9 methods to improve spine practice management

Practice Management

Experts in the spine ASC field consistently strive to hone effective practice management strategies and techniques.

Learn more about spine practice management at the Becker's 15th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine, June 22 to 24, 2017 in Chicago. Click here to learn more and register.


Here are nine things to know about opening a spine ASC or practice:


1. Establish a vision and run with it.


The founding physician creates and shapes a practice's vision and directs as he or she sees fit. Challenges are abound, however, and include setting up a solid revenue cycle department, negotiating with payers for reimbursement, maintaining referral sources for the practice, properly managing human resources and complying with new healthcare regulations. Stick to your vision in directing the practice and caring for patients, and the rest will fall in line.


2. Rely on practice management companies.


Partnering with practice management companies can be a win-win model for private spine practices. The collaboration allows practices to efficiently adapt and thrive in healthcare's changing environment. Surgeons can focus on the medicine while practice partners deal with the business of running a practice, leading to increased patient volume, better outcomes tracking and additional ancillary services.


3. Optimize profitability.


Private practices can optimize profitability in a multitude of ways:

  • Streamlining the billing process
  • Improving technology
  • Optimizing staff
  • Implementing EHR
  • Replacing EHR
  • Outsourcing billing 


4. Recruit effectively.


Larger physician specialty groups thrive when staffed by motivated, independent physicians with an entrepreneurial mindset. Practices such as Plano-based Texas Back Institute recruit physicians from large medical universities, as their love for teaching, lecturing and writing pushes the practice to constantly be on the forefront of new techniques and technological developments.


5. Diversify your specialties.


Patient-driven practices must offer a wide variety of spine specialties to thrive, according to Dennis Crandall, MD, of Tempe, Ariz.-based Sonoran Spine Center. Because relying on patients' and referring physicians' quality expectations is a means for success, private spine practices should try to treat everyone who walks through the door.


When first opening a practice, it's important to always be available; convenience and flexibility increases a physician's reliability and favorability in patients' and referring physicians' eyes.


In addition, young physicians find building relationships with other young physicians early on very worthwhile down the road. The more referrals a physician can get early on in his or her career, the better the practice will do later on.


6. Choose a practice model.


Independent physicians often seek practice models that grant them autonomy. In a 2016 ProCare Systems report, 49 percent of physician respondents believed aligning with other like-minded specialists in independent practice collaborations was the most appealing private practice model. These loose strategic alliances strictly focus on increasing size and scale for payer negotiations and other potential partnerships.


The same report revealed 94 percent of surveyed physicians believe "the marketplace ought to offer new practice models to ensure independence and sustainability for the new healthcare economy."


Of the respondents, 23 percent wish to pursue mergers and acquisitions with other practice groups to increase scale and leverage with providers and insurers.


7. Managing the practice as a business.


While physicians are well-trained in medically treating patients, they often lack the business experience necessary to fully understand how to manage the business of medicine. If they choose to manage their practice's business operations themselves, they should rely on available resources such as the information published by Becker's, American Academy of Orthopaedic Surgeons and other organizations on practice management and business of medicine programs.


8. Learn to overcome decreasing spine surgery reimbursements.


Understanding where a practice can use positive reimbursement trends to correctly negative the current reimbursement environment is essential to financial success. Bridgeport, W.Va.-based MedRev Solutions President Danielle Koelbl said, "Present redacted payer data from other payers to compare their rates with other payors for high volume procedures."


Presenting the information to payers as data is more likely to persuade them.


9. Consider new payment models.


Analyze whether new payment models such as ACOs and bundled payments make sense for your practice. Many spine practices seek methods such as bundled payments that will allow them to assume risk in accordance with national healthcare provider trends.


Medscape reported a significant increasing trend — from 3 percent in 2016 to 36 percent in 2017 — in the number of physicians participating in ACOs.


Over the same time period, participation in cash-only payment models has increased slightly from 3 percent to 6 percent while concierge payment models have increased from 1 percent to 3 percent.


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