Practice Strategy, Executive Oversight & Execution Project Management
SCALE Contributor: Platform Development Team
Improving Practice Operations – Key Focus Areas
Continued desire to consolidate practices, whether driven independently by physicians or PE-based, creating a need for increased project management and deep domain expertise of nuanced processes
Many growing platforms seeking guidance and clarity regarding how to best structure and scale MSOs, align key stakeholders (e.g., MD retention) and deal with other issues such as cross-state platforms and implications of TIN integration. Platforms are working through the many layers of what integration can, should and should not mean across cultural and core functional domains
Practices failing to keep pace with market changes are facing steep indirect costs via missed value opportunities and gradually being outcompeted – need for strong, coordinated management leadership across key functions as well as sufficient investment in foundational reporting & analytics, technology solutions and branding & marketing
Continued growth in practices seeking to expand their ancillary and care coordination services and looking for ways capture revenue from multiple downstream services, not just E&M and procedures
Revenue Cycle Management
SCALE Contributor
Bobby Trenczer
President, SCALE RCM
SCALE Forecast
Creating and utilizing dynamic business analytics & dashboard reporting to monitor and improve quality, performance results and productivity efficiency
The AMA, with CMS’ support, updated coding guidelines for outpatient visits in 2021
Code based on Time or Medical Decision Making
Reduced documentation requirements – “appropriate” history and exam
Telemedicine expansion, ensuring compliant coding and documentation
Many multisite practices lag behind in centralized functions such as eligibility checks resulting in more expensive workflows
Growing emphasis on best practice protocols for patient balance collections
Improved contracted fee schedule rate management
IT / Data Systems
SCALE Contributor
David Kovel Executive Partner IT Systems & Population Health Analytics
SCALE Forecast
Practice consolidation activity is driving questions around IT systems integration strategy – historical lack of in-house IT expertise across a broad portion of the market is creating confusion and reactive approaches to complex IT systems integration execution processes
Platforms of scale are gradually incorporating more strategic IT business plans into their scaling & investment strategies – process automation, advanced data analytics, claims analysis, etc.
Improved system and service integration through API capabilities of cloud systems (e.g., two-way texting, phone services, single sign on)
As coverage emerges, improved 5G cellular throughput for mobility outside of practice location and provisioned as network provider
Data mining and reporting for clinical outcomes management and value-based care participation
Continue increased tele-communication capabilities for provider to patient encounters, as well as support for remote practice workforce
Enhanced security roll-out through multi-factor authentication techniques (SMS, Phone applications)
Use of extraction and digitization methods for legacy medical records archiving on Cloud-based storage.
Use of robotic process automation to reduce labor costs associated with routine work processes
Download the PDF for our full list of 2021 MSO operational discipline predictions.
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