Robert Mittendorff, MD, MBA’s Post

The Civil War in Healthcare: Undermining Patient Care Physicians are increasingly feeling the pressure of rising practice costs and inadequate reimbursement policies, leading to a sense of disenfranchisement. Instead of leveraging their critical role to pursue positive changes, some physician groups have turned their frustrations outward, publishing negative pieces that pit them against nurse practitioners and pharmacists. This divisive "against" narrative is troubling, as it undermines interdisciplinary collaboration, which has been proven to enhance patient outcomes and improve the overall healthcare experience. The healthcare landscape has evolved, with power becoming more distributed among different professionals. This shift, while creating tension among some physicians, is a positive development for patient care. A collaborative, team-based approach allows for more comprehensive and people-centered care, addressing patients’ complex needs more effectively. Unfortunately, the divisive rhetoric jeopardizes this progress, leading to fragmented care, increased medical errors, and poorer health outcomes. To move forward, healthcare professionals must unite, acknowledge each other's contributions, and advocate for policies supporting team-based care and appropriate reimbursement models. Read the full post here: ➡️ We are building something great, subscribe to Healthcare Humanized™ (https://buff.ly/48buHsi) and Echoes in Healthcare™ (https://buff.ly/4bQlRD3) ♻️ Repost to help others. 👍 Like | 💬 Comment | ↗️ Share

The Civil War in Healthcare: Undermining Patient Care Physicians are increasingly feeling the pressure of rising practice costs and inadequate reimbursement policies, leading to a sense of disenfranchisement. Instead of leveraging their critical role to pursue positive changes, some physician groups have turned their frustrations outward, publishing negative pieces that pit them against nurse practitioners and pharmacists. This divisive "against" narrative is troubling, as it undermines interdisciplinary collaboration, which has been proven to enhance patient outcomes and improve the overall healthcare experience. The healthcare landscape has evolved, with power becoming more distributed among different professionals. This shift, while creating tension among some physicians, is a positive development for patient care. A collaborative, team-based approach allows for more comprehensive and people-centered care, addressing patients’ complex needs more effectively. Unfortunately, the divisive rhetoric jeopardizes this progress, leading to fragmented care, increased medical errors, and poorer health outcomes. To move forward, healthcare professionals must unite, acknowledge each other's contributions, and advocate for policies supporting team-based care and appropriate reimbursement models. Read the full post here: ➡️ We are building something great, subscribe to Healthcare Humanized™ (https://lnkd.in/gU9YUMyb) and Echoes in Healthcare™ (https://lnkd.in/gyinPPXZ) ♻️ Repost to help others. 👍 Like | 💬 Comment | ↗️ Share

Physicians' autonomy and owning hospitals are hot topics. Some physicians write about the importance of owning the finances and directing patient care to be whole. Physicians speak to the cost of care, lack of price transparency, and the effect on patients without care. Many speak to the dissipating number of physicians in independent practice, about 25% today. The actual number in private practice is closer to 20%, as the other 5% are members of hospital and PE physician organizations for favorable payor contacting. So, if the premise is true that only private practice physicians have control over their patients and finances, why are they struggling? Here's a short list for the private practices that are fee-for-service: ❌ CMS cuts hurt. ❌ Rising supply and labor costs hurt. ❌ BUCA contracts are intentionally poor. ❌ Patient steerage to extensive hospital systems hurts. ❌ Recruitment is a challenge - clinical and non-clinical. ❌ Patient demands are a challenge. ❌ Physicians in private practice own the finances, and there are no subsidies to offset losses. ❌ Onerous regulatory environment. Physicians in private practice are in control, and there should be no surprises - good or bad. They should know their market intimately. They should know their annual payor contract rates to identify revenue opportunities - drop a payor, add favorable payors, offer direct-to-consumer cash pricing, and contract directly with regional employers to increase cash flow. Independent physician owners should know their expenses and look aggressively to reduce non-labor costs. Independent physician owners, if billing fee-for-service, should have their revenue cycle periodically audited to ensure competitiveness, compliance, accuracy, and timeliness. Independent physician owners should explore revenue enhancement opportunities applicable to their patient population. Exploration of enhanced technology to improve efficiency and patient and care team satisfaction is critical. Exploration of functions that can be outsourced to SMEs can be a consideration. Exploration of marketing to target patient populations is key. While a private practice physician owner cannot do it all, the buck stops with them literally. If the goal is to thrive in private practice vs. fight to survive, there needs to be a team of professionals to support the physician owner. Without a solid team of professionals with subject matter expertise to back you that gives you peace of mind to thrive in private practice, a physician owner will continue to fight for survival. One does not need extensive overhead to thrive. It's the right complement of professionals with expertise that will make the difference. 🌟 #accountability #smes #leadership #healthcare #transparency #viability #healthcarefinance #rcm #thrive #revenueoptimization

