Can’t We Just Hover and Let Boston Come to Us? IF WE RESIST CHANGE IN OUR BUSINESS MODELS, WE WILL CRASH By Phil Ellis I was waiting to board a flight once, and after an announcement was made that our departure would be delayed due to fog in Boston, I heard a young girl say to her mom, “Since the earth rotates, can’t we just take off and hover and let Boston come to us?” Her embarrassed mother looked at me as if the kid had just blurted out a four-letter bomb, so I said, “Lady, I think that makes perfectly good sense.” unfortunately, many seem to accept the fact that things will just come to us. have you heard anybody say in the past month, week, or even today, “i remember when hospitals were buying practices in the ’90s and it didn’t work. it won’t work now… they’ll be back?” Perhaps a few didn’t work out, but the trend toward integration is overwhelming, and between acos, bundled billing, and other changes in the delivery model of healthcare, it’s here to stay. We cannot just hover and wait for those practices to come to us. When i started with ciProms 22 years ago, our “medical billing” services were designed for independent physician practices. our services were clear cut: pick up superbills, enter them into our practice management (Pm) software, send in the paper claim, appeal the denial, post the payment, collect co-insurance from the patient, and present monthly results to the client. now it is very different. We don’t have relationships with just the traditional “target client.” now we go far beyond relationships with “clients.” We spend as much time marketing to healthcare associations, hospital c-suites, software firms, cPas, universities, and others as we do the traditional “independent physician practice.” remember those? as bob dylan so eloquently sang in 1964, “the times they are a changing,” and our offered services must change with them. not only do we have to market to a wide mix of potential clients now, but the services we provide have also profoundly changed. today we download interfaced files to import client charge patient demos into our Pm. and for many of our clients who moved on to ehr, we don’t need to import charges. they are already in 28 hbma billing • march.aPril.2013 the client’s ehr software, so we log into their system to manage the receivables. and speaking of software, remember when those firms were behind-the-scenes vendors selling software to billers? Well, now they have moved to the forefront, telling practices and hospitals they don’t need billing services any longer, because the ehr will take care of those functions. our services have expanded far beyond “medical billing.” in the current environment, saying that we do “medical billing” would be similar to google saying they do online searches. We offer so much more than that and we can only do so through those expanded forms of client relationships. You were right, mr. dylan: the times they did a’ change – but change brings opportunity. oh no, here he goes again with one of his “if weren’t for my sister, i’d be an only child” moments. Yes, i admit it; i do tend to see things a little differently. Why accept 20/20 as perfect vision? these kinds of things bother me, so i tend to look outside the warehouse – far outside the box – to find answers to these questions. for those still reading, my point here is that there is still a great need for our industry, but with different functions. go back to the product life cycle we learned about in school. remember how products and services go from introduction to growth, then to maturity, to decline, and to withdrawal. Well, we got lucky, because not long ago, as the business of medical billing passed through “maturity” and was headed straight for “decline,” somebody mercifully stepped in and changed its name to “revenue cycle management” (rcm). that was a game
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