In an increasingly competitive “Vein Care” market, physicians are faced with a multitude of issues threatening their success and viability as a stand alone, independent medical practice. A constantly changing reimbursement structure increasingly impacts the practice of medicine. In order to stay competitive and succeed long-term, physician leadership must take an active, structured approach to the strategic planning process to remain competitive. The paramount goal of any medical practice should be to thoroughly and appropriately assess the value you provide within your service area, and to ensure that strategic planning will foster the continued delivery of clinical value in a dynamic health care market.
• What is your Value Proposition? The purpose of any business is to create and deliver value to a market in need of services. This is commonly referred to as a value proposition. For vein practices, the value proposition centers on the delivery of high-quality, cost-effective vein care treatments provided by physicians. The value proposition will also identify the target markets to which the value is delivered. Target markets are defined as those consumer groups the vein practice seeks to provide with vein treatments, and can be segmented into both direct-to-consumer and direct-to referring physician marketing initiatives.
• Develop a Marketing Plan. A marketing plan for a vein practice is a strategy that is designed to facilitate the achievement of specific growth goals. It is not simply scheduling an occasional free vein screening or patient event. It is an overall strategy that encompasses advertising, media relations / PR, physician referrals, patient referrals, as well as planned events to create practice exposure (free screenings, PCP lunch n learns, community education seminars, etc.).
To be effective, your marketing plan must be S.M.A.R.T:
S – Specific: What do you want to accomplish?
M – Measurable: How will you measure success?
A – Attainable: Are your goals achievable?
R – Realistic: Unrealistic goals are never met!
T – Timely: What is your timeline for completion?
• Develop A Strategic Plan. Effective strategic planning must be understood as a process that equally emphasizes internal and external factors impacting the practice. The medical practice undertaking this process must be willing to challenge the very core of its business in light of patient needs, external PCP referral patterns, and the strengths and weaknesses of your current staff. What are the consequences of incorrectly assessing your competitive landscape? In the current environment of declining reimbursement, increased competition and rapidly changing technology, the stakes have changed and the consequences of not understanding your competitive marketplace have gone up. To help practices appropriately identify new opportunities, adequately assess changes in the market and the environment, and then implement sustainable strategies. A defined, formal strategic plan must be adopted.
• Complete a SWOT Analysis. SWOT is a marketing buzzword. All medical practices should know their Strengths, Weaknesses, Opportunities, and Threats. A vein practice has to understand its internal Strengths and Weaknesses and also be cognizant of external Opportunities and Threats. To do a SWOT analysis correctly, you must look at your competition, as well as your own vein practice, from a patient’s perspective. Look at your marketplace with an open and honest perspective. After the SWOT analysis is complete, you will need to build on your strengths, do everything possible to eliminate or correct weaknesses, take advantage of opportunities in the marketplace, and do whatever it takes to minimize or avoid threats to your practice. One of the more interesting definitions of marketing is that “Marketing is the process by which resources are brought to bear against opportunities and threats.” Physician leadership must be willing to dissect all areas of your vein practice and be honest in assessing whether the practice may have failed with previous strategies, may not be as accomplished or successful as its competitors, and may need to change / drop current practice patterns and operations. An honest and forthright challenge to the value proposition is an essential starting point. Further, physician leadership must be willing to assess the competitive environment in which it competes. This assessment must seek to understand, on all levels, the emerging issues impacting operations, competition and the target market(s) for its services.
• Revenue Cycle Management. A medical practice is one of today’s most complex businesses, and it must generate revenue if it is to survive. Billing comes to most people’s minds when you mention Revenue Cycle Management, but the topic is really much broader. Revenue Cycle Management is a process that truly affects your entire vein practice. From a new patient’s first inquiry to completion of their treatment plan, an efficient Revenue Cycle Management process can make or break your medical practice. Nearly every function in the practice has the ability to positively or negatively impact your ability to collect its revenues in a timely and accurate manner. The revenue cycle comprises the numerous tasks of the billing and collection process — namely, gathering and entering data about professional services rendered and ensuring that bills are paid in full. Think of a typical vein practice’s revenue cycle as a wheel. The spokes are the critical functions of the billing and collection process. Each function has several key touch points, often in the form of tasks, that practice staff or providers must perform. Unless each function is performed effectively, the wheel will fail to turn. If it stops for too long, the business will collapse.
