DRG Coding Advisor-Performance improvement can help the bottom line
Involve the entire staff in the process
Platte Medical Clinic was operating at a loss of about $20,000 a month when the hospital that owned the practice hired a management firm to find ways to turn the situation around. The consulting company mandated that each practice develop a plan to improve its financial performance. The goal was to reach break-even status.
"They asked each manager to come up with ways to cut expenses and maximize revenue at the same time," says Lori Norris, FACMPE, physician recruiting and marketing director for North Kansas City (MO) Hospital, formerly practice manager for Platte Medical Clinic in Platte City, MO.
Platte Medical Clinic is a member of Meritas Health Corp., a group of seven clinics owned by North Kansas City Hospital.
Norris says she started by listing projects she believed would help the practice meet its objectives of cutting expenses and maximizing revenue. Then she sat down with the physicians in the practice to discuss why it was important to improve the practice's financial performance and to ask for their suggestions.
She repeated the process with the office staff. "Everyone in the practice had to understand that this wasn't going to be easy and it wasn't going to go away. We needed them to be committed and to buy into the performance improvement process," Norris says. She solicited ideas from everyone in the practice on how they could increase revenue and efficiency and minimize expenses.
The staff originally came up with about 20 expense-reduction projects and about 20 revenue-enhancing ideas. These were honed down to eight to 10 projects in each category. The ideas ran the gamut from new methods for appointment scheduling and patient check-in to ways supplies could be given out and how claims could be paid.
Projects that lacked support were dropped
"We looked at the entire operational process. That's why it's important to involve everybody in the practice. A lot of people have different perspectives," Norris says.
Some ideas were rejected from the outset. For instance, if the physicians were reluctant to take on a project, it was eliminated from the list. "There was some trial and error. If the buy-in wasn't there, we knew we weren't going to realize the results no matter how much effort and cost we put into a project," she adds.
The planning process took a couple of months. Some changes were implemented right away, and others took time. "It was pretty easy to implement. We went through the initial training with the managers then repeated it with the physicians and staff," Norris says.
To track progress, she created a spreadsheet showing the projects and goals, allowing progress to be checked at any time. "As we worked through the plan, we realized that some goals weren't achievable. If they weren't realistic, we had to back off," Norris says. For instance, the plan called for increasing net patient revenue by $5 per patient. A more realistic figure would have been $1 to $2 to start with, she adds. "We originally set our goals too high. I encourage anyone else who starts such a plan to take baby steps."
Staff hold quarterly meetings when everyone is accountable for what has been happening with the plans. "If they aren't looking at them everyday, they aren't going to be successful," Norris says.
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