Historically, there has been an invisible line separating the clinical and administrative sides of healthcare practices. But as we move to a more comprehensive model of treatment, it makes sense to diminish that separation.
One way to help a practice evolve is to look to the practice manager. Modifying the role and responsibilities of a practice manager can be an important factor in the success of an office. Laura Palmer, senior industry analyst of professional development for the Medical Group Management Association, has tips on what a practice manager should be doing and how to make some of those changes.
“We will be looking at a broader way of bridging clinical and administrative functions,” Palmer said. “We should be trying to design systems that work across the board from technology, human interaction with staff and the exchange of information with patients and their whole support system.”
A team approach
Palmer said the key to making practices work moving forward is to create a physician and practice administrator team model. Because of the move to a value-based system, quality metrics, patient satisfaction, and cost will be tied together. The job of the practice administrator will be to connect the clinical and data-driven sides.
For instance, patient satisfaction will be linked to more than whether or not he or she liked the doctor. They may look at things like how soon phone messages were returned, how long it takes to speak with an actual person in the office, if the office hours are sufficient, and how long it takes to get an appointment.
“Some of these things start out clinical but become operational,” Palmer said. “We have to understand them as a whole instead of looking at them separately.”
Health reform changes
Palmer said it will be incumbent on the administrative staff to understand insurance changes that are occurring with healthcare reform. There are a large number of high-deductible plans on the market, so the practice manager has to ensure the office staff is communicating well with patients.
In urology and nephrology, many of the pharmacy expenses are high and many patients have long-term treatment needs. Staff may have to work with patients differently to ensure they are receiving the treatment they need and paying their bills. Staff has to be able to know what treatments will cost and what patients’ liability will be.
Caring for patients within a population health model is also something that can fall under the purview of the practice administrator. Offices can now take on the task of tracking how often patients are seen in the emergency room to see if they could use help from social workers or home healthcare.
“We are having to see how we can work with community resources and look at the total lifestyle and social services available with patients,” Palmer said. “It impacts how often they are in the office and how we manage chronic disease.”
An office manager can help practices become involved in patient education and support groups. Instead of leaving it up to caregivers and patients to find assistance like home health providers or case management, an office manager can be a liaison to facilitate services.