Tuesday, January 31, 2023

6 Steps to hiring medical practice staff

Investing time and attention in the medical practice staff hiring process can reduce costs and boost staff retention.

In a busy medical office, an empty staff position can be a real problem. Days that were already full and often hectic are even more so. Patients are complaining. The instinctive response is to fill the slot ASAP. Resist the impulse! Any short-term relief will almost inevitably produce long-term aggravation and higher employment costs.

The data vary widely, but it is generally agreed that filling a staff position costs more than the associated annual salary. Most of these costs are “soft costs” that have a real impact on productivity and operating costs but do not require the practice to write a check to cover them. They includeLost productivity and increased overtime while the position
is vacant
Time associated with interviewing candidates
Even more lost productivity and increased overtime while the new hire is learning the ropes

The biggest soft cost, however, is making a hiring mistake. Hiring carefully is worth the investment. Here are six steps to significantly reduce hiring costs:

Step 1: Define your requirements


Experience and credentials are important but they are the easy part of describing requirements. The more difficult requirements are the ones not apparent in a résumé or transcript. They include

Personality. For instance, should the individual be cheerful? Optimistic? High-energy? Empathetic? Independent?

Work ethic. Do you want a self-starter? Team player? Leader? Someone who is detail-oriented?

Appearance and manner. Should the individual speak up? Look people in the eye? Be poised? Youthful? Mature?


Step 2: Describe the ideal candidate


It will be useful to flesh out the attributes by actually describing how your ideal candidate would respond in two or three hypothetical situations. (You can use these hypotheticals in the eventual interviews.)

I also recommend describing the ideal candidate from the candidate’s point of view. To whom would the job be most appealing? To whom might the appeal be short-lived? Your best source of this information is your impression of staff, current and past. What type of person at what age and stage has performed well, been happy and stayed a long time? What are the attributes of people who have not worked out well?

The object of the exercise is to have something definite against which to measure candidates. It is unlikely that you will find an ideal candidate, but you will get much closer if you know what you want and hold out for a reasonably good fit.

Step 3: Make adjustments


You may discover that the highly professional, well-turned out, mature person you would really like to hire has no interest in the duties of the job and finds the compensation inadequate. A long-term solution requires adjustments to your requirements, the job, or both.

Think about more than adjustments in monetary compensation. More flexible hours, the opportunity to learn, educational benefits, a pleasant workplace, and discounts on care and services are all examples of perks that have real value to candidates without necessarily increasing costs. Once you know the desired attributes, it becomes relatively easy to tailor the job to attract the ideal candidate.

Step 4: Establish a process that weeds out candidates for you


Before anyone looks at candidate submissions, have someone respond to every one with a request for some action on the part of the candidate. The action should be related to the position so that the request maintains your credibility, but the task itself is unimportant.

The objective is to let casual candidates self-select out of the process. If you still have too many candidates to seriously consider, assign another task. About 90% of the pool will drop out with each request.

Step 5: Verify selected résumé and application information


If something on a résumé or application is important to you, independently verify the assertions. Otherwise, ignore the contents of those documents.

Step 6: Give new hires an easy way to quit after a short trial period


It is not at all unusual for a new hire to discover that accepting the job was a mistake. The sooner the new hire can admit it and move on, the less you will have lost in integrating the new person into the practice.

A bonus is that your second choice may still be available and willing.

Hiring is a necessary evil. Investing time and attention in the process so that your hires are smart ones reduces the costs substantially.


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Monday, January 30, 2023

The sexy side of revenue cycle management

OK, maybe using the term "sexy" to describe anything related to revenue cycle management is a bridge too far. Or perhaps I'm just health-IT-enthusiast enough to go there.

Healthcare revenue cycle management is experiencing a revolution with the latest automation and remote work trends. A recent panel discussion with leaders from Banner Health, New York University Langone Health, Indiana University Health, and Luminis Health discussed the challenges and opportunities in revenue cycle management.

Here's what the most esteemed leaders in healthcare had to say about the hottest trends in healthcare revenue cycle management.


Staffing challenges


One of the biggest challenges faced by healthcare organizations is staffing. Finding and retaining qualified staff is difficult, expensive, and time-consuming. For example, senior-level revenue cycle positions can take more than 200 days to fill at nearly $6,000. Even entry-level positions can take more than 80 days and cost north of $2,000.

