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A Pediatrician’s View: Improving Revenue and Care through Patient Communication

by Jeff A. Drasnin, MD, FAAP, pediatrics

Operating a small business in today’s economy is difficult. Small, privately owned physician practices must have their financial house in order to provide high-quality medical care. The truth is most physicians are ill-equipped to survive in a very tough business environment. We spend years training to take good care of our patients, but have no idea how to balance a budget or run a practice effectively. How can we best improve practice management, delivery of care, patient communication, financial health... all at the same time?

What’s required to make it all work?
A stable practice needs to do two things: Control costs and maximize revenue. Obvious, right? But it’s true.

Controlling costs is difficult but manageable—and with the right staff, it can be done. I’d like to discuss that second part, but with an added challenge: Maximizing revenue while simultaneously improving care.

In today’s ever-changing economic environment, small practices must continually look for ways to increase revenue stream. The system demands it.

Reimbursement rates are, to some degree, out of our control. We can negotiate but are often left with whatever insurance companies or the government is willing to pay. Since most of us still operate within the fee-for-service model, the vast majority of our revenue comes from office visits. Some practices can try to charge for additional services, but most fees aren’t reimbursed by major payers and end up falling to the patient. This is a pattern we’d like to avoid.

So, with fixed reimbursement rates and overhead, how can you increase your bottom line?
With schedule density. By increasing patient flow through your office. There are two ways to accomplish this: 1. Gain new patients; and 2. Increase the number of visits from current patients. Word-of-mouth is the best way to achieve that first goal, but growth doesn’t happen overnight. That second goal is what's really worth focusing on. And it’s more beneficial for everyone.

Seeing patients more often can be not only financially rewarding, but it also promotes better care—it is far more cost-effective to keep people healthy than to treat them when they’re sick. Insurance companies know this and will often reimburse better for a health maintenance exam than an acute illness visit.

Let’s get healthy patients into the office and keep them healthy.
And let’s get patients with chronic illnesses into the office so their illnesses can be managed. This approach can cut overall costs, improve the general level of health across a population and result in better financial success. It is a classic win-win.

How can we get this done?
Our office has found that athenaCommunicator, athenahealth’s patient communication solution, can be a great driver of both health and revenue. By using athenahealth’s reporting features, our pediatric office has been able to sort through our population to identify patients who have not been in recently for well-child exams, and contact those with chronic diseases such as asthma.

We started by running reports and placing “ticklers” into the computer to have athenaCommunicator call and e-mail families, to remind them of any routine health maintenance visits. We also used the patient communication system to contact all asthmatic patients during the fall, to encourage them to come in for their flu vaccines.

With these two automated actions, we both increased our schedule density (to just short of capacity) and did “the right thing” by improving care for a specific at-risk population—and our patient population in general.

The next step—to enable us to see patients more often—occurs on an ongoing basis. Here’s how we do it: When a patient checks out, if their next appointment is not made on the spot, a tickler is automatically placed into athenaCommunicator to remind the family of the next recommended visit.

For well-child care, this is timed to call and e-mail the family in 10 months, so they can set an annual-visit appointment. For asthmatics, that reminder is set for every 6 months.

We use a similar process for other acute illness states and well-baby exams. In the two years since we started this process, open appointment times at our practice are rare, and we’ve received a tremendous amount of positive feedback from our families.

Good care and financial stability, together. What a novel concept. It may sound cliché, but the athenahealth message is true: Our practice really is “Better Now.”

Dr. Drasnin is an athenahealth client specializing in pediatric medicine at Englender, Sper, Drasnin, MDs, in Cincinnati, Ohio.

Dr. Drasnin is an athenahealth client specializing in pediatric medicine at ESD Pediatric Group in Cincinnati, Ohio.

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