Conventus: Maintaining healthcare practice profitability without sacrificing patient care
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Transcript of Conventus: Maintaining healthcare practice profitability without sacrificing patient care
<Confidential>1
TheFuture is Now:
Maintainingpractice profitabilitywithout sacrificing
patient care
<Confidential>2
The Landscape
Increasing Legislative & Regulatory Requirements
Reimbursement Uncertainties
New Payment Models
New Delivery Models
Physician Alignments
<Confidential>3
Welcome to The New Healthcare Paradigm
Maximize Patient Care Time
+
Minimize EVERYTHING ELSE
=
Better Quality Care
+Decreased Risk
+Better Reimbursement
<Confidential>4
Get ready for Value-Based Purchasing
In 2016, CMS will apply Value-Based Payment formulas for Medicare fees All physician practices with 10+ eligible professionals Payments based on national quality of care and cost
of care benchmarks
Quality/Cost Low Cost Average Cost High Cost
High Quality +2.0x* +1.0x* +0.0%
Medium Quality +1.0x* +0.0% +1.0%
Low Quality +0.0% =1.0% -2.0%
*Eligible for an additional +1.0x if reporting clinical data for quality measures and average beneficiary risk score is in the top 25% of allbeneficiary risk scores.
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Reinventing your Practice
Risks
Operational
Clinical
Regulatory & Technology
MPL & Legal
Financial
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Operational Risks
Question: What is the most valuable asset in your practice?
Answer:The Provider's Time!
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The Value of a Practice Minute
Schedule
$1.49
Check-In
$1.30
Room-In$1.62
Patient Visit$7.50
In-Office
Follow-Up
$1.62
Check-Out
$1.30
Post-Visit
Follow-Up
$1.75
Billing$1.74
Total=$18.32Source: Mary S. Applegate, MD, FACP, FAAP, Clinical Asst. Professor of Medicine, The Ohio State University College of Medicine
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Workflow Analysis
-An established process describing:
A series of tasks (activities) How they are accomplished (steps) By whom (people) In what sequence (order) At what priority
that accomplishes a defined step(s) in an activity
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Workflow Analysis
What's In It for My Practice? Health Insurance Exchanges Value Based Purchasing v. Fee
For Service Patient Engagement Streamlining Practice Based on DATA New Technology Works for Practice
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Workflow Analysis
What we've learned from CARE Certification Program on-site sessions: Management Attitude: “Everything is fine” Time Constraints Call Volume & Triage Duplicative Efforts Lack of Coordination between Front & Back Office Lack of Teamwork Patient Non-Compliance Physician Attitude:
“We don't have time for customer service.” “We tried that & it doesn't work.”
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Workflow Analysis
How To Do a Workflow Analysis1. Select a Process – Start Small!2. Involve Staff! Collaborate!3. Identify Current Activities/Steps – List or
Graphic4. Identify Issues/Bottlenecks
Data!
5. Identify Improved Activities/Steps – List or Graphic
6. Test (PDSA) Data!
7. Modify & Train
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Workflow Analysis
Processes To Analyze Patient Flow Through Office (through-put)
1. Scheduling/Appointments
2. Reception
3. Waiting
4. Rooming
5. Clinical Exam
6. Check Out
7. Follow Up/Care Coordination
Revenue Cycle Management/Billing/Claims Referrals Diagnostic Testing
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Workflow Analysis Example
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Continuous Workflow Improvement
Do Study
Act
Plan
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Workflow Analysis
Resources: Capko, Judy, Secrets of the Best-Run
Practices, Greenbranch Publishing Cohen, Frank, Lean Six Sigma for the
Medical Practice – Improving Profitability by Improving Processes, Greenbranch Publishing
Institute for Healthcare Improvement, PDSA Worksheet, http://www.ihi.org/resources/pages/tools/plandostudyactworksheet.aspx
Woodcock, Elizabeth, Mastering Patient Flow Using Lean Thinking to Improve Your Practice Operations, MGMA
<Confidential>16
The Results
Increased reimbursements
Improved quality of care
Higher patient & staff satisfaction
Lower risk of malpractice
<Confidential>17
For Details
For a personal presentation, contactSusan Lieberman, MBA
Vice President, Risk ManagementConventus Inter-Insurance Exchange
877-444-0484, [email protected]
www.conventusnj.com