4 Mistakes Hospital and Health Systems Make that Financially Challenge their Medical Practices Our nation is full of hospitals and health systems who lament the financial performance of their medical practices despite actively contributing to those financial struggles in four significant ways: 1.      Contracting. It is a common practice for a health system or hospital with medical practices to contract with insurers in a way that accepts lower payment for physician services in exchange for higher hospital services reimbursement. 2.      Revenue Cycle. The cost to collect percentage for physician services billing is always going to be higher than the cost to collect for hospital services. If system financial leaders establish expectations that the cost to collect for physician services needs to be aligned with hospital service billing benchmarks, the physician services bills might be written off because it isn’t worth the time to chase that money (or more importantly they can’t hit their cost to collect benchmark if they do try to get the money). 3.      Overhead. Independent medical practices do not typically require or utilize all the infrastructure services that hospitals or health systems do, and therefore do not have to bear the cost of those services. Hospitals and health services regularly allocate hospital and health system overhead to medical practices based on percent of cost structure or percent of revenue. 4.      Managing the practice like a hospital. The metrics that are important are different. Staffing considerations are different. Managing two different businesses the same way out of convenience can result in at least one of them being managed ineffectively. The intent of this post is not to advocate for independent medical groups. Nor is it to suggest that financial failure of a health system or hospital owned medical group is only due to decisions outside of the medical group. Integrated health systems can (and do) bring a lot of positives to the table for physician practices and their patients. This is a call for health systems to manage their practices better by recognizing the differences between medical practice leadership and hospital leadership, and to hire practice administrators who know those differences and how to make the practices successful. A little more detail on each item in the comments. @MGMA #healthcare

Three things we need to fix in Healthcare 🛠️ (and how I think we can start) 1) While Value-based payment (VBP) initiatives are aimed at enhancing healthcare outcomes through direct return on investment for quality improvement (QI), inadvertently assumes a level playing field in financial resources across healthcare facilities. Moreover, the focus of VBP initiatives on specific patient groups and outcomes may show disparities in QI investments across inpatient populations. Multiple CFOs I've spoken to have highlighted the potential harm to safety-net hospitals, which face the dual challenges of lower reimbursement rates and higher costs, from policies that may inadvertently exacerbate resource limitations, thereby hampering their ability to invest. 2)The pervasive nature of burnout among medical students and physicians serve as a wake up call to the healthcare industry. The emphasis on finding clinicians with a calling to assist their colleagues is a necessity of fostering a supportive community within this profession. This realization brought me to a uncomfortable truth: the cost of clinician burnout extends far beyond the turnover rates, manifesting in diminished productivity and, the compromise in patient care. Healing, it seems begins with the healers themselves, by recognizing the nature of their work and creating sanctuaries at work where anyone can openly share their struggles without fear of judgment. 3)Denials management, again a critical component of the revenue cycle is highlighted as a high-priority area that is plagued. The dynamic nature of regulations means that healthcare organizations are in a perpetual state of catch-up, attempting to adapt to the latest denial trends. The importance of visibility into the sources of denials, studying cases in retrospect and advocating for a systematic and prompt tracking approach is the need of the hour. The call to action right now to enhance patient value, defined as achieving the best health outcomes that matter to patients at the lowest possible cost. Now, cost containment pressures are pushing payors towards performance-based payments, moving away from fee-for-service. This shift is signaling a critical period of adaptation to a variety of workflow measures, payment models with differing risk exposures. Also my subtle takeaway- involve your star physicians in clinical documentation, and advocate for their insight into payment outcomes and denial trends. This visibility can empower physicians to actively engage in improving documentation practice and closely understand the financial and quality implications.

Calling all CNLs! We’re on the lookout for volunteers to share their incredible experiences in a testimonials video. If you’re a Certified Nurse Leader with a story to tell, we want to hear from you. Help us inspire others and showcase the impact of CNLs in healthcare. Let’s highlight your journey and dedication. Testimonials should not exceed two (2) minutes in length; and provide an example of how the CNL’s skill set has been instrumental in bringing about improved outcome(s) in one of the following areas:   Patient Care and Systems Outcomes CNLs who help utilize the best evidence-based practices resulting in better patient, systems, safety and clinical outcomes. Increased Cost Effectiveness CNLs in the healthcare delivery process who are influential in bringing about reduction in costs, process improvement, and improved standards of care with the use of evidence-based practices.   Bridging Gaps on Interdisciplinary Teams CNLs who help facilitate better coordination of care across healthcare settings, including high-risk situations, and are crucial in bringing about higher rates of staff satisfaction due to unit and team efficiency.   Leadership CNLs who lead patient-care practices and delivery, including the design, coordination, and evaluation of care for individuals, families, groups, and populations. CNLs who manage and collaborate with other health professional team members.    How to Submit Your Testimonial If you’d like to be featured in CNC’s Discover CNLs Video Series, please email Ruby Karar at RKarar@aacnnursing.org by August 18, 2023. Your email should include the following details: ·      Your full name ·      Job Title ·      Name of Healthcare Facility ·      City/State ·      A brief description (about 250 words) of your testimonial based on one of the skill sets listed above, along with improved outcome(s) that you’d like to share with viewers. Please include Discover CNLs Video Series in the subject line of your email.

