Longer-term Action If Medicare Cuts Take Place

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Here is Medscape's advice for doctors after MC cuts April 1;   SAD...

http://www.medscape.com/viewarticle/719378_3

Longer-term Action If Medicare Cuts Take Place

You probably already know that you should cut overhead and find ways to run your practice more efficiently.

What are important now are more strategic changes in several areas. Some may involve a shift in how you deal with Medicare patients; a new template for patient encounters; additional ways to bring in revenue, changes to your office staffing, and adoption of new technology. Some of the suggestions might not appeal to you, but they could help save your practice.

Restructure or Reschedule Medicare Patient Encounters

Start taking steps to understand the percent of your practice patients and patient encounters coming from Medicare, says Scroggins.

It's too extreme for most doctors to eliminate all Medicare patients from their practice, and many would not want to. But doctors can still allocate fewer resources to that patient, says Jeff Denning, a practice management consultant with PPG Consulting in La Jolla, California.

" Physicians who can replace Medicare patients with other patients should limit appointment exposure to Medicare patients and give better service, quicker availability, to the patients with better paying plans. For those who cannot do this, they can continue to practice as efficiently as possible, limit optional expenses, and complain to their representatives, " says Denning.

" Doctors have to ask themselves: how many hours of the week can we afford to see patients paying 21.2% less than they were yesterday? " says Scroggins. " Doctors may need to think of changing the amount of time they allocate to Medicare patient encounters or limiting the hours per day they can accept Medicare patient appointments. And even with that, you want to handle those times as efficiently as possible. "

" Some doctors might ask, 'Is that even feasible? I can't even treat a patient in half the amount of time. " But think about whether there is a way to treat the patient so you can deliver care without losing money, " says Scroggins.

You might decide to see 6 patients an hour instead of 4 and to get the exam rooms turned over more quickly. Or, while it may sound unfair or insensitive, a practice could allocate only a day a week for Medicare patients and move those patients through much faster.

You could allocate certain times to see just Medicare patients, such as Tuesday and Thursday mornings. When Medicare patients call for appointments, the staff would say, " We will put you in on the next Medicare clinic day. " Or you might consider hiring a nurse practitioner to see the Medicare population, suggests Scroggins.

Look at Everything You Do During a Patient Visit

This will help you revisit the patient encounter. " Some doctors like to be the one who takes the weight and gets the patient samples, " says Aburmishan. " But the doctor needs to identify everything he or she does that's not revenue-generating. All those things should be done by staff. "

One way to figure out how to make your patient encounters more efficient is to have someone trail you throughout the office for the entire day, with an eye toward what you're doing that's not related to charting or patient interaction. Having someone trail you often yields surprising and useful results.