Physicians Practice - January 2008 - (Page 32)

GETTING PAID time, as the patient is sitting there.” Generally, says Marvin, you can expect to save $10,000 to $20,000 per physician, and a 200 percent increase in collections. “The biggest beneﬁt comes in the reduction of staff time,” he adds. politicians, and anyone else who should be listening. It can be a standard “I disagree” letter, where you mail-merge your local, state, and national medical associations, governing state bodies, and the like. Don’t assume they’re already well-apprised Cavale notes the public’s employers need to listen up and take action, as “the consumer is not really the consumer of care. They’ve delegated that option to their employers. … You must pay attention as an employer.” This means performing due diligence when shopping for healthcare, says Madden, which she claims many employers don’t do. “You have a lot of employers just trying to keep costs low, and not really paying attention to quality of care. They leave it up to insurance companies. There needs to be a much bigger awareness of what are you buying and why you are buying it. It’s not a valuable proposition just because you saved $10,000 on Aetna over Cigna. [With employers and employees] working together, you’d be surprised how effective it is with insurance companies. It really forces their hand.” HOW LOW WILL IT GO? “… It’s really important that physicians communicate with as many people as possible. Don’t just let it be a small subset of rabble-rousers, or they get marked as such.” TO ARMS! Suzanne Madden, consultant SPEAK UP Mertz thinks that “there’s no national understanding of this whole reimbursement thing, on either the physician or the public side.” And truly, he says, payments are all over the map. Fabrizio has noticed most of his consulting practice shifting to integration — practices joining together, or getting bought by hospitals. “They’re [each] just one doctor,” he says. “They don’t have time. They can’t be politically active. Patients walk in the door morning, noon, and night.” Breeze agrees. “Physicians are trying to be physicians, trying to take care of patients. To get their compensation, they need a JD or an MBA. … As I’m seeing changes in healthcare, it’s becoming more and more difﬁcult to sustain as a single practitioner.” Joining together can be beneﬁcial operationally, but be careful not to negate the power of one, says Madden. She strongly advocates writing letters of objection to payers, 32 | PHYSICIANS PRACTICE | JANUARY 2008 of your issue. “I’m often surprised at political people,” says Madden. “They just don’t know.” And don’t write one letter from your group; instead, have everyone in the group write one individually. Is this worth the trouble? Absolutely. “I know many physicians who say, ‘Oh, what’s the use?” says Madden. “But it’s really important that physicians communicate with as many people as possible. Don’t just let it be a small subset of rabble-rousers, or they get marked as such.” And don’t discount the public. Even the supposedly politically shrewd physician organizations “grouse and lobby,” says Mertz, “but nobody goes to the public. Nobody says, ‘Hey, we’re going to have a 200,000-physician shortage. If you live in a rural area, you’re going to have no doctor.’” One crowd that could potentially do some damage is the senior set. “They’ve got the time to understand the issues,” Mertz says. “They could have a gray army out there, pounding on the doors.” If trends continue, reimbursements will theoretically hit bottom in a few years, akin to an asteroid striking Earth while the dinosaurs munched happily on ﬂora, fauna, and each other. “We’re in a changing world right now,” says Breeze. A growing movement of physicians are soliciting large groups and hospitals, looking for a stress-relieving salary payment structure, for example. Something’s gotta give, and soon. Will we move to a single-payer system? Hard to say, although even if we do, “the devil’s in the details,” says Fabrizio, and implementation would take years. He suggests that only a major political shift will cause any major change in the current reimbursement slide. “There has to be changes by all the constituents. Unfortunately, I don’t see any movements to have everyone talking at the same table — the AMA, physicians’ groups, no one.” • Shirley Grace is a senior writer for Physicians Practice. She can be reached at sgrace@physicianspractice.com. WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - January 2008

Physicians Practice - January 2008 Contents The Bigger Picture: Fixing Medicaid Letters Physicians Practice Pearls: You Can Teach an Old Dog New Tricks Noteworthy Cover Story: Fee Schedule Survey: 2007 Results Adding Ancillaries: Bucking the Practice Ask the Experts Idealab: 'How I Got Over My EMR Excuses' Technology: Don't Be Denied The Tech Doctor: Blessing or Curse? The Administrator's Desk: Learning From the Best Coding Career: To Partner, or Not? Management: Controlling Your Inventory Human Resources: How to Fire an Enployee Finance: Beyond Reimbursment - How to Fix Your Mix Classifieds Advertiser Index

Physicians Practice - January 2008

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