During the past 50 years, private practitioners have witnessed many substantial changes to the U.S. healthcare system and have been pressured to change the way they practice medicine.
Due to these changes, physician practices are constantly struggling to cope with declining reimbursement, looming cuts in reimbursement, and governmental and regulatory factors creating more complexity in claims management. In addition, the Health Insurance Portability and Accountability Act (HIPAA) has increased the compliance regulations that will impact billing, coding, and claims processing with the implementation of ICD-10-CM, which is adding to the complexity of delivering care.
It’s no wonder, then, that physicians and their staff are seeking new solutions and tools to deal with the challenges of managing the business of rheumatology.
In response to this need, the Committee on Rheumatologic Care (CORC) has created the Best Practice Management track for the 2011 ACR/ARHP Annual Scientific Meeting in Chicago on November 4–9.
“The practice management sessions will provide education—basic to advanced level—for all professionals involved in managing rheumatology practices of all sizes,” states Raymond Hong, MD, CORC liaison to the annual meeting planning committee. The practice sessions will offer straightforward, practical information and effective solutions to rheumatologists, fellows-in-training, practice managers, and other healthcare professionals. These courses are designed to address practice issues and will tackle fundamental topics such as payment reform, mastering patient flow, performing self audits, HIPAA 5010, and ICD-10.
It’s crucial for physicians and practice management staff to stay abreast of compliance, insurance reimbursement, office efficiency, coding, and billing issues for effective and efficient practice management.
Currently, most physicians are receiving their business education through trial and error, which can be costly. Karen Kolba, MD, CORC chair, says, “With the increase of civil and criminal penalties for fraud and abuse, practicing rheumatologists cannot afford the trial-and-error teacher.”
In a study done by the Accreditation Council for Graduate Medical Education, six core competencies were identified that are important to the practice of medicine: patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Out of the six, practice management skills are becoming increasingly important in navigating the healthcare system.
A physician can no longer be concerned only with the clinical aspects of practice but also must pay close attention to its financial management, compliance issues, and billing and coding changes. Dr. Kolba says, “The College is in the perfect position to provide appropriate education and training for rheumatologists to run their practices and communicate with their staff, accountants, and other healthcare professionals.”