The Journal of medical practice management : MPM最新文献

Over the past 30 years, obesity rates have more than tripled in the United States, and although rates seem to have stabilized over the past 5 years, about one- third of American children are still overweight or obese. The Center for Better Health and Nutrition (CBHN) is a comprehensive obesity treatment, manage- ment, and prevention arm of the Heart Institute within Cincinnati Children's Hospital Medical Center, offering necessary medical treatment to an often un- derserved population. With volumes increasing at substantial levels and services being reimbursed at low rates, the financial health of the program has been closely analyzed in order to determine the long-term sustainability of CBHN. Downstream revenue was analyzed and found to account for over $754,000 in fiscal year (FY) 2015; quality improvement efforts such as E/M coding and imple- menting the Nurse Practitioner role also added to increased revenue and a lower cost profile. Capturing all billable services, such as biometric measurement, was found to be valuable to the program's bottom line. By considering all applicable revenue sources, implementing quality improvement efforts, and billing for all relevant services, the program operates at a low level of profitability.

Certain third-party vendors are now offering to "assist" practices by placing ma- terial and links associated with their services on the practice's website. This offer requires the practice to provide access to its website's contents. Patient privacy, insurance coverage, ethical duties, and IT integrity are all reasons that a practice should not provide a vendor administrative access to its website. Vendors seek- ing to promote goods or services via the practice should never be given access to alter the practice's website content. In the event a practice needs website assistance, it should seek help only from a qualified and insured person or entity.

Research conducted by members of the American Society of Bariatric Physicians (recently renamed the Obesity Medicine Association) and others shows remark- able health benefits associated with wellness protocols that limit the intake of carbohydrates and sugars, which results in lower insulin demand and levels. The research demonstrates that the lowering of insulin levels dramatically improves diabetes'-5 and the factors associated with metabolic syndrome,6-8 including cen- tral obesity, high blood pressure, and elevated blood lipids, which, of course, are risk factors associated with cardiovascular disease. Other conditions that have shown improvement under the influence of reduced insulin levels include fatty liver disease,9 polycystic ovary syndrome,10 gastroesophageal reflux disease,"12 irritable bowel syndrome with diarrhea,13 and other maladies. Significantly, dietary carbohydrate restriction induces ketosis, a state in which the body is forced to burn fat instead of sugar as its primary source of fuel. When in ketosis, patients are able to lose weight safely, effectively, and relatively quickly.

Healthcare has looked to various industries, such as airlines, hotels, restaurants, and entertainment, for concepts on how to run our medical practices. We have also embraced the computer industry and have followed closely Microsoft and Apple as we have used their technologies in both our clinical practices and our offices. However, we have only rarely looked at nature to provide us with exam- ples of exemplary behaviors that serve as models for becoming better doctors. In this article we look in detail at the lifecycle of the Pacific Coast salmon and how such an investigation may influence our medical careers.

When two or more members of the medical practice team are locked in a con- flict, their animosity can turn a healthy working environment into a toxic space. That is why the medical practice manager needs to develop skills in conflict pre- vention, conflict management, and conflict resolution. This article explores the negative and positive fallout when medical practice staff members are in conflict with one another. It defines conflict management and conflict resolution and suggests situations when each strategy is best. It offers medical practice man- agers 10 strategies they can use to prevent staff conflicts. It also offers 25 tips for managing and resolving conflicts and a strategy medical practice managers can use if they are personally conflict averse or resistant. It suggests six common sources of workplace conflict and six possible outcomes for employees who are in conflict. Finally, this article describes the real cost of conflict to the medical practice, both monetary and nonmonetary.

Entrepreneurs are known for recognizing opportunity-that is "How can I start a business to make money from this opportunity?" However, once a commer- cial entity is formed to take advantage of an opportunity, the leadership prior- ity shifts from entrepreneurial to strategic. A strategic perspective leverages limited resources to position a business for future success relative to rivals in a competitive environment. Often, the talents needed to be a good entrepreneur are counter to those needed to be a good strategist. In Part I of this article, we presented the internal considerations; in this part we add the external consider- ations and then summarize the strategic plan.

Physicians provide millions of patients with essential medical care each year on which a dollar value cannot be placed. However, the economic role physicians play in healthcare delivery can be calibrated. According to a new Merritt Hawkins survey indicating net annual revenue generated by physicians for their affiliated hospitals, and according to data indicating the economic contributions physicians make to their communities, this role remains highly significant. Even as payment models transition from volume-based metrics to value-based metrics, the economic role of physicians in healthcare will remain pivotal.

The term productivity, as used in the practice ot medicine, reters to a measurement of physician output over a specified period of time. Output can be a measure of such things as dollars generated or collected or the number of patient encounters, studies conducted, or procedures performed. A challenge faced when attempting to use gross or net income or volume of patients as measures of productivity is that the productivity measures of equally productive physicians will differ based on payer and patient mixes and on the complexity of the services rendered. This article discusses the use of the relative value unit as a metric of productivity and how the use of this metric levels the playing field.

Cleveland Clinic has used a collaborative approach in seeking ways to make care more affordable by identifying approaches to create better value by improving quality and decreasing costs. It is possible to achieve cost savings and create better value without compromising quality. By engaging caregivers and creating multidisciplinary teams to evaluate cost savings, over $500 million was saved, and hundreds of ideas were implemented. This article reviews 30 cost-saving ideas that any medical practice could use. The ultimate goal is to reposition costs and make care more affordable.