Physicians: Start Preparing for 2016 Changes in Healthcare

By: Jeff Cohen

Stepping into 2016, physicians and medical practices must continue to be vigilant about the changing landscape in healthcare.  Those who adapt quickly and smartly will thrive, while those who don’t will lose.  What can they do?


Stability for medical practices requires two things:  clear analytics and fixes.  Smart medical practices will examine threats outside the practice and within it.  As far as external threats go, the key area to focus on is competition.  Do you know what competitors are doing and how they’re different than you?

Internal threats are general revealed in the form of (a) employees that need better training and communication, (b) employees that just need to go, and (c) creating a succession plan for the practice.  If the practice is top heavy with older physicians, what plan is in place to ensure that “new blood” is brought in?  What recruitment strategies are in place?  Can the practice go it alone or does it need a recruitment arrangement with a hospital that can demonstrate a community need?  How will the older physicians phase out?  Is there a plan in the corporate documents to make sure phase out is slow and planned?  What do departing physicians get?  What about billing and collection?  When was the last time that was analyzed?  And finally, coding analysis.  Is money being left on the table?  Far too many practices actually undercode visits and services out of fear of payer audit.  Apart from constituting a False Claims Act violation (though regulators are not fast to indict providers who are underpaid), the differential can mean the difference between a good year and a bad one.

Finally, in light of the fact that regulatory and recoupment activity has never been higher, practices would do well to ensure compliance via a self-audit and compliance plan.  This is a different animal than a coding audit.  This one looks at all contractual relationships to ensure compliance and augments coding compliance.  


Healthy medical practices will remain healthy by growing, like sharks that keep swimming.  That means becoming part of a larger, more sophisticated entity that allows them to (1) grow revenues, and (2) reduce overhead (as a percentage of gross revenues).  Since growing revenues will come with new services and/or better contract rates, the sure way to get there is to grow patient base and expand service lines.


Aside from lawyers (not plaintiff personal injury types), physicians are historically bad sales people.  The days of thinking that quality alone drives patients are long behind us.  And in fact, many patients will chose a doctor from an online ad or website.  As such, successful practices will have a website that is optimized, will routinely reexamine search terms and means to ensure successful web placement (which changes all the time), will engage social media, and webinars.  And they will meet at least annually to see what worked, what didn’t and what changes need to be made.  This is not a “set it and forget it” thing.  The healthiest practices will become marketing machines that provide medical services.

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