Best Practices

A 2013 To-do List for Top Practices

By Derek Preece

What are advanced practices focusing on in 2013? It’s an interesting question, and one that is instructive to all ophthalmology practices as we approach a year certain to be filled with changes that will have far reaching implications for ophthalmology. The best practices will focus on these three areas during the coming year.

1. Access to Patients

Even the best-managed practice with the most talented physicians will fail if patients cannot visit because of insurance restrictions. Several months ago I met with a group of doctors to discuss the implications of an accountable care organization (ACO) that had just been approved in their market. They felt comforted by our discussion of the CMS policy that allows Medicare ACO patients to continue to see them without any penalty.

However, their administrator contacted me later with the news that a large insurer in their state has introduced a plan to use that ACO as the sole provider of care for a certain population of patients. If this practice doesn’t become affiliated with the ACO, it will lose access to the insurer’s patients. That would deal a severe blow to practice revenues.

What should you do now? Begin to take these steps to ensure your access to patients:

► Make sure you have a “seat” at the ACO table; i.e., you are involved in the discussion in your local market.

► Develop (or maintain) relationships with key players in your area. These include physician opinion leaders, important hospital administrators and insurance representatives.

► Evaluate and act on opportunities that will ensure access to patients in the future.

2. Improved Efficiency

For 2013, CMS announced a 27% cut in the conversion factor that determines Medicare reimbursements. This is nothing new, and it is likely (and hopeful) that Congress will pass legislation late this month or in early 2013 to modify that drastic reduction. There is no denying, however, that downward pressure on reimbursements will continue to be the course for the foreseeable future. This means that the best practices will want to focus on ways to improve efficiency so they can weather future storms (and be better prepared than practices that make no serious progress in this area). These steps can help ensure improvements in your practice’s efficiency:

► Have all departments (front desk, technicians, billing, optical, etc.) review their processes and look for better ways to get their work done.

► Help your doctors review their exam and surgery processes to find efficiencies.

► Continue to evaluate technology for ways to reduce labor time and costs.

3. Enhanced Quality

There are many ways to define “quality” in an ophthalmology practice, and all focus on patients. The best practices in the future will take special care to see that patients are well cared for, pleased with the services provided, and that examination and surgical outcomes are of the highest possible caliber.

What should you do now? Improving quality is an ongoing effort, but here are some areas to focus on in 2013:

► Measure your patients’ level of satisfaction and implement processes to improve in areas where patient perceptions are less than stellar.

► Comply with all coding and other regulatory mandates.

► Bolster staff training so quality improves in every area of your practice. Think strategically about what your staff needs to know to perform at a high level, and then make sure they have access to training programs that provide that knowledge. As you think about what your practice will focus on in the New Year, consider these three critical strategic initiatives and what you can do to move forward in a meaningful way in each area. OM

Derek Preece is a principal and senior consultant at BSM Consulting, a healthcare consulting firm in Incline Village, Nev., and Scottsdale, Ariz. Resources are available at www.BSMCafe.com.