the physician community in recent years, there is still not enough focus dedicated to long-term risk management, which is essential to improving outcomes, lowering costs, and maximizing payments.

High performing medical groups use a number of tactics to encourage prevention and in turn, improve physician performance. One approach is to leverage electronic medical records (EMRs) or patient registries to identify gaps in care and use automated reminders to proactively seek to close them. Practices can task ACPs to carry out wellness examinations, which allows such staff to work at the top of their licenses while freeing up physicians to focus on patients requiring more complex care. Another tactic is to target patient cohorts that are due for cancer screenings and vaccinations, and get them in the door to complete them.

Keeping patients engaged with their health decreases the likelihood of preventable negative outcomes as well as chronic disease management in the future. This can translate into measurable quality and experience improvements, which not only have the potential to unlock financial incentives, but bolster patient satisfaction, volume, revenue, and loyalty.

Automating Processes

Like most industries, healthcare is finding ways to incorporate automation into everyday tasks and processes. Medical practices, in particular, stand to benefit from automated clinical and operational workflows because it helps to address a number of contemporary challenges, including heightened patient expectations, increased prevalence of provider burnout, and high operating expenses.

The benefits of automation in the practice setting are numerous. Firstly, it can relieve staff of manually intensive activities, such as front office tasks and patient outreach. Such labor savings can elevate non-physician clinical employees into higher functioning roles, enabling them to focus more on patient care. Second, it offers a higher level of consistency and quality because automation tools are not subject to human error and exhaustion.

Use of information technology, such as EMRs, clinical decision support systems, and automated preventive reminders, can provide a more consistent basis of care and quite literally help save lives. As an added benefit, automation technology equips providers with actionable data that can be used to inform practice improvement decisions. Although any patient or provider would prefer the personal touch, as the reality of healthcare changes, finding efficiencies will help ensure better outcomes and experiences for patients and staff members.

Upward and Onward

The tactics presented in this article are three among many that can boost the performance and productivity of your medical group. To remain competitive, it’s imperative that you continually challenge the status quo and seek to adopt standardization measures across your physician network.

We invite you to check out the resources below for additional information that can assist you on your journey to becoming a high performing medical group:

Ben Kraus, Market Manager, is based in CipherHealth's headquarters in New York City. He focuses on issues concerning ambulatory care and alternative payment models, and has a special interest in how technology can spur the shift from volume to value in healthcare and enhance care coordination. In the wee hours of night, you just might find Ben jamming on stage with his bass guitar in one of the many music venues throughout the five boroughs.