Critical Revenue Cycle Functions Include
1. Contracting with insurers. Managing and monitoring reimbursement agreements with government and private payers. Are you being paid at your contracted rates?
2. Eliciting and processing patient information. Competently and efficiently registering and scheduling patients, confirming appointments, verifying insurance before services are rendered, obtaining pre-authorizations for treatment.
3. Capturing charges: Documenting all services provided to patients, correctly coding services, proper use of modifiers, and providing required documentation.
4. Billing: Producing and submitting claims to payers and sending statements to patients in a timely manner after contractual adjustments have been made.
5. Processing payments: Posting payments, verifying that your medical practice is being paid its contracted rates, handling denials by insurers and correctly adjudicating accounts. Appealing underpaid claims.
6. Handling payer accounts receivable: Monitoring performance and resolving or appealing payor denials.
7. Managing patient collections: Determining and collecting what patients owe, administering financial policies and receiving payments.
For each function, a well-run vein practice should establish, assign, and monitor the administrative functions that must be performed. Unfortunately, many practices that our firm consults with are not performing many of these tasks efficiently and consistently. Opportunities to interact with patients and payors are missed and, as a result, the revenue cycle does not operate at peak efficiency.
• Personnel Management. There is no way to entirely eliminate employee turnover. There is nothing you can do when people move, change careers or retire. However, there are certain steps you can and should take to minimize employee turnover. Focus on factors that are in your control. Personnel management is concerned with the effective use of the skills of people. In a medical practice, personnel management starts with the recruitment and hiring of qualified people and continues with directing and encouraging their growth as they encounter problems and tensions. Personnel management is a balancing act. At one extreme, you hire only qualified people who are well suited to the practice’s needs. At the other extreme, you train and develop employees to meet the practice’s needs. Most practices land somewhere in the middle – they hire the best people they can find and afford, and they also recognize the need to train and develop both current and new employees as the practice grows.
Assessing Staffing Needs. Due to the small staff size in a typical vein practice, you need to base the practice’s personnel policies on explicit, well-proven principles. An example of these principles are:
1. All positions should be filled with people who are both willing and able to do the job.
2. The more accurate and realistic your expectations are for each position, the more likely it is that workers will be matched to the right job and, therefore, be more competent in that job.
3. A well written job description is key to communicating job expectations to staff. “Do the best job you can” is not job guidance.
4. Employees chosen on the basis of the best applicant available are more effective than those chosen on the basis of friendship or expediency (warm body).
5. If specific job expectations are clearly spelled out, and if performance appraisals are based on these expectations, performance is higher.
6. Employee training results in higher performance if it is based on measurable learning objectives.
Job Descriptions. Formulate your job descriptions based on the work that needs to be done. If your practice changes significantly, so must your staffing. You likely will need to add personnel and also adjust your job descriptions to ensure that everyone is doing work that must be done and no one is doing work that has become irrelevant. If a vein practice has too few employees, they will become complacent and burn out. If many of your employees are doing irrelevant work and no one has been assigned to do work that has become relevant (or if you assign the wrong employee to perform new tasks) your employee’s will become confused and frustrated.
Job Specifications. The job specification describes the person expected to fill a job. It details the knowledge (both education and experience), qualities, skills and abilities needed to perform the job satisfactorily. The job specification provides a standard against which to measure how well an applicant matches a job opening and should be used as the basis for recruiting.
Orienting New Employees to Your Practice. An employee handbook communicates important information about your practice to the employee. The handbook should cover topics such as expectations, pay policies, working conditions, fringe benefits and the practice’s philosophy toward patients. Once an individual is hired, he or she should receive a comprehensive orientation on the general policies of the practice and on the specific nature of the job. Job expectations should be explained in detail and agreed upon, as well as questions answered before the new employee begins work. New employees should be introduced to other employees and made to feel welcome.
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