Managing the Medicaid medical office
California practice offers recipe for success
For nearly 15 years, family-owned and -operated Molina Medical Centers (MMC) has provided Medicaid services to California’s MediCal population. Based in Long Beach, Molina is a major iche player in the highly competitive southern California market.
Physician’s Payment Update talked with John Molina, MMC’s vice president for administration and finance, about some of the practice’s operational secrets for turning what seems to many a marginal reimbursement rate into a profit, while still providing quality medical care. Molina offers these tips:
• Decentralize your offices. Instead of setting up one huge centrally located clinic intended to serve an entire patient base, "we might create four separate offices [and] then assign beneficiaries to the one closest to their home," notes Molina.
A typical MMC clinic is between 4,000 to 5,000 square feet in size and is open 8:30 a.m. to 5:30 p.m. Monday to Friday. Some, however, also have evening and weekend hours.
• Minimize waits. MMC’s goal is to move a patient from the waiting room to an exam room within 20 minutes. This speedy service, in turn, discourages people from leaving because of frustration and missing their appointment.
• Limit the provider workload. MMC does not like for individual providers to see more than 25 patients a day. "We’ve found this is the maximum number of patients most providers can comfortably see during a shift. If you schedule more, the scheduling pattern starts to break down and bottlenecks develop," Molina says.
Once a clinic starts to regularly generate too many visits, MMC considers opening another office in the immediate area.
One major payoff from this approach is fewer emergency room visits and more preventive care among MMC’s beneficiary base. In fact, Molina claims just 1% of the practice’s Medicaid patients ever use the emergency room for nonemergency medical needs.
"The easier and more comfortable you make it for people to move through the system, the more responsive they are to making the best use of it," says Molina.
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