Skip to main content

Know Before You Go: Four Practice Advancement Insights in Advance of Medical Practice Excellence: Financial and Operations Conference

doctor talking to patient with clipboard in hand

To build a better medical practice, you must transform and then sustain the change. Through customized engagements and best practice experience, Practice Advancement Strategies guides clinical teams through the following challenges and opportunities:

  • staff shortages/burnout;
  • practice culture;
  • payer negotiation and contracting; and
  • value-based care outcomes

These will be hot topics at the next Medical Group Management Association event: the Medical Practice Excellence: Financial and Operations Conference, just around the corner in Orlando, March 19-21.

To help you prepare — for the conference or progress in general — DataGen Practice Advancement Strategies offers the following insider tips for practice advancement.

1.  Transformed teams can transform patient care.

Research shows that earning Patient-Centered Medical Home Recognition from the National Committee for Quality Assurance can reduce staff burnout by more than 20%. While workforce shortages clearly impact burnout, careful workforce design can help mitigate both. Practices that evenly distribute team responsibilities and allow staff to perform at the top of their license increase staff satisfaction while better serving patients.

2. Culture transforms practice.

Successful practices align culture and mission. Practice transformation starts with strong leaders who do two things: take ownership and inspire their teams to do the same.

  • Leader actions: Implement change with the whole team by understanding and breaking down individual barriers so transformation feels collaborative and achievable, not forced.
  • Team actions: Challenge personal perceptions and understand the impact of their actions on patients, the practice and the entire healthcare continuum.
  • Joint actions: Practice strong communication, follow a defined plan and celebrate every milestone.

These are the building blocks of transformed practices.

3. Patient-centered practices have leverage with payers.

Practices must negotiate with payers from a position of power. To achieve this, NCQA advises medical groups to focus on patient-centered care supported by community partners. The result is a medical neighborhood whose member organizations can lean on one another to impact more lives.

But it gets more specific. Practices that are “payer strong” can represent patient complexity and total cost of care accurately. Through risk stratification, precision coding and documentation, these practices deliver value over volume: the right care to the right person at the right time. Practices that can prove it — especially those with NCQA accreditation — are well positioned to negotiate better reimbursement.

4. Payers respond to value delivery.

Some are predicting that value-based care will turn an important corner in 2023 by delivering better-measured, evidence-based, holistic care. Strategies will include data capture and focusing on the whole person to impact the whole practice. Pressure-testing progress will require monitoring with measures that are stratified by vulnerable groups and aligned with practice and payer objectives.

The goal? To achieve the original Triple Aim — better quality, cost and patient satisfaction — by expanding it to include provider satisfaction and equitable care that considers social drivers.

The common denominator

The four Practice Advancement Strategies insights above have a firm foundation in NCQA care models. Practices that adopt these models can earn formal NCQA recognition — Patient-Centered Medical Home and Patient-Centered Specialty Practice — that may lead to higher payer reimbursement. The larger payoff is a practice positioned for sustained, patient-centered success — financially, operationally and culturally.

Feeling better prepared for MGMA and want to talk more? Come see us at the Financial and Operations Conference, Booth 107 to learn more about Practice Advancement Strategies. We’d love to say hello!

Find out more about DataGen's Practice Advancement Strategies. 


Popular posts from this blog

Alternative payment models: Strategies for success

In this edition of DataGen Insights, we look at how alternative payment model participants can ensure their processes and workflows are optimally set up for success. To help, DataGen listed the top three strategies all providers participating in APMs can employ and created a handy checklist to enable maximum returns and reduce financial risk. Please explore our website to learn more about our  products and services .  Download DataGen Insights today .  We hope you enjoy!

Why it's critical for Primary Care First participants to control and understand leakage

Patients' primary care visits outside of their attributed primary care office, also called “leaked” patient visits, can have unintended consequences for Primary Care First participants. Beginning July 2022, PCF Cohort 1 will face a reduction in population-based payments based on their leakage rate. The payment adjustment will be based on their 2021 claims data and will roll forward quarterly. To calculate your leakage rate, divide the number of qualifying visits and services your attributed beneficiaries have made to care centers outside of your practice (for example, visits to urgent care centers) by the total number of qualifying visits and services your attributed beneficiaries have made. Calculating primary care leakage with claims data alone comes with some unintended challenges. Unfortunately, some circumstances can unfairly and negatively impact a practice’s leakage rate: Nuances classifying care delivered by provider team members: It’s difficult to distinguish

CMMI’s New Enhancing Oncology Model – Deadline Approaching

As the final at-risk period for the Oncology Care Model was closing at the end of June, the Center for Medicare and Medicaid Innovation announced its new Enhancing Oncology Model (EOM). EOM aims to improve the coordination of oncology care, drive practice transformation and reduce Medicare fee-for-service spending through episode-based payment.  What is EOM? EOM is a voluntary, five-year model set to begin July 1, 2023. Patients undergoing chemotherapy for the treatment of cancer will trigger six-month episodes of care.  Eligible EOM participants include physician group practices with at least one Medicare-enrolled physician or a non-physician practitioner who furnishes evaluation and management services to Medicare beneficiaries receiving chemotherapy for cancer treatment.  EOM participants are required to implement eight participant redesign activities to drive care transformation in their practice. Examples include the provision of patient navigation, 24/7 access to an appropriate c