Healthcare adopts virtual business office
In an effort to provide streamlined care, and to gain strength in numbers, four independent orthopedic physician groups across North Carolina joined together in 2016 to form a new practice called EmergeOrtho. The practices were spread across the state, each one operating multiple offices. This made it hard to communicate — a problem made worse by the fact that they were not using the same EHR, revenue cycle management, or practice management systems.
After the massive merger, the organization needed to bring together the business functions of 49 different offices — billing systems, medical record, staff procedures — in order to realize the full benefits of operational integration and economy-of-scale savings.
EmergeOrtho adopted a comprehensive EHR, practice management, patient engagement, and care coordination solution, athenaOne. This went a long way in allowing the group to add additional providers with minimal increase in administrative staff.
But in order to effectively manage this staff, EmergeOrtho needed to create a centralized business office. Instead of dedicating one physical space and aggregating staff there, they opted for a more modern approach. “We decided to make it virtual,” says Chris Adkins, Chief Administrative Officer.
Adkins set up a phased plan to establish a Virtual Centralized Business Office (CBO). In 2018, they worked with an athenahealth consultant to examine how the business functions were spread throughout the offices, a task made more complex by having added a fifth practice group to the mix.
“We knew there would be a lot of repetition, but we didn’t realize how differently everyone handled things like billing, purchasing, and HR teams,” says Adkins. They took the time to study each administrator’s role, looking at areas of redundancy and evaluating their individual capabilities. From there, they took aim at the disparate policies and procedures being used, and got them standardized and onto the same platform. They also spent months studying metrics to address outstanding accounts receivable.
With the groundwork laid, the last phase is to go live with the virtual CBO, with staff able to work from any office using the same tools and access the same information.
Adkins expects it to take a year to truly consolidate business operations and see major cost savings, largely through administrators’ attrition, and by making changes to their jobs and roles. The organization expects to attrite about 12 full-time employees or new job placements. And with one cohesive team with a single department head and mandate, he expects sizeable efficiencies of scale.
Adkins plans to dive deeper into metrics, including DAR, charge entry lag, missing tickets, claim throughput, change entry error rates, and denial rates. In the meantime, EmergeOrtho has already seen improvement with compliance and collection efforts, having appointed one administrator to oversee all of the missing tickets, state-wide.
While some members of the group have been eager to launch the virtual office, Adkins is glad to have taken the slower, more thoughtful route. “It’s been a big learning curve,” he says. “It’s different for us than a hospital-affiliated group or even a smaller private practice. And we’re really trying to keep everyone focused on the goals of improving collections, compliance, and coding.”