May 05, 2015
Making Family Practice Profitable Again

The number of office-based primary care physicians (PCPs) has decreased in recent years, due in part to the high overheads of running a practice compared with shrinking reimbursements. But the patient volumes are out there and, with the advent of the Affordable Care Act, there are more potential patients with healthcare coverage than ever.

Although PCPs now have to work within the constructs of a changing game that includes alternative payment models such as accountable care organizations (ACOs) and quality-based reimbursements, that’s not necessarily a bad thing. By following these four tips, it’s still possible for PCPs to make family practice profitable again.

1. Working within the ACO model

In the ACO model, PCPs are the quarterback of care, and are essential to the success of treatment outcomes. As healthcare providers are decreasingly paid according to volume of work, eliminating duplicative services, screenings and diagnostics will actually result in better reimbursement and free up resources. The knock-on effect should be that PCPs are able to improve access for more patient groups, which in turn means they’ll still see adequate volumes of patients to meet overhead costs and turn a profit.

2. Finding ways to spend less

This doesn’t mean doing away with necessary staff and services. Rather, it’s about actively monitoring operating costs to create benchmark data and tools to assess and improve performance. Practices should increasingly be doing this kind of number-crunching to determine quality metrics, so applying the same philosophy to number-crunching should be a natural extension.

3. Coding at the point of service

Highly profitable practices collect receivables more quickly than their peers and had $11,361 less bad debt than other practices, according to the Medical Management Group Association performance report. These practices also had only 8% of their total accounts receivable in the 120+ day category.

Collection efforts start long before they ever reach the billing staff’s desks — they start right there in the room, at the point of patient contact. When physicians come away from a visit with a full compendium of notes, taken in real time and coded for common services immediately thereafter, the ball starts rolling sooner. Having a scribe service in the practice, for example, is key to making this happen, while letting the PCP give full attention to patients, which enhances the quality of patient experiences and increases patient satisfaction.

4. Being smart about producing more

More-profitable practices also implement operational efficiencies to cultivate and strengthen PCP productivity, “including employing non-physician providers and ensuring efficient patient flow.” Financially healthy practices invest in staff such as scribes, because the cost more than pays for itself in more clinician time spent seeing patients, more accurate coding, faster billing, and more.

Thankfully, PCPs are not alone: Eight family-physician-related groups, including the American Academy of Family Physicians, have formed Family Medicine for America’s Health, a coalition to fight the corner of family practices.

Critically, the group is pushing for less-cumbersome electronic health records, to help free time for conversation with patients, and to help PCPs switch to a team-based format, with a payment structure that reflects the work of population health management that begins at the PCP level. Employing scribes can help PCPs meet both these goals, while returning family practice to profitability.