healthcare on the edge

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Practice Management in the 21 st Century Healthcare Teetering on the Edge? Mark Stallwood Dip Practice Management, B.V.Sc, Grad Dip Ed. MBA.

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MOTE Conference 2013

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Page 1: Healthcare on the edge

Practice Management in the

21st Century

Healthcare

Teetering on the Edge? Mark Stallwood

Dip Practice Management, B.V.Sc, Grad Dip Ed. MBA.

Page 2: Healthcare on the edge

Macro View

WHO defines healthcare system as the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations.

Page 3: Healthcare on the edge

Entitlements

• The right to a system of health protection providing equality of opportunity for everyone to enjoy the highest attainable level of health;

• The right to prevention, treatment and control of diseases;

•Access to essential medicines;

Page 4: Healthcare on the edge

Healthcare Models

• Traditional

• Foundational

• Biomedical

• Social

• Economic

(Arbuckle 2012)

Page 5: Healthcare on the edge

SO...

•Different countries approach healthcare in different ways and this determines how we manage practice…

Page 6: Healthcare on the edge

• Government (Federal & State)managed • Includes Medicare, PBS, Public

Health • GP’s are gatekeepers • Taxpayer funded universal

system (levy), medical (pays 85% of costs) and some pharmaceutical & dental • Private system is ancillary,

insurance (52%) & provision of services.

Page 7: Healthcare on the edge

• Government managed

• Includes medical, prescriptions, some dental

• Taxpayer funded universal system

• GP’s are gatekeepers

• GP co payment $30

• Private system is ancillary, insurance (32%) & provision of services.

Page 8: Healthcare on the edge

• Government managed (Provinces and Territories)

• Includes medical, hospital, in patient prescriptions,

• Taxpayer funded

• GP co payment $30

• Private system is ancillary, insurance (66%) for additional services.

Page 9: Healthcare on the edge

• Government managed

• Taxpayer funded universal system

• GP’s are gatekeepers

• Prescription co payment $15

• Private system is ancillary, insurance (11%) & provision of elective services.

Page 10: Healthcare on the edge

• Fragmented management

• Mix of Private and NFP

• Private cover (56% -50% underinsured) ▫ 500 companies

• Govt. Public (27%)

• No Cover (16%)

• GP’s not gatekeepers

Page 11: Healthcare on the edge

“In a perfect world, you would see a patient, submit a claim, and get paid. In a perfect world, what you charged for the procedure or service would reasonably reflect both the cost and the value of what you did, and you would, in fact, be paid what you charged” (Cohen 2011 Medical Economics)

Page 12: Healthcare on the edge

What is Practice Management

• focus on the best use of resources to achieve the best outcomes for patients, in the most cost effective and efficient manner and provide an acceptable return to all involved in providing that service.

Page 13: Healthcare on the edge

What many people think

• Focus on billing patients

• Ensure patients bookings are happening

• Basic administration

Page 14: Healthcare on the edge

What it actually is…

•Human Resource Management

• Financial Management

• Risk and Compliance Management

•Marketing

• Logistics

• Planning

Page 15: Healthcare on the edge

Practice is a business

Some interesting facts….

• 75% have no plan

• 80% have no budget

•Medical practices go bankrupt

•Accreditation is not best practice it is minimum standards

Page 16: Healthcare on the edge

What else has changed

• Patients in many countries now have choice – Healthcare consumers

Issues are now:

▫ Time

▫ Convenience

▫Outcomes

▫ Perceived level of Service

Page 17: Healthcare on the edge

http://www.youtube.com/watch?v=7_qwjcxwUqw&NR=1&feature=endscreen

Page 18: Healthcare on the edge

So what are the issues for

my practice manager?

Page 19: Healthcare on the edge

Human Resources

75 – 80 % of day to day issues are people related

• Lack of training

• Poor staff selection

• Lack of policy and procedure manuals

• Staff motivation

Page 20: Healthcare on the edge

http://www.youtube.com/watch?v=u6XAPnuFjJc&list=PLEFA1641CDE7AFEA6

Page 21: Healthcare on the edge

Financial Management

•No budget

•No cash flow management

•No asset management

• Few audit processes

Page 22: Healthcare on the edge

Risk Management & Compliance

• Poor understanding of business risk

• 120+ pieces of non medical legislation

•OWH & S

• IR

Page 23: Healthcare on the edge

Marketing

Applies to all practices

All about communication to:

• Patient

• Colleagues

• Potential Staff

Page 24: Healthcare on the edge

Marketing (2)

• Practice Image

• Logo, Letterheads

•Newsletters

•Web Page

• Social Media

Page 25: Healthcare on the edge

ICT

Keeping up to date

• Practice management systems

•Webpages

• Social Media

• Communication Systems

•Online Booking systems

Page 26: Healthcare on the edge

Planning

•No shared values

•No shared direction

•No goals

•No succession plan

Page 27: Healthcare on the edge

So where is the evidence? Department of Education, Employment and Workplace Relations funded a study by the Society for Knowledge Economics Leadership in 2011 Culture and Management Practices of High Performing Workplaces in Australia • Only service industries • 5600 employees

Page 28: Healthcare on the edge

Findings

1. People management is a key priority

2. Involvement of staff in decision making process occurs

3. These organisations are more responsive to customers and key stakeholders

4. They have a learning culture

5. They enable staff to fully utilise their skills and abilities

Page 29: Healthcare on the edge

Findings – Startling Bits!

•High performing workplaces generate 12% more revenue than similar businesses that were low performing.

• The profit margin in High Performing Workplaces (HPW) is nearly three times greater than in Low Performing Workplaces (LPW).

Page 30: Healthcare on the edge

So what is your next step?

Page 31: Healthcare on the edge

Questions?