Improve Your Bottom Line with Quality Reporting

Part of evolution for physicians is quality reporting through pay-for-performance programs.

Times change. What happened 10, five, three years ago is now ancient history, according to Ken Metsky, a partner with the accounting firm Citrin Cooperman. Evolution is critical.

“Either you evolve, or you become a dinosaur,” he says.

Part of that evolution for physicians is quality reporting through pay-for-performance programs. Consumers kick the tires of automobiles before driving them home and try on articles of clothing before making a purchase. They’re looking for quality, so it stands to reason that — if they could — they’d do the same when selecting their physician. And that decision-making can have a significant impact on a medical practice’s bottom line.

Metsky says that large health care providers, hospitals and insurance companies have a tremendous amount of data at their fingertips. In order to decrease their costs and be more profitable, they have to be more proactive in their health care. He’s referring to preventive care, which allows their patient population to be healthier and ultimately result in lower costs to all the providers, including the insurance company.

“It’s a win-win,” Metsky says. “And it’s a mindset change in the industry. Be more proactive than reactive.”

That mindset change is easier for larger health care organizations, but what about the local practitioners or small groups? The answer, Metsky says, is to become a member of an accountable care organization.

“That will allow them to share information; to be more efficient,” he says. “And to learn from each other. It’s going to be an evolution.”

Metsky says that it’s important for all medical practices, large and small, to think more like a business. In doing so, he believes there are certain efficiencies that medical practices can bring about — changes they can make internally — to become more profitable. And it starts with physicians no longer performing services that someone else can handle.

“Physicians need to be able to train those on their staff who are not of the MD designation to do certain functions that will then allow the physician just to perform their medical function,” Metsky explains. “It’s about learning; about being able to push down items that either a clerical person or a medical assistant can do versus the physician. And being more prudent with those functions.”

Being more efficient in the office, he says, will enable physicians to see more patients. When you’re less efficient, your time is not as productive, whether it’s in medicine or any other field.

“Physicians still have to spend a certain number of minutes with these patients any way,” Metsky adds. “However, if [the patients] need blood work, doctors should not be doing that.”

Small changes in the office can mean seeing more patients in the same amount of time or even cutting their office time by an hour for more free time.

The next step for physicians, Metsky says, is to let the population at large understand what these changes mean, not only for the practitioner, but also for the patients. If patients are healthier because they’re more involved in preventative care, being proactive with their own individual health, ultimately, they’re going to save dollars, they’re going to be healthier, and they’re going to live longer.

“You know, you talk about this whole concept, pay-for-performance — when these accountable care organizations are saving significant dollars, those savings are and will be shared not only with the insurance companies, but also with the provider of the services, which are the physicians,” Metsky explains.

He says that the ultimate goal of pay-for-performance and quality reporting is that it’s a win-win for everybody. Patients benefit by being healthier. Insurance organizations and providers benefit because they share the cost savings.

“Statistically, it’s been done, and physicians can make more money by saving dollars for these companies and getting a piece of those shared revenues,” Metsky says. “We spend such a large amount of our gross national product on health care in the United States that we’ve got to be more efficient. We’re making some strides. It’s going to take time. It’s an evolution.”

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