"The volatility of change is enormous in healthcare," said Christina Harney, Vice President of Access Management at IU Health. "At the end of the day, the team you have around you drives how successful you are."

Then there's the wrinkle of remote work. For some, it's a challenge. For others, a benefit. On the one hand, it provides workers with more opportunities, making recruiting and retaining talent difficult. But, on the other hand, adopting a work-from-home model allows leaders to pull from a larger pool of qualified candidates.

Becky Peters, Executive Director of Patient Access at Banner Health, found that allowing remote work has helped her team hire more qualified people across the country. "Since we opened up our hiring model to other states, we have seen an increase in being able to keep those staff," said Peters.

A hybrid approach seems to be working well for Sheldon Pink, Vice President of Revenue Cycle at Luminis Health, who reported that although their employees returned to the office quickly, they recognize that "there are other places where the work can be done."

Allowing employees to work from home, either part-time or permanently, seems to help improve morale and retention.


Automation poised to strike


Who would have thought that one of the sexiest opportunities in 2023 lay in automating revenue cycle processes?

And yet, it may turn out to be.

Automation is also poised to play a significant role in healthcare revenue cycle management. Harney reported that IU Health has already implemented automation to simplify scheduling algorithms, which allows access center agents to schedule appointments faster and more accurately. Patients can also "self-schedule appointments for primary and specialty care." Harney says automating preregistrations for hospital and physician visits is also a game changer.

Harney says IU Health has already implemented Experian Health's registration accelerator product and has done "a tremendous amount of work with bots." The game changer? Automating preregistrations for hospital and physician visits. Automatically conducting quality checks registrations and alerts them if an issue is detected.

The bots often resolve issues independently, without the registrar's involvement. By the end of 2022, she guesses they will have done over 100,000 registrations.


Goodbye manual processes


Then there are the other manual processes automated tools set to replace, like verifying a patient's coverage, which will reduce denials on the back end. Harney says they've already seen their first pass eligibility denial rate "go down significantly" and that the benefits have worked their way through the revenue cycle.

They've also implemented automation to simplify scheduling algorithms, which allows access center agents to schedule appointments faster and more accurately. As a result, their patients can now "self-schedule appointments for both primary and specialty care."

Another significant benefit of automation is providing good-faith estimates and achieving compliance with the No Surprises Act. Automation also helps reduce denials on the back end by verifying a patient's coverage.

Harney says they use a tool to send printed estimates through the mail for their self-pay patients. Now they're looking to automate even more, making it easier for patients to make informed decisions and pay their liabilities while helping staff to collect.


Increased revenues via automation


Now we get to the really sexy part: Money.

Peters rolled out an initiative shortly after joining Banner Health four-and-a-half years ago. It is called "revenue cycle modernization," and involves implementing automation in 26 projects between all areas of the revenue cycle.

"We saw a huge increase in our point-of-service collections, registration accuracy, and productivity," said Peters.

One of Banner Health's top operational goals for 2023? Increasing revenue.

"It's really about cash," said Peters. "Making sure we are financially strong, making sure our metrics are where they need to be. So, continuing to optimize all the tools we have and automating as much as possible."


Healthcare trends wrap-up


Staffing changes. Automating revenue cycle processes. Increasing revenue.

Can we really call them the sexy sides of revenue cycle management?

Well, let's put it this way:

In the context of a looming recession, decades-high inflation, and the effects of higher interest rates rippling through the economy, we think focusing on what matters — building the right team and strengthening efficiencies — might turn out to be the best decision healthcare innovators can make to lay the groundwork for years to come.

Overall, workflow automation is estimated to save the U.S. healthcare system more than $16 billion. If that's not sexy, I don't know what is!


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Sunday, January 29, 2023

2023 Outlook for small businesses in the healthcare sector

Small businesses in the healthcare sector navigated a choppy and challenging 2022 by being nimble, creative, and disciplined. They will need each of these skills plus a little luck to succeed in what is likely to be a choppy and challenging 2023. The year 2022 will be remembered for the Federal Reserve’s interest rate hikes that attempted to tame inflation by slowing the economy. It will also be remembered for high, but declining, inflation and a resilient job market that fueled both wage growth and strong consumer spending.

