Were you the first to buy an iPhone? Were you the first to install electronic health records (EHR) in your office in order to get reimbursed $44,000 by Medicare? There is a perception that âfirst moversâ excel and laggards struggle. In fact, Harvard Business Review debunked this myth years ago.(1) The advantage seems to be with followers, who are more profitable in the long run.
Compare those EHR solutions that first movers paid upwards of $100,000 to implement several years ago to meet the âmeaningful useâ standard to whatâs available for free or nominal costs today. Mitochon Systems (http://mitochon.com/) and Practice Fusion (http://www.practicefusion.com/) manage records via cloud computing through your already existing system, and they use an advertising model and do it for free! Therefore, there is no software or hardware to install and they are certified EHR. For those who believe that nothing in life is free, PatientClick is another âall in oneâ EHR that costs $199.00 per month and works with Avisena (http://www.avisena.com/), a technology and services company that specializes in medical software. Advantage laggards.
Similar opportunities abound for those practitioners who waited for the Supreme Court decision on Obamacare. While there is speculation of physicians leaving the medical field or even retiring given the new legislation, the reality is that there are benefits and opportunities that physicians can take advantage of at their own pace.
Here is my list of opportunities to look at now after the rush of first movers.
1. 10% Medicare Bonus for PCPs. ACA provides that primary care providers (including MDs, PAs and NPs) will receive a 10% bonus based on Medicare billings beginning in 2011 and ending in 2015. Physicians must have over two years of existing Medicare B billings and new physicians will be eligible if they have any Part B billings from the previous calendar year. Physicians can qualify for the 10% bonus if the total outpatient billing from new and established outpatient visits, new and established nursing home visits, and new and established home care visits are over 60% of all Part B billings (this excludes new and follow up inpatients and ER visits). Key here is managing patient mix.
2. Medicaid. ACA will raise Medicaid payment rates to the level of Medicare payment rates for equivalent primary care services from 2013 through 2014. Depending on what the Governor and legislature do, it may be a good time to stick your toe into Medicaid, particularly with managed care plans.
3. Medicare/Medicaid Risk Contracting. With all of the MSOs and IPAs in the South Florida area, contracting with one of them is a great way to start risk contracting for Medicare and Medicaid patients. Given the high reimbursement rates for Medicare Managed Care in South Florida, it provides significantly more resources to the physician and patient to manage patient care and get better outcomes.
4. ACOs. An ACO is a network of doctors and hospitals that work together to manage and coordinate care for Medicare fee-for-service beneficiaries. ACOs must manage all the health care needs of at least 5,000 Medicare beneficiaries. As long as you donât have to make an investment, there is no downside to joining, but you can only participate in one, so take your time to select the right one.
5. Adapt services and expand offerings. Look to increase income by adding ancillary services, additional providers, products, or even having an independent business unit operating in the office:
a. Clinical Research Programs. Again, given the South Florida market, this can become a great adjunct to a medical practice.
b. Cosmetic and Laser Treatments. Cosmetic treatments and products that can be done right in the office, such as Botox and laser hair removal.
c. Critical Care Assessment. Is a non-invasive, fully automated computer-based system that provides a non-invasive test that can identify patients at risk for a variety of health problems. The test generates about $350 to $600 per patient, and is accepted by most commercial insurance and Medicare in Florida.
d. Concierge/Boutique Practice. For PCPs and non-invasive specialists such as cardiologists, this is a way of actually reducing the number of patients while allowing more time with the each patient, and increasing the bottom line.
6. Consider hiring non-physicians if additional staffing is needed. Hiring a nurse practitioner or physician assistant will cost practices less than adding another full-time physician.
Remember, go slow, and win the race.
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