Never Mess with Someone's Income
I once worked with a physician who made the comment that is my title today. I hear his words every time I look around at the business of medical practices today – a drastic cut in physician pay by Medicare, flat and declining reimbursement across the board, and operating costs that steadily rise.
MGMA surveyed their members on the top challenges facing practices today. The report was published in the July issue of “MGMA Connexion”: The top three issues were:
Maintaining physician compensation in an environment of declining reimbursement and dealing with operating costs that are rising more rapidly than revenues. Following closely in third place was selecting and implementing a new electronic health records (EHR) system.
What now?
First and foremost – keep calling your congressional representatives and senators. They are back in Washington, and have the chance to reverse the pending 10.6% Medicare fee cut. CMS is holding claims, but they will have to release the claims for processing by the middle of next week. Everyone seems to agree on the reversal – the hold up is the attempt to add other Medicare items to the bill. The Republicans want to shore up the Medicare Advantage program. Let them strip off the excess weight and pass the core, physician fee bill tomorrow. Enough. Then they can get to work and start increasing fees, and revamp the physician fee program.
If you haven’t already done so – and I’ve been pushing this for months - now is the time to work up a plan for working through the next several years. It means re-working processes and procedures to handle patients with the same or fewer support staff, and by adding to revenue by adding diagnostic testing and other low-tech and low-risk services. You need to plan and implement EHR, and invest in marketing with the goal of adding another clinical provider, either a physician or a nurse practitioner or PA. When adding another clinician, your support staff should not increase one for one – you should get some economy of scale, adding say, two people rather then the current ratio of four staff per clinician.
OK – take a deep breath and plunge on. As Samuel Johnson said, “When you ain’t got the money, you’ve got to think”.