As we enter 2023, employment remains high and wage growth strong, supporting the American consumer’s ability to spend. However, cracks in demand are beginning to appear. Consumers are still spending but many have eaten into their savings and increased their credit card debt to do so. A weakening of the U.S. consumer generally has a negative effect on U.S. small businesses, as most small business revenue is derived from consumer spending. If consumer spending declines in 2023, we can expect small businesses to suffer.

The macro forces of an aging U.S. population, new innovations in treatment, and broader insurance coverage for Americans continue to make healthcare an attractive industry in 2023. While staffing shortages, burnout, wage inflation, and mountains of paperwork that reduce employee satisfaction are serious problems, healthcare professionals are poised for continued growth in the coming year.

Many small businesses in the healthcare sector, and others, will also struggle to obtain the capital required to fund their daily operations. Banks are now facing increasing delinquency rates, higher borrowing costs, and deposit outflows as consumers burn through their savings and chase higher yields from non-bank investment opportunities. As a result, many banks are being forced to reduce lending to small businesses and raise prices. This means higher cost of capital and fewer options for growing small businesses.

Fortunately, there are several strong non-bank small business lenders, such as Kapitus, that are working to fill the funding gap left as banks tighten. Kapitus has been providing growth capital to small businesses for the past 17 years, through periods of expansion, contraction, natural disasters and a global pandemic. It is during periods of uncertainty that our customers need us most, and we expect 2023 to be a year in which our capital is especially valued.



Other economic factors that will have an impact this year:


Inflation: Economic discussions in 2022 were dominated by the surge in inflation and the Federal Reserve’s quest to bring it under control. Unemployment has remained low and job vacancies high throughout the Fed’s tightening cycle, despite efforts to reduce demand. As a result, wage inflation remains high, and we expect the Federal Reserve to continue raising rates in 2023 until wage growth and job vacancies are brought in line with historical levels. We expect inflation to remain above the Fed’s 2% target rate throughout 2023 with several more rate increases to come. However, we do expect the Fed’s action to ultimately succeed in slowing the economy and reducing inflation rates, especially in the second half of the year.

The Global Supply Chain: The global supply chain made a dramatic recovery in 2022 as the world opened-up from the pandemic and stimulus-driven excess demand subsided. Russia’s invasion of Ukraine disrupted oil and grain markets causing spikes in energy and food prices, but the market has largely compensated for these disruptions, and we expect the normalization of supply chains that we experience in 2022 to continue into 2023. Potential wild cards disrupting this prediction would include an escalation of the war in Ukraine that brought in additional combatants, or the introduction of another significant conflict such as the invasion of Taiwan. Also, while we believe that the worst of Covid is behind us, China continues to struggle with the virus and the potential for a new variant sweeping the world remains a possibility.

Manufacturing: The trend toward the repatriation of manufacturing to the U.S. will continue in 2023 as long supply chains and geopolitical unrest drive businesses to seek more reliable alternatives. The Infrastructure Act of 2021 and the Inflation Reduction Act of 2022 each provide incentives to companies that build manufacturing capacity in the U.S. and source from US manufacturers. We expect these incentives to begin having a positive effect this year. In addition, new manufacturing technologies should allow new facilities to operate more efficiently, bringing down the labor cost differential between the U.S. and overseas markets. Continued cost reduction for U.S. manufacturers is critical as a strong dollar has hurt the competitiveness of U.S. manufacturing on the global stage and is slowing the overall repatriation trend. Unfortunately, the dollar is unlikely to reverse course until the Fed ends its tightening cycle.

The political environment: With Republicans taking control of the House and Democrats holding the Senate and the White House, major economic legislation appears unlikely in 2023. A very small Republican majority in the House lends power to the more extreme elements of the party which could make governing difficult for the Speaker of the House who will need to negotiate with multiple constituents in order to move critical legislation (such as raising the debt ceiling) forward. We expect to see at least the credible threat of a government shutdown in 2023, leading to market volatility and a potential impact on interest and currency rates.

Small businesses employ nearly 50% of the workforce and account for approximately 44% of the country’s GDP, making them a critical force driving the U.S. economy. Small businesses owners are creative and resilient having managed through the pandemic, inflation, demand fluctuation and supply chain disruptions. Despite the challenges they face today, small businesses in the healthcare sector will adapt to whatever changes 2023 brings and move to meet the market where consumers are. This is the strength of our capitalistic system and the backbone of the U.S. economy.


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