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CloudView blog

Ideas and insights to help health care providers stay informed and profitable in today's challenging health care environment.

5 Essentials for Staying Independent

by Brian Anderson, MD, Senior Manager, Clinical Effectiveness

When I reflect on my training and residency, it’s clear I was never prepared to navigate the world of HCC codes, RAF scoring, and all the documentation needed to meet the standards for demonstrating improved clinical outcomes. When I think about the incredible amount of hard work involved in such a benign statement as “seamless care coordination,” my head spins and heart aches for my fellow primary care physicians. Each is deeply invested in the well-being of their patients and struggling to maintain their financial viability as a practice or organization.

If you’re an independent provider, I’m sure you can relate. Despite the hurdles, there are ways to continue practicing on your terms and still ensure your financial success and growth. Here are five essentials every independent practice needs – and can achieve if they know where to look.

1. Strong Financial Performance
Independent practices need to maximize efficiency and financial performance, and be prepared to handle new methods of reimbursement. Typical revenue cycle management solutions can’t meet the demands of a new, value-based health care system – that’s because new reimbursement models require revenue cycle systems to track and submit cost and quality data, and be able to appropriately distribute compensation based on practice performance.

Independent practices should look to practice management solutions with both front-end knowledge and back-office support that can be seamlessly integrated into practice workflow. This can alleviate a practice’s administrative responsibilities, boost productivity, and let physicians focus on patient care.

The right vendor should be able to handle tasks across the workflow, from patient scheduling, and claims submission and tracking, to researching and implementing real-time updates to payer rules.

2. Connectivity and Clinical Integration
One of the driving forces behind health care reform is the need for better coordination among providers. Lack of care coordination can result in fragmented health care, unnecessary costs, even treatment errors. One study found that 49% of referrals included no information for the receiving physician;  in 55% of referrals, the ordering physician got no follow-up information from the receiving provider1.

Some independent practices assume that sharing patient information effectively requires providers to be on the same electronic health record system – and give up their independence to join a hospital’s EHR system. This is not the case.

With a cloud-based platform, providers can exchange data easily across a wide range of systems because all information is securely stored and accessed via the Internet. Cloud-based solutions enable all users to access a single source of truth, so there’s no duplicate work or multiple versions of information. With this kind of ease and freedom, independent practices can choose the EHR that works best for them while benefitting from true integration with vendors, partners and others in their network.

3. Ability to Thrive in a Risk-Based Environment
Winning at risk doesn’t necessarily mean joining an ACO or other risk-based quality program. Independent practices must focus on improving quality and efficiency to stay competitive with, and receive referrals from, ACOs and other risk-based entities in their region.

To do this, primary care physicians need the right tools for coordinating care, tracking patient outcomes and provider performance, and managing payments from a risk-based contract. This is especially important for independent specialists, who can attract ordering physicians taking on risk by becoming quality-focused, low-cost providers.

4. Strong Patient Engagement

As an independent practice, you must give patients and referral partners a reason to choose your organization. In addition to strong financial performance and clinical outcomes, practices should promote a culture of patient engagement. The right tactics can foster better patient retention and loyalty in the face of increasing competition. And the right technology is essential.

Patient portals enhance patient-provider communication and enable patients to check test results, refill prescriptions, review their medical record, and view education materials, all online, at their convenience. Patient portals also drive notable efficiencies at our practices, streamlining administrative tasks such as registration, appointment scheduling, and delivering patient reminders. They allow practices to generate electronic statements and facilitate online payments.

When supplemented with live phone operators and automated messaging services, a patient portal can be a powerful engagement tool. Together, technology and patient communication services can help satisfy patients who demand 24/7 access to their health information, increase revenue via efficient self-pay collections, and help meet the most challenging Meaningful Use Stage 2 requirements.

5. Adaptability to Change

One thing is certain in the current health care environment: Change will continue. Independent practices need to be ready to adapt to new payment models, new clinical care models, declining reimbursement, and mandatory initiatives such as Meaningful Use and the transition to ICD-10.

Cloud-based partners who align their incentives with yours – and go at risk with you as well – are best positioned to help steward you through all the changes to come. It’s how athenahealth does it, and it’s how we think it should be done. It’s why we offer built-in, behind-the-scenes support to research and anticipate changes without extra cost. It’s why we have people and processes in place to optimize collections, eliminate workflow inefficiencies, aggregate disparate data, and provide deep visibility into your operations.

The reality is that to succeed as an independent practice – and keep your patients priority number one – you need tools and services that keep you thriving in today’s remarkably challenging environment. The key is knowing what to look for in those services and finding partners who care for your independence as much as you do.

1. “Coordinating Care – A Perilous Journey through the Health Care System,” Thomas Bodenheimer, M.D., The New England Journal of Medicine, March 6, 2008, p. 1065.

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