Low Reimbursement, High Costs Threaten Physician RCM Success
"...[Despite] the constant change in the industry and ongoing pressure on profitability — physicians remain resilient and proactive about improving practice performance.”
By - The three leading concerns among physicians' predictions regarding profitability drops are declining reimbursements, increasing personnel expenses, and issues regarding supplies, says CareCloud’s recently released third annual Practice Profitability Index (PPI).
Says Ken Comee, CareCloud’s CEO, within a press release, “Perhaps the single most important insight from the 2015 PPI is that — despite the constant change in the industry and ongoing pressure on profitability — physicians remain resilient and proactive about improving practice performance.”
The PPI confirms the 5,000 physicians surveyed nationally are exhibiting “cautious optimism,” says CareCloud. “[While] respondents with positive projections still represent the smallest segment, physicians across the board are investing in practice operations to counter continued regulatory challenges, financial pressures, and administrative burdens,” the organization summarizes.
Physicians eyeing technology to advance revenue cycle
Physicians are in the market for sturdier core IT solutions to strengthen their revenue cycle management initiatives, says CareCloud.
“Forty percent of physicians continue to focus on shoring up their revenue cycle management processes, while optimizing staffing came in a close second,” CareCloud claims, additionally maintaining that one-third of physicians reportedly remain focused on how technology can improve future performance.
Physicians facing new ICD-10 challenges
Reimbursement drops, high expense levels, and the ICD-10 transition (in order of highest to lowest) are the top three reported challenges this year, says CareCloud.
CareCloud notes that ICD-10 may have been listed as the third highest concern – a slot formerly held by the Affordable Care Act (ACA) – since physicians completed the survey last July and August, mere weeks before the ICD-10 implementation deadline went into effect.
Over half of the over 5,000 physicians surveyed online claimed ICD-10 is hindering their profitability. Sixty percent confirmed tangible apprehensions regarding their ICD-10 readiness levels.
Fifty-nine percent of physicians confirm they are seeking to sell primarily due to administrative duties, profitability struggles, and regulatory demands, says CareCloud. This 59 percent increased by 6 percent compared to last year’s data.
Parallels to last year’s PPI evident
As EHRIntelligence.com reported, according to last year’s PPI, ICD-10 preparation levels were indeed on the horizon for previously surveyed physicians.
“The arrival of healthcare reform has coincided with a continued slide in physician practice profitability,” last year’s study said.
Last year, physicians were reportedly more than twice as likely to expect profitability drops in the year ahead. The sizable amount of time physicians were spending on administrative burdens was also confirmed last year as directly hindering patient engagement efforts.
As RevCycleIntelligence.com reported, 86 percent of 200 surveyed physicians via a recent SERMO poll confirm ICD-10 implementation is detrimentally affecting patient care.
Nonetheless, post-ICD-10 aftermath reports remain optimistic as the healthcare industry collectively assesses what comes next.
Over 1 million first attempt ICD-10 claims reportedly yielded a 99 percent success rate last month. Additionally, as the Centers for Medicare & Medicaid Services (CMS) reported, a ten percent denial rate was reported among 4.6 million daily ICD-10 claims throughout October.
