Show Me the Money! 8 Ways to Boost Income
Provider incomes are not on track for big increases in 2017, partly due to an announcement by the Centers for Medicare & Medicaid Services (CMS) last November of a scant 0.24% rise in the fee schedule. Some practice management experts predict that in 2017, no specialty will see an increase of more than 1%, and some may actually see declines in income. A recent article posted on Medscape suggests that rather than despair, practices can look to some strategies to help boost income despite these limitations. Here are 8 suggestions to help increase the bottom line:
1. Collect before the appointment to avoid issues that may arise with high-deductible insurance policies. Strategies to make that shift include offering front-office staff incentives for highest percentage of collections or keeping patients’ credit cards on file. Offering payment plans to patients is also a good idea.
2. Avoid the 2017 Medicare Reporting Penalty (and shoot for the bonus)! The Merit-Based Incentive Payment System (MIPS) kicks in this year and CMS has made changes that actually should make it pretty easy. Physicians who are adept with gathering and reporting MIPS quality measures have the opportunity to earn bonuses in the new program ranging from 10-12% of their Medicare reimbursement.
3. Work on billing and practice efficiency. Controlling costs and revenue cycle may pay off as will submitting clean claims with specific billing codes.
4. Focus on chronic care management (CCM). CMS estimates that about two thirds of Medicare beneficiaries would be eligible for these services, but use of CCM has been disappointingly low.
5. Don’t forget about follow-up. Transitional care management (TCM) program pays doctors for work they have been doing already, but following the TCM guidelines of contacting the patient promptly after discharge, providing “non–face-to-face” services by staff, and a face-to-face office visit soon after discharge with a doctor or advanced caregiver, such as a nurse practitioner or physician assistant offers higher reimbursement than what is paid for an office visit.
6. Offer annual wellness check-ups for Medicare patients. New Medicare beneficiaries are given a check-up, called the “Welcome to Medicare” visit, when they join Medicare, and yearly wellness visits after that. They do not have to pay a cost share for these visits, and the physician gets $172 for the initial checkup and $111 for the annual wellness visits.
7. Coordinate behavioral health services for patients. This year Medicare will begin paying primary care physicians (PCPs) separately to provide behavioral health services to their patients under a team-based care model called “behavioral health integration” (BHI). A PCP or advanced practitioner works with a psychologist, social worker, or nurse with behavioral health training, and Medicare provides additional reimbursements.
8. Expand work for Medical Assistants (MAs). Shifting routine monitoring from doctors to nurses and MAs frees up physicians to attend to complex patients who need more care. This model can increase volume and revenue.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: March 29, 2017
Adapted from the original article.