Unveiling the Shocking State of Medical Billing Quality in US Hospitals A comprehensive survey conducted in 2022 has exposed a shocking lack of quality in medical billing practices across the majority of U.S. hospitals. The study, encompassing over 2,200 healthcare facilities, highlights significant deficiencies in meeting the new billing standards, emphasizing the urgent need for improvement. Key Findings The study, published in healthcare media, delved into the medical billing quality of hospitals, scrutinizing over 2,200 institutions based on new measures implemented in 2022. Shockingly, the majority of hospitals were found to be falling short, particularly in crucial areas such as timely issuance of itemized bills to patients. Major Shortcomings One of the glaring issues identified is the absence of qualified billing representatives in numerous hospitals, causing delays in the provision of itemized billing statements. The study revealed that many hospitals resort to legal action to collect medical debt, neglecting to send itemized billing statements to patients within the stipulated 30-day period and failing to offer patients access to qualified billing representatives. Widespread Deficiency The study's results indicate a widespread lack of quality medical billing across the U.S., with only 38 percent of hospitals meeting all three billing quality standards. Disturbingly, a substantial number of hospitals reported taking legal action against patients for late or insufficient payments, demonstrating a concerning trend in the industry. Call for Further Investigation Researchers from Northwestern University, the authors of the study, stressed the necessity for additional investigation to ascertain the reasonableness and fairness of the newly proposed billing quality measures and standards. They also recommended the standardization of measurement and reporting of hospital billing practices, believing it could enhance accountability, diminish variations in billing practices, and alleviate barriers to care in the United States. Regulatory Response While experts acknowledge that hospitals can do more to enhance their medical billing processes for the benefit of patients, recent regulations, including the No Surprises Act, have been introduced to address some of the observed gaps in billing quality and practices. And at last, the revelations from the 2022 survey underscore a critical need for an overhaul in medical billing practices within U.S. hospitals. As the healthcare industry grapples with these challenges, regulatory measures and ongoing efforts to standardize practices offer hope for a future where patients can expect transparent, fair, and timely billing processes. For expert coding service join with us today! #medicalbilling #healthcarebenefits #homehealthcare #healthcareagency #healthcareproviders

Keep healthcare human. Last night, while waiting for a flight, I was scrolling through LinkedIn. A post discussing physician burnout caught my attention, highlighting the corporatization of medicine as a significant factor affecting physician well-being. This phenomenon often leads physicians to lose control over crucial patient care and decision-making aspects. Corporate entities might enforce standardized protocols and productivity metrics that favor profits over personalized patient needs, resulting in physicians feeling frustrated, helpless, and unfulfilled. My colleague Rachel Wood, PhD and I have been researching nurse loneliness and burnout, particularly among nephrology nurses, since last year. Having spent nearly a decade in roles emphasizing quality metrics, this topic deeply resonates with me. Whenever I meet with a nurse or any clinician to discuss performance, I make it a point to explain the purpose behind the metrics I discuss, aiming to alleviate some of the pressure they feel. I'm not a fan of 'scorecard' medicine, but I've learned that how results are delivered makes a significant difference. Productivity should not be the sole focus; healthcare providers can be productive yet concentrate on the wrong areas or adhere to outdated processes that need improvement. While I support using data to guide the work we do as healthcare workers, it's crucial never to overlook the human sacrifices inherent in this profession. Healthcare organizations, regardless of discipline, should prioritize clinician autonomy and involvement in decision-making processes. Empowering clinicians in shaping clinical protocols, patient care strategies, and operational policies can cultivate a sense of ownership and enhance job satisfaction. It's essential to maintain the human touch in healthcare, ensuring that we never forget the core of our vocation amidst the drive for efficiency and data-driven decisions.

Physicians, are you maximizing your income and receiving every dollar you’ve earned? A question that more physicians must ask themselves, as optimizing medical billing can significantly boost revenue without having to work more or harder than you already are. In today’s context of rising costs and minimal fee increases, this is more critical than ever. To address this topic, our team at DoctorCare sat down with financial health experts at Physician Wealth Advisory, to create a comprehensive guide. This guide offers insights on how FHO physicians in Ontario can implement effective strategies to optimize their billing processes, enhancing income streams while reducing administrative burdens. Read the full blog here: https://loom.ly/Q1jrmgg Sebastien Chevrier, CIM, QAFP #medicalbilling #OHIP #FHO #ontariophysicians

Ontario FHO Physicians: this is for you. These are common conversations and pieces of advice that I hear our excellent account managers having with our Practice Care customers on a daily basis for the purposes of billing efficiency. Read: make more money and get paid for everything you’ve earned. Often, it comes down to the time it takes to action these items, and that’s where physicians and their practices miss the mark. I encourage you to take a few minutes and read through this article. Make some notes. The return of your time spent will pay dividends monetarily immedietly. #FHO #Ontario #Healthcare #OHIP #medicine #billing