Best operating practices to follow in 2019

With the end of the year in sight, now is the opportune time to evaluate your practice team’s priorities. To ensure you start the new year off on the right foot, I have compiled a list of best operational practices to follow. Read the below recommendations to make 2019 your most successful year yet.

FOCUS ON MIPS

I find practices that establish a dedicated person or team to oversee measures related to Medicare’s Merit-based Incentive Payment System (MIPS) and EHR generally achieve higher MIPS scores than those that do not. This is not to say oversight is a full-time position. Yet, dedication that results in higher scores protects — and potentially increases — a practice’s Medicare reimbursement levels. To ensure high performance, it’s imperative that your staff champion stays up to date on potential MIPS changes.

One change I want to point out is a requirement in the proposed 2019 MIPS program rules to upgrade your practice’s certified EHR software to the 2015 version. I recommend being proactive and reaching out to EHR vendors now to schedule a time to download the demo version and set a date for conversion before the end of the year. Apart from this requirement, the proposed 2019 MIPS changes mainly consist of raising performance bars, tweaking measure sets and increasing flexibility in submission methods. To learn more, visit qpp.cms.gov/ .

AUDIT YOURSELF

On the topic of compliance, make sure you’re proactively fixing coding and documentation errors before outsiders find them. This is especially critical if you have a compliance plan in place, as you will be held accountable to the commitment(s) outlined in your plan. A compliance plan that is not actively followed is worse than not having one at all. Make the commitment, schedule quality assurance meetings and start evaluating 10 charts per full-time provider each quarter. Focus your limited resources on your highest risk areas, then meet and discuss the results.

Having positive and interactive discussions about guidelines raises everyone’s level of understanding and helps the team keep improving. Billing, coding and documentation compliance is not something to overlook, especially with the industry’s ever-increasing rules and regulations.

AUTOMATE PROCESSES

Today’s practice management and EHR systems, along with add-on software modules, can automate many processes to make them more efficient. Most high-performing practices utilize these tools to send automated reminders to patients of their upcoming appointment; check insurance eligibility; offer patient portal functionalities (such as online bill pay); message patients securely; refill prescription requests and complete online registration forms. With most software, the average user only utilizes 36% of a system’s functionality,¹ so I suggest working on raising this percentage in your practice to gain measurable outcomes. Be sure to choose your initiatives thoughtfully — automated phone attendants are not usually on the list of items that make patients happy (or anyone else who calls).

CREATE AND MONITOR

Whether it’s answering phones and collecting information, checking patients in and out or delivering care, your first line of defense against inefficiency is implementing consistent processes throughout your practice. Review your workflows as a team, identify bottlenecks and collect input on how to streamline inefficient processes. Creating and monitoring streamlined processes throughout increases accuracy, resulting in improved efficiency and profitability. Furthermore, when things go right 95% of the time, you are able to deal with outlier instances more effectively. Once your team experiences good solutions, they are motivated to consider and volunteer more ideas to help with practice efficiency.

IMPLEMENT CONTINUOUS QUALITY IMPROVEMENT

When people directly affected by the practice’s established processes play a role in their development, accountability is naturally achieved. Furthermore, processes developed in this matter that fit into the practice’s “big-picture” attain the best results. For example, it would be prudent to consult with your front office personnel on how to alleviate check-out station bottlenecks before adding a new associate physician to your practice.

Use open communication and lay the foundation for continuous improvement by examining one process with your team per month or per quarter, scrutinizing whether there is any room for improvement. Begin with a process that is causing a bottleneck or has proven to be a particularly thorny issue for patients or staff.

While some things may not be able to be reworked completely, your team will appreciate that you are working to make improvements. Moving forward, staff will continue to think about how to maximize processes and likely come up with new systems to try in the future.

ENGAGE YOUR EMPLOYEES

Staff engagement directly impacts the patient experience. It is in your best interest to ensure your staff provides an excellent patient experience for several reasons. First, your patients may be directly solicited by Medicare to measure your practice’s patient satisfaction outcomes, which your practice team directly contributes to and affects.

Second, your patients will decide whether to continue their relationship with your practice based on their experience.

Lastly, patients who have a positive experience are more likely to refer friends and family to your practice. Meanwhile, engaged staff members are more likely to refer good trainee candidates and former colleagues to your practice, which may provide strong support team members.

SET PRACTICE AND INDIVIDUAL GOALS

Create your strategic practice plan using a focused process, aligning specific goals and working toward those goals as a team. Regularly communicate to your team how daily efforts relate to the practice’s strategic plan. This can be done effectively through a combination of tactics, such as e-mailing staff newsletters and holding department and staff-wide meetings on a routine basis.

Beyond setting practice goals, it is equally important to set individual goals — for physicians and support staff — to ensure personnel engagement remains high. Facilitating open communication and fostering accountability through goal-setting will keep your team — and more importantly, your practice — on the right track.

MOVE FORWARD WITH CONFIDENCE

The only way to enact change is to shine a light on what is and isn’t working in your practice. All the aforementioned advice is designed to move yours in a positive direction. These guidelines will serve to increase accuracy, efficiency, accountability, quality of life and career satisfaction for practice stakeholders and employees, all while improving patient satisfaction in the new year. OM

REFERENCE

1. Cohn M. Are 64% of Features Really Rarely or Never Used? Mountain Goat Software. https://www.mountaingoatsoftware.com/blog/are-64-of-features-really-rarely-or-never-used

Laurie K. Brown is a senior consultant for BSM Consulting, based in Tucson, Ariz. She is certified as a professional coder and auditor, and brings more than 30 years of health-care experience to BSM.