Aquina Blog

A survey conducted by NueMD in 2017 of more than 1,000 healthcare professionals measured how knowledgeable healthcare professionals are about The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and what outcomes they expect the new payment model to have on their practice.

The survey revealed both small and large practices don't know a lot about MACRA and many feel uncertain about its potential impact on healthcare.

Key findings include:

• 50% of those surveyed said they are not familiar with MACRA
• 56% are unsure if they are expected to participate in 2017
• 49% have not encountered information on MACRA

When practices were asked to consider MACRA’s effect on their financial well-being over the next three years, the responses were quite eye-opening:

The Medical Group Management Association (MGMA) conducted member research in July 2017 to better understand the cost and challenge of complying with federal government regulations and mandates.

The results of the Medical Group Management Association (MGMA) 2017 Regulatory Burden Survey reveal there are no shortage of opportunities to reduce regulatory burdens on physician practices.

The survey includes responses from 750 group practices, with the largest representation from independent medical practices with 6 to 20 physicians. You can view the full survey results here.

Below are some key findings.

Micro-hospitals are popping up around the country, but many providers still lack a solid understanding of what a micro-hospital is and how it can help satisfy emerging needs in their markets.

Micro-hospitals are 24/7, small-scale inpatient facilities—around 15,000 to 50,000 square feet—with between eight and ten inpatient beds for observation and short-stay use.

Like their name implies, these are small facilities with an average of 10 beds and a focus on emergency or middle to medium high acuity care, higher than urgent care, but lower acuity than a trauma center. They have everything needed to operate an emergency department: imaging equipment, lab services, everything except an ICU and MRIs.

Using a collection agency may seem like a good idea. If your practice is struggling to get debt paid, handing it off to the so-called professionals seems like a no-brainer. However, using collection agencies is often less successful and not as profitable.

According to The Association of Credit and Collection Professionals:

“On average a practice recovers just $13.80 for every $100 owed once a patient’s bad debt
is turned over to a third-party collection agency.”

Instead, by implementing simple procedural changes for collecting bad debt, making patients aware of them, and enforcing them, your practice can easily increase the chances of collecting.

Here are some actions you can take to help improve the financial process and make patients’ bills easier to pay and understand.

A study conducted by McKinsey revealed that due to the increasing costs of medical coverage, consumers are taking on more of the risk associated with health care, the traditional relationship between consumers, providers, and payors is changing.

Their analysis suggests that the vast majority (more than 74 percent) of insured consumers are both able and willing to pay their out-of-pocket medical expenses for annual liabilities of less than $1,000 a year.

However, the study revealed that the lack of financing options, inefficiencies in billing practices, and consumer confusion are all major drivers of non-payment of medical bills.

“37% of patients stated lack of financing options as
the main reason for nonpayment.”

Your industry is becoming more and more competitive. Retail clinics, telemedicine options, and other local practices can threaten your bottom line. One way to overcome this concern is to grow your practice size.

In fact, a recent report by MGMA states that larger practices tend to be more profitable than small practices.

A quick review of the data points to the fact that larger practices are also more apt to include medical and surgical subspecialties that can be supported by the practice’s larger base of primary care physicians.

This leads to the practice having the ability to provide more services which have greater complexity and generate greater amounts of revenue.

“As practices grow in size and production units increase, those larger practices have better
opportunities to decrease costs as they become more spread out.”

This is reflected in the data provided:

A recent study into the changing shopping habits of consumers has yielded some interesting insights. With the rising costs associated with doctor’s visits, it seems patients are now beginning to behave more like traditional consumers when shopping for any other professional service. It concludes people want healthcare that is more convenient, inexpensive, and of high quality.

Patients are no longer willing to wait for 3 hours to see a doctor. They expect to know what they’ll need to pay before service is provided, and they want easy methods of making those payments.  To stay competitive, practices need to anticipate and embrace these rising expectations.​

“26% of patients expect to speak with
a doctor within an hour”

While the majority of patients still prefer real-time interactions with providers, many are willing to use other methods if it’s more convenient or reduces wait time for an answer.

A recent story on NBC.com shared an all too common experience of an unexpected hospital visit for a young couple, the Raymans. As more and more people struggle to pay hospital expenses, a sudden medical emergency can break the bank. For the hospitals who provided the service, it can often mean going unpaid.

“77 percent of Americans cannot afford an unexpected
medical bill of $2,000 or more.”

Despite having health insurance, Rayman was hit with a $2,800 bill for surgery to have a golf-ball sized lump on his neck removed.

The family couldn't afford to pay the surprise bill right away. But they spotted a phone number for a payment program and were able to secure a 0 percent loan for 36 months.

A recent article in the Wall Street Journal explores the rapid rise of consumers and doctors turning to easier, faster and more convenient ways to meet - Telemedicine

Doctors are linking up with patients by phone, email and webcam. They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes.

Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home. Telemedicine also allows for better care in places where medical expertise is hard to come by.

“35% decrease in patients’ average length of stay and
30% fewer deaths than anticipated.”

As a measure of how rapidly telemedicine is spreading, consider: More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30% this year.

In a Milliman Medical Index (MMI) study last year, patients are continuing to seek out high-deductible health plans to offset the financial burden caused by a health concern.

A high-deductible health plan is any plan with a deductible of at least $1,300/year for individuals, $2,600/ year for families, where out of pocket expenses such as deductibles and copays equal no more than $6,500/year or $13,100/year, respectively.

FINANCIAL IMPACT ON PATIENTS

The study noted that the average total cost of care for a family of 4 now equals almost $26,000 annually. To make matters worse, employee expenses continue to rise faster than employer expenses.