Recently, Nashville Medical News had the opportunity to sit down with the current president and incoming president of the Nashville Medical Group Management Association (NMGMA) to get their take on some of the most pressing issues facing physician practices.
Kathi Carney, CPC, CPMA, CPC-I, CHC
Laura Watkins, FACMPE, CPC, senior medical practice consultant for SVMIC, is wrapping up her term as NMGMA president. In October, Kathi Carney, CPC, CPMA, CPC-I, CHC, director, LBMC Physician Business Solutions, takes the gavel to lead the Nashville affiliate of the national practice management organization.
NMN: What new challenges must practice managers address in the midst of disruption from COVID-19?
Laura Watkins (LW): With COVID-19, we have witnessed the rapid and exceptional transition of operational processes and protocols in medical practices. From introduction to integration of technologies such as telemedicine and virtual services, implementation of advanced safety protocols and modifications to staffing, practices continue to fine-tune their operations to ensure patient safety and employee health. In addition, many practices are experiencing lower patient volume and postponement of elective surgeries and procedures. The result has been decreased or delayed practice revenue. Depending on the financial situation and resources of the practice, financial viability may pose an additional challenge.
Kathi Carney (KC): I think the biggest challenge is being able to think outside the box. The whole work flow of their practices was disrupted ... but practices needed to learn how to adapt. Many had to quickly implement telehealth, reduce staffing, modify their schedules and figure out how to continue to care for their patients.
NMN: Outside of the pandemic, what are some of the top ongoing issues managers must address?
KC: Revenue is always a source of concern, inside or outside the pandemic. Staying up-to-date on all the regulation and carrier regulations can be a daunting task. New ICD 10 codes and major CPT changes are coming for 2021 (E/M codes), as well as reductions on payments. It's what keeps most practice administrators up at night.
LW: Practices will need to continue the transformation to value-based care and explore ways to optimize and broaden patient access to comprehensive healthcare services by improving operational efficiencies, quality of care and patient experience. While awaiting further guidance on telehealth coverage, practices should investigate additional healthcare delivery and engagement options. Practices should check with their EHR vendor, other technology vendors and payers to evaluate the possibilities.
NMN: Realistically, how do you stay on top of myriad functions if you are a small practice?
LW: Frequent changes and updates are common in healthcare and demand regular review of governmental, payer, and industry resources. This undertaking can consume a great deal of time, which can prove especially challenging for a small practice with limited staff. If considering outsourcing, managers should begin by identifying, assessing and determining the areas in the practice that would be most cost effective. Potential areas of consideration are IT management, billing, social media or payroll.
KC: Within a small practice , the administrator definitely has their hands full. To be able to manage and be in the know, I recommend aligning yourself with others in the same specialty or field. I also recommend outsourcing those functions that make sense to outsource, be it revenue cycle, credentialing or even perhaps bookkeeping. Outsourced companies are laser-focused on the task at hand and can save a practice money, as well as providing peace of mind knowing that this particular task is being handled by experts in their fields.
NMN: No matter what the practice size, administrators have to wear a lot of hats. What's the best advice you've received, and what advice do you share with others coming up in the profession?
KC: My best advice is that you cannot do it all! You have to have a great support system, such as colleagues in the same specialty groups or MGMA. Having that network is essential ... even if it is just for a sounding board when you are looking for a solution to an issue.
LW: For me, it was not words of advice but an observation of a leader in my early career that made an impression. This individual exhibited confidence in his employees ... and if a mistake was made, he would turn it in to a teaching moment. His goal was to empower our growth and development by providing guidance and learning opportunities. In the ever-changing healthcare climate, administrators should invest in employee training, development and continued learning.
NMN: What often gets overlooked but is important to success?
KC: I have learned over the years, as I have seasoned in the role, that you need to utilize all the resources you have available to you. MGMA, your specialty professional organization, TMA, SVMIC and others are great resources for education that can make your tasks easier. As you grow in your role, or evolve, never forget to seek out education. If you do not open your mind to new ideas, the practice ... and you ... will fall behind.
LW: The practice management role is challenging. I encourage you to develop and make new connections with others in similar positions. As a member of Nashville MGMA, the knowledge, education and connections I have garnered over the years are irreplaceable, and I welcome you to join NMGMA too!