Medical practices across the United States are struggling to see profits. It’s no wonder news sites are quick to pump out predictions about the decline of small private practices.
In a joint survey by QuantiaMD and CareCloud, 5,012 U.S.-based physicians were asked to identify the factors negatively impacting their profitability in the coming year. Declining reimbursements (65%), rising costs (57%), the Affordable Care Act (48%), and coding and billing changes (44%) were cited as the most common causes.
Although each comes with a unique set of challenges, practice management systems may be the solution to combatting all four issues. Of course, this is contingent on choosing the “right” software. So today, we look at the essential functionality a practice management system should have to keep your practice profitable.
Declining Reimbursements
With Medicare payments cut by 2% across the board, there’s little wonder why declining reimbursements took the top spot. While there isn’t much that can be done about the Medicare reduction itself, submitting clean claims and receiving maximum reimbursements will help soften the blow.
Practice management systems prove beneficial in both regards as long as they’re loaded with claim optimization features. A system should come with patient eligibility and code checking tools that ensure you submit clean claims every time.
Perhaps more important is the ability to crosscheck payments received against payer contract rules. Reimbursements are already declining, so the last thing you need is an insurance company underpaying your services.
Rising Costs
With the costs of running a practice becoming more prohibitive, cheaper alternatives must emerge in order to maintain profitability. A solid practice management system may be the answer.
Take claims submittal for instance. Submitting a clean paper claim costs physicians $6.63, while submitting an identical electronic claim only costs $2.90. MGMA estimates this difference can result in an additional $40,000 a year.
Practice management systems can also deliver savings when it comes to staffing costs. By automating certain tasks like statement creation and appointment scheduling, a smaller staff can work more efficiently and handle a greater workload.
Affordable Care Act (ACA)
The ACA has raised a host of compliance issues for physician practices that have spent substantial amounts of money implementing and monitoring compliance plans. Fortunately, a first-rate practice management system can turn the ACA from a negative into a positive.
In prior articles, we’ve discussed the 32 million patients who will flood the healthcare system in 2014 and how many practices aren’t prepared to handle this influx. But with the right practice management system, you don’t have to be part of that group.
Practice management systems get patients through the office faster without sacrificing quality by improving practice workflow. The key is to purchase a practice management system that goes beyond appointment scheduling. The system should provide you with a complete patient overview that allocates resources in the most efficient manner possible and leads to faster patient visits.
Coding and Billing Changes
The biggest challenge of them all may be the ICD-10 switch coming in October 2014. Even with ICD-10 training, practices are still likely to see an initial increase in claim denials due to improper coding. This will result in billers wasting valuable time correcting denied claims for resubmittal.
Therefore, it’s essential to get coding right the first time. Choose a practice management system with code checking features to protect against coding errors. A cloud-based practice management system is particularly useful here, as automatic system updates make sure your system’s coding rules are up to date.
Practice management systems don’t usually receive as much attention as their EHR brethren, but maybe just as important to the viability of medical practices. Don’t wait until it’s too late to find the right solution for your practice.
Learn more about how PM systems can boost profitability with this free webinar.
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