In the day-to-day management of medical practices, the most critical concern is (and always will be) patient care. But in the evolving landscape of U.S. healthcare and medical billing services, providing responsible care involves considering far more than just the effectiveness of treatment plans, prescriptions, and preventive services.
Following decades of arguments and advocacy, the landscape of the healthcare industry is shifting ever closer to a whole performance and quality-based future. From the MIPS, MACRA, and Meaningful Use incentive programs to the embrace of ACOs, collaborative care models, and pay-for-performance and outcomes-based fee schedules, there’s an increased focus on the financial side of healthcare and the importance of financial stewardship. This shift in focus has had a major impact on both patients and providers.
What is "Financial Stewardship?"
An increasingly important expectation of the healthcare industry, the concept of financial stewardship is a consideration for the financial responsibility and well-being of the patient, other individuals, and groups. This includes managing for quality and removing any unnecessary costs. The rise of value-based care brings with it an enhanced ethical obligation on the part of both providers and practice managers to be good stewards not only of their patients but also of their patients’ financial resources.
Fiscal stewardship is expressed through the ongoing shift to value-based care models. This means patients will continue to receive high-quality care at low costs that provide benefits to not only the patient but the payer and physicians as well.
Why Should Your Medical Practice Embrace Fiscal Stewardship?
With value-based care and administrative cost reduction initiatives on the rise, the keys to medical practice success are evolving rapidly. In 2019, the Centers for Medicare and Medicaid Services (CMS) announced that more hospitals will receive incentive payments than penalties under Medicare’s Value-Based Purchasing Program in the fiscal year 2020 with the total payment amount that shy of $2 billion. The same amount of $1.9 billion will be offered by Medicare to hospitals in the fiscal year 2021, which will be distributed to participating hospitals that improve the quality of patient care over time relative to their peers.
While there is still some dispute in the healthcare industry about whether value-based care truly does deliver improved health outcomes and cost savings, the concept continues to have strong bipartisan political support. Value-based care was central to many of the Affordable Care Act’s provisions and the Department of Health and Human Services (HHS) announced five new primary care payment models in 2019 designed to encourage the transition to value-based care.
Fiscal Stewardship and Your Healthcare Practice
As a consequence, gone are the days when simply expanding your patient base and providing care to ever-more patients was the key to sustainable growth. The responsibility is now on everyone to assume an appropriate level of financial risk for the care and treatment provided to patients, making “fiscal stewardship” a huge key to success in the emerging value-first medical economy.
With so many evolving programs and policies in play, there’s no one-size-fits-all approach for a medical practice to become a beacon of financial stewardship. Rather, embracing the concept is about finding new ways to eliminate wasteful spending, respecting the relationship between the cost and value of care, and providing new efficiencies and benefits within your existing approach.
5 Ways Financial Stewardship Can Improve Your Medical Billing
Medical billing may not be the first aspect of your healthcare practice that comes to mind when you think of financial stewardship, but there are stronger connections between them than you might expect. Incorporating the principles of fiscal stewardship into your practice can improve your medical billing practices in several ways.
1. Embrace New Innovations.
Managing for quality and removing unnecessary costs from your day-to-day efforts requires a new level of data sharing and collaboration between payers, providers, and consumers. To engage in the information flows that enable better care coordination, smarter decision making, and streamlined program reporting, organizations should cast off their reliance on outmoded systems and embrace new technologies that can lower costs and increase care quality.
2. Collaborate Cross-Functionally.
No matter the size or structure of your practice, there should be strong interplay between the front office and back office. Even if you’re running a large practice with its own set of interdepartmental expectations, it’s important to periodically revisit how much time your clinical and administrative teams collaborate with more financially-focused functions. If your teams lack a strong sense of allegiance to one another or struggle to communicate across operations, it can be difficult to collaborate in support of outcomes-based care and patient-focused fiscal stewardship.
3. Think Beyond Your Office.
Starting small is important, but it’s also important to consider what kind of stewardship you can engage in to support your larger community. Ultimately, financial stewardship of healthcare resources can promote population health by increasing access to affordable care, reducing pressure on health care institutions to cut back on important services, and freeing up resources for other activities that improve health in a given geography. Consider teaming up with other practices in your area, outsourcing expensive elements of your back-office operations (such as medical billing services), or finding synergies between your specialty and any community-focused organizations in your region. In doing so, you can extend your commitment to financial stewardship well beyond your office walls.
4. Utilize Data to Track Financial Performance.
Hospitals and medical practices should aim to implement a healthcare revenue cycle based on data. Using this key data, medical practices can develop and track key performance indicators (KPIs) to regulate its financial health. Doing so can help improve areas of high-spending or low efficiency. As mentioned earlier, cross-team collaboration and transparency can allow for better decision-making when it comes to financially-focused functions.
5. Turn to Automation.
To reduce unnecessary costs, payers are increasing prior authorization and coverage eligibility requirements. In fact, about 84 percent of medical industry leaders reported increased prior authorization requirements in 2020. This can cause problems for the revenue cycles of medical practices and hospitals if they don’t invest in the technology needed for prior authorization. However, adopting automation proper automating before authorization and eligibility processes can improve the efficiency of clinical processes, optimize healthcare revenue cycles, and help medical practices adapt to the ever-evolving healthcare industry.
Transform Your Medical Practice & Drive Revenue with NCG Medical
The transition from fee-for-service to value-based care has been a difficult one for many organizations and healthcare providers, largely because generations of physicians have been trained to be stewards of their patients’ health and well-being without much focus on the financial impacts of that care. Today’s environment of rising medical costs has forced them to make a paradigm shift that takes their patients’ fiscal outcomes into account as well as their clinical outcomes.
Partnering with an experienced medical billing services provider can help your healthcare practice embrace the concept of fiscal stewardship and deliver superior value-based care. By optimizing your medical billing and coding to put your practice on the best possible footing, you can afford to spend more time delivering the care your patients need for improved (and affordable) health outcomes. At NCG Medical, we’ve spent four decades practicing our own form of financial stewardship with a variety of healthcare practices, including radiation oncology, surgery centers, dermatology, and family medicine, and can help your medical practice optimize your medical billing.
The Drummond Certified™ certification seal is for software solutions which have been tested and certified for complete and modular electronic health records (EHR) testing under the Drummond Certified program.
