conventus: maintaining healthcare practice profitability without sacrificing patient care
DESCRIPTION
Conventus presents key concepts for increasing healthcare practice profitability without sacrificing quality of care through the use of workflow analysis and improvement. This presentation, developed by Susan Lieberman, Vide President of Risk Management for Conventus Medical Liability Insurance.TRANSCRIPT
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TheFuture is Now:
Maintainingpractice profitabilitywithout sacrificing
patient care
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The Landscape
Increasing Legislative & Regulatory Requirements
Reimbursement Uncertainties
New Payment Models
New Delivery Models
Physician Alignments
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Welcome to The New Healthcare Paradigm
Maximize Patient Care Time
+
Minimize EVERYTHING ELSE
=
Better Quality Care
+Decreased Risk
+Better Reimbursement
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Get ready for Value-Based Purchasing
In 2016, CMS will apply Value-Based Payment formulas for Medicare fees All physician practices with 10+ eligible professionals Payments based on national quality of care and cost
of care benchmarks
Quality/Cost Low Cost Average Cost High Cost
High Quality +2.0x* +1.0x* +0.0%
Medium Quality +1.0x* +0.0% +1.0%
Low Quality +0.0% =1.0% -2.0%
*Eligible for an additional +1.0x if reporting clinical data for quality measures and average beneficiary risk score is in the top 25% of allbeneficiary risk scores.
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Reinventing your Practice
Risks
Operational
Clinical
Regulatory & Technology
MPL & Legal
Financial
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Operational Risks
Question: What is the most valuable asset in your practice?
Answer:The Provider's Time!
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The Value of a Practice Minute
Schedule
$1.49
Check-In
$1.30
Room-In$1.62
Patient Visit$7.50
In-Office
Follow-Up
$1.62
Check-Out
$1.30
Post-Visit
Follow-Up
$1.75
Billing$1.74
Total=$18.32Source: Mary S. Applegate, MD, FACP, FAAP, Clinical Asst. Professor of Medicine, The Ohio State University College of Medicine
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Workflow Analysis
-An established process describing:
A series of tasks (activities) How they are accomplished (steps) By whom (people) In what sequence (order) At what priority
that accomplishes a defined step(s) in an activity
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Workflow Analysis
What's In It for My Practice? Health Insurance Exchanges Value Based Purchasing v. Fee
For Service Patient Engagement Streamlining Practice Based on DATA New Technology Works for Practice
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Workflow Analysis
What we've learned from CARE Certification Program on-site sessions: Management Attitude: “Everything is fine” Time Constraints Call Volume & Triage Duplicative Efforts Lack of Coordination between Front & Back Office Lack of Teamwork Patient Non-Compliance Physician Attitude:
“We don't have time for customer service.” “We tried that & it doesn't work.”
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Workflow Analysis
How To Do a Workflow Analysis1. Select a Process – Start Small!2. Involve Staff! Collaborate!3. Identify Current Activities/Steps – List or
Graphic4. Identify Issues/Bottlenecks
Data!
5. Identify Improved Activities/Steps – List or Graphic
6. Test (PDSA) Data!
7. Modify & Train
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Workflow Analysis
Processes To Analyze Patient Flow Through Office (through-put)
1. Scheduling/Appointments
2. Reception
3. Waiting
4. Rooming
5. Clinical Exam
6. Check Out
7. Follow Up/Care Coordination
Revenue Cycle Management/Billing/Claims Referrals Diagnostic Testing
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Workflow Analysis Example
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Continuous Workflow Improvement
Do Study
Act
Plan
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Workflow Analysis
Resources: Capko, Judy, Secrets of the Best-Run
Practices, Greenbranch Publishing Cohen, Frank, Lean Six Sigma for the
Medical Practice – Improving Profitability by Improving Processes, Greenbranch Publishing
Institute for Healthcare Improvement, PDSA Worksheet, http://www.ihi.org/resources/pages/tools/plandostudyactworksheet.aspx
Woodcock, Elizabeth, Mastering Patient Flow Using Lean Thinking to Improve Your Practice Operations, MGMA
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The Results
Increased reimbursements
Improved quality of care
Higher patient & staff satisfaction
Lower risk of malpractice
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For Details
For a personal presentation, contactSusan Lieberman, MBA
Vice President, Risk ManagementConventus Inter-Insurance Exchange
877-444-0484, [email protected]
www.conventusnj.com