With increasing regulations and decreasing reimbursements, hand surgeons are under increasing pressure to do more with less. The upcoming pre-course offers information on multiple critical areas which the membership must be aware of in order to optimize their individual practice.

 

Healthcare has become one of the most highly regulated industries in the country.  Moreover, as the federal and state governments become more involved in the payment and delivery of health care, the regulatory framework within which physicians must practice is becoming increasingly complex.  Faced with the challenge of funding massive healthcare expenditures, government and commercial payor programs are spending more money than ever on identifying fraud and abuse and recouping improper payments.  The section on legal aspects presentation will provide an overview of some of the most significant legal issues currently faced by physicians including fraud and abuse laws (e.g., Stark/kickback), audit exposure and false claims (e.g., whistleblower actions), and will include steps that every physician should take to maintain compliance. 

 

In 2010, President Obama signed into law one of the most comprehensive healthcare reform bills ever enacted.  Affordable Care Act (ACA) is the most transformational legislative change to our healthcare system since the Social Security Act of 1965 that established Medicare and Medicaid. The ACA focuses on reforming the private health insurance market by mandating universal health insurance coverage, and providing better coverage for those with pre-existing conditions. This law also improves prescription drug coverage under Medicare. These steps are anticipated to extend the life of the Medicare trust fund by at least 12 years. In addition, the ACA initiates several pilot and demonstration projects that change how providers are financially rewarded and penalized.  These new payment models will significantly impact all providers.  Physicians and hospitals will be asked to take on more risk through episodic and shared savings programs.  These new payment strategies will require more clinical and financial integration between providers.  This will impact utilization and cost of care for orthopedics and is an integral component of value-based care.

 

The section on expense management will supply you with useful tips and techniques on how to manage your office overhead.  Topics covered will include the five biggest contributors to overhead; the effect of embezzlement on revenues and expenses; ways to leverage the money you spend on your physical facility; strategies for maximizing your staff productivity; and the financial impact of adopting new technologies such as EMR and PACS. 

 

Do you know how much it costs to open your doors or even know how to get an estimate of how to calculate this? Why is this metric even important? How can “cloud computing” impact your bottom line? With ever decreasing reimbursements and pressures on the financial aspect of your practice, knowing how to calculate practice metrics and decide if new technology innovations are right for you and your practice will be some of the areas covered in running an efficient office.

 

Marketing has moved well beyond the holiday cards and fruit baskets that many of us have used in the past. Understanding your practice’s demographics and referral sources is very important but often hard to accomplish. The patient experience will increasingly be a tool for maximizing payment and satisfying government and insurance requirements. More importantly, a very satisfied patient will continue to be your best source of new business in your community. Conversely, a disgruntled patient can do a lot of harm to your practice due to the prevalence of internet rating sites. In an increasingly data-driven world, the patient experience continues to rule. A big budget is not necessary for taking advantage of the tight relationship between customer service, marketing and patient satisfaction.

 

These topics along with alternative revenue streams and how physicians can evaluate and leverage partnerships between themselves and hospitals will also be addressed.