We are seeing more and more insurance carriers throughout the country pushing the medical community to adopt computerized health records - sometimes through higher reimbursement offerings.  Now the liability or malpractice carriers are getting involved with this by offering discounts to providers that are moving to electronic systems.

The move by Northwest Physicians follows a recent trend of liability carriers promoting online patient-doctor connectivity, with hopes of fostering better communication with patients and improved patient safety.

Under the new program, 2,600 physicians insured by the company will receive patient safety discount points for connecting online with their patients using an online service called iHealth, which includes a practice Web site for physicians and secure e-mail and patient personal health records for patients.

It recently hit the news that Blue Cross of Massachusetts is considering returning to a capitation system of payment.  While this is far from becoming a national trend, it behooves us as practice owners to remember this type of system and what it meant for our businesses.  In his article, Peter Lucash reminds us of the pros and cons of capitation and some methods to handle it from a business perspective.  

If you are approached about a capitation plan, the contract has to be reviewed carefully, and a financial pro forma has to be built and run. It shouldn’t be a hugely expensive proposition, but necessary. On the other side, you need to monitor the contract and have a good grasp of your costs.

There are many legitimate reasons for a patient no-show, but trying to manage an efficient practice requires that providers and practice managers do everything possible to prevent the downtime of clinical staff.  Cancellations are tough, but no-shows leave no opportunity to fill a time slot from a waiting list, and often times expensive staff is left with little to do.

As if good healthcare isn’t enough incentive to show for appointments, perhaps a monetary incentive is really what is needed to keep patients showing for their patients.  The American Academy of Family Physicians reports on a new Medicare billing change that allows physicians to charge for missed patients, as long as a few rules are followed.

When a patient fails to show up for an appointment, the resulting hole in the physician’s schedule can mean the loss of billable time. However, a change in Medicare’s general billing requirements now allows physicians to charge Medicare beneficiaries for missed appointments.

The policy became effective in October, but many family physicians still are unaware of the change.

According to the Medicare Claims Processing Manual, Chapter 1 - General Billing Requirements, CMS’ new policy allows physicians and suppliers to charge Medicare beneficiaries for missed appointments, as long as they also charge non-Medicare patients for missed appointments.

There’s a lot going on in our economy right now, and while Medicare and stiff competition from physician owned practices aren’t solely responsible for the tough times faced by some physical therapy practice owners, one would be hard pressed to show that they aren’t playing a significant role.

“Are physical therapists feeling pressures across the country? Absolutely,” said Dave Mason, the American Physical Therapy Association’s vice president of government and reimbursement advocacy.

Physical therapy businesses are facing competition from doctors who are more frequently operating in-house physical therapy practices, Mason said. Both private insurers and the federal Medicare have launched more determined cost-control efforts, he added.

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Click here or call (888) 827-5613 for information on a free program dedicated to helping private practices throughout the U.S. strategically adjust to the slowing economy.  Free program runs through March 31st, 2009 and is open to practice owners and administrators of any healthcare discipline.

Tannus Quatre PT, MBA is a practice consultant and principal with Vantage Clinical Solutions, Inc., a national healthcare consulting and management firm located on the west coast.  Tannus can be reached through the Vantage Clinical Solutions website by clicking here.