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Reimbursement and Practice Management

Go with the Flow – Ride with the Tide

Ride with the Tide

Probable Medicare Sustainable Growth Rate (SGR) repeal with a legislated temporary fix in payment rates, Medicare Fee Schedule adjustments, and the shift towards value-based criteria for payment – collectively they represent a big wave of payment change. The wave of change will likely grow, knowing private payers often follow the Centers for Medicare & Medicaid Services (CMS) lead.

With these imminent changes, there may be a temptation to simply "go with the flow" or "ride the tide." After all, proposed changes and new regulations have been developing for the past several months, with several more months of dialogue and debate ahead before we have the final rules.

While we might not feel like we have much say in the big waves of change in the Medicare payment formula or conversion factors we can lead the way those changes take shape in our own medical clinics.

Here's how we can create our own flow:

  • Adhere to clinical care pathways and processes
  • Elevate the patient experience of care
  • Document the outcomes of care
  • Demonstrate efficiency

Are our clinics set up to meet criteria for collecting and reporting data efficiently with adequate information systems? Are our clinicians and staff adequately trained with the systems that support effective patient flow while assuring quality care, raising the bar on the patient experience, and becoming efficient with the new resources?

It may not be easy to take on the big waves of healthcare reform. Yet amidst the organizational change, clinics can succeed if the focus on remains on the horizon – putting the patient first.

United States