FEATURE STORY Healthcare Reform: Driving Change or Driving Providers Out of Business? MANAGE THE BUSINESS NEEDS THAT ARE CAUSING YOUR PROVIDERS PAIN By Mary Rita Hyland, RN, BS, MBA, CHP F or providers, change has been occurring at a very rapid pace. Medical practices are heavily involved in completing system and process upgrades for Meaningful Use, changing from paper to electronic medical records, implementing updates to accommodate future ICD-10 coding requirements, and more. Physicians are struggling to accomplish these activities with their existing staff, who may not be IT savvy, leading many to ask, is healthcare reform bankrupting the single physician practice? The reality of this is already being played out. Consider all the changes practices must make: upgrades to IT systems to accommodate electronic health records to meet Meaningful Use requirements, IT hardware and software updates for ICD-10, increased IT storage for electronic medical records, coding and documentation software improvements. Now consider the fact that these changes have associated costs. These unexpected drivers further impact the need for additional education of healthcare organizations. Workflows, processes, and tools must also be updated to accommodate system changes. To navigate what needs to be done, providers need capable, knowledgeable staff who can effectively analyze the impact to their practices, have the expertise to accomplish these activities, and find the time to devote to this extensive project – while managing day-to-day activities. Outsourcing may be your best option to accomplish these activities and save your sanity – as well as your clients’ practices. But taking the leap to outsourced services sets off an investigative journey of its own. Identifying the segments of the process you want to outsource is just the beginning. Whether you are outsourcing to identify the best software to complement existing systems or you are trying to identify a company to take on the tasks of coding and other back office services, launching a search for the right company to fulfill these needs can be an exhaustive task. Qualified companies, coders, or consultants should be selected through research of credentials, certifications, and feedback from others who have chosen and utilized them for similar activities. We cannot forget about patients. Oh yes, those individuals who come to your clients for their expertise in diagnosing illness, treating injuries, and more. As distracting as all of these regulatory events are, losing sight of the drivers of the medical practice creates a greater loss for the healthcare industry. Your clients’ knowledge and expertise as physicians, nurse practitioners, or other medical specialists cannot be easily duplicated or replaced. We, as patients, depend on each healthcare practitioner to diagnose, offer treatment options, provide surgery, rehabilitation, or ease our pain. Healthcare industry partners have the expertise to support these efforts and help alleviate frustrations and keep practices solvent. Billing companies need to be in the forefront to guide healthcare providers so they can focus on providing their medical expertise in the treatment and healing of those in need. We all need you, and we will do anything we can to assist your providers. Reach out and let us ease their pain! ■ Mary Rita Hyland, RN, BS, MBA, CHP, is the vice president at Cooperative Exchange. THE JOURNAL OF THE HEALTHCARE BILLING AND MANAGEMENT ASSOCIATION 17
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