3 Strategies for Medical Practice Excellence in the Era of COVID-19

October 28, 2020 - The COVID-19 pandemic has moved the benchmarks for medical practice excellence. What once worked in a pre-pandemic world may not be adequate for the COVID-19 era or may need to be tweaked in order to address the challenges underscored or exacerbated by the virus.

That was the general theme of MGMA’s Medical Practice Excellence Conference, which was held virtually last week.

Virtually every panel and keynote speaker addressed the impact COVID-19 has had on medical practices, which has been significant. MGMA’s own data has shown that physician practice revenue was cut in half at the start of the pandemic as volumes declined by 60 percent.

But on theme with this year’s conference – Rise Above – the healthcare industry leaders also emphasized the opportunities coming out of the pandemic. For example, new ways to look at revenue cycle management, practice leadership and transformation, and even physical space.

A closer look at revenue cycle management, productivity

Revenue cycle management was a major theme of this year’s conference and perhaps the most interesting theme to RevCycleIntelligence readers. Nearly a dozen sessions addressed revenue cycle management explicitly as a way to achieve medical practice excellence, while many other panels touched on the opportunities in revenue cycle management.

READ MORE: How COVID-19 Imperiled Physician Practices, And How to Save Them

As mentioned above, COVID-19 significantly affected patient volumes and revenues for most ambulatory practices. Most practice volumes have since rebounded, but it has become increasingly important for leaders to optimize revenue capture and reimbursement to overcome the revenue losses.

One provider optimizing revenue cycle management during this time is Sharp HealthCare. Carol Wanke, vice president of post acute revenue cycle and managed care operations at the San Diego, California-based system shared how a closer look at KPIs and workflows led to increased productivity.

At Sharp HealthCare, revenue cycle leaders are leveraging granular data on employee productivity to ensure best practices are followed and applying gamification to keep employees motivated.

“We wanted to begin looking for new and innovative ways to motivate and recognize employees in real-time,” Wanke said. “We wanted to drive desired behavior across varying levels of experience to counteract drift from desired revenue cycle activities and we wanted to attract and retain the best and brightest talent in the industry.”

Optimal productivity was also a factor of success for the Graves-Gilbert Clinic, which was the only independent medical practice to attain MGMA’s Better Performer status in 2020.

READ MORE: How Independent Practices Can Come Out of COVID-19 Stronger

“Productivity among our providers is excellent,” the practice’s CFO, Steven Sinclair, CPA, CMPE, said at the conference. “This is very helpful in keeping everyone pulling their own weight, which contributes to maintaining financial stability for us.”

Productivity will be key to overcoming the financial and operational challenges brought on by COVID-19, and data released by MGMA during the conference showed that practices with better productivity monitored staff and provider output at the practice level and individually. Investments in business office and nursing staff also helped to boost practice productivity among the Better Performers.

Leading positive change post-pandemic

Another top theme of the conference was the role of leadership during and after a crisis.

“We are at a point where we are having to adapt to so many different things, and when I think about adaptivity, I think about adaptive leadership and adaptive change,” Amiee Greeter, senior VP at Coker Group, told attendees during a panel discussion.

“The difference here is that we're in a period where adaptivity requires us to think outside the box,” Greeter continued. “So, it can't be doing the same things that we've done or having the same solutions that have worked for us previously, using the same processes, those are kind of the hallmarks of technical change. We’re at a time where we've got to be thinking about breaking loyalties, switching referral patterns, shaking up who's doing what, thinking of different ways to do things.”

READ MORE: Is the Doctor’s Office Dead? Practice of Primary Care Goes Virtual

But healthcare has lacked the type of leadership needed to address the challenges during COVID-19, suggested MGMA’s president and CEO Halee Fischer-Wright, MD, MMM, FAAP, FACMPE.

“This is the opportunity to blow things up and try something else because I don't think we don't have what we need to get the outcomes we want,” Fischer-Wright stated. “This is a time that the lack of leadership and playing the short game versus the long game has really hurt us with how we've addressed the issues of COVID.”

Sparrow Hospital’s Alan Vierling, MSN, shared that effective leadership through change hinges on establishing a singular vision, such as ensuring caregivers at the hospital stay safe during the crisis, and acting quickly to achieve that goal. Effective leadership should also communicate often, even daily, and remain visible, the hospital administrator stated.

Self-awareness is also key to being a “future-ready leader,” according to organizational psychologist Tasha Eurich, who was a keynote speaker. Eurich underscored the value of self-knowledge and understanding how others see the leader, saying these skills are a business imperative in today’s environment.

Physical space and staffing

It is a bad time to be in commercial real estate, joked MGMA’s Fischer-Wright, who used to be a business consultant in that field.

Social distancing requirements and the explosion of telehealth utilization has turned practice space on its head, and practice leaders are having to find new ways to use – or not use – their locations. This has led to one of the more unique trends emerging in healthcare: the use of physical space.

Practice footprints are going to shrink as providers transition more services to the home coming out of COVID-19, industry leaders predicted at the conference.

“Typically, people that were incentivized for value-based care versus fee-for-service care, we saw that conversion, but we were kind of at the tip of the spear for that,” Fischer-Wright stated.

Along those lines, the MGMA leader and former pediatrician also predicted a shift from low-level administrators to higher-level administrators. So, practice footprints may also shrink more in the office space versus patient space.

Physical locations and staffing may also shift because of alternative care offerings, like telehealth, according to Ann Greiner, president and CEO of Primary Care Collaborative.

“We're going find our way as to what the right mixes of remote versus in-person, depending upon the patient and their preference, but also depending upon the condition, and the particular issue at hand,” Greiner said.  “I hope that we're also really using this opportunity to leverage behavioral health into primary care.”

There is a real opportunity to recreate workflows and integrate technology, especially around services that really do not need a physician to happen, Greeter added.

“We are going to have certain functions now occurring in home offices across the country,” the consultant stated. “So, some of our call center functions and those kinds of things don't need to be in the practice anymore, they can be done from home. And if you take out some of those support functions, you may not need as much space.”

Finding new ways to use practice space, as well as lead transformations and optimize revenue cycle management are top priorities for medical practices looking beyond the COVID-19 pandemic. These strategies will be critical to ensuring financial viability and even profitability as practices start to recover in the coming year.