Opportunities and Challenges of Independent Providers

Value-Based Care Insights is a podcast that explores how to optimize the performance of programs to meet the demands of an increasing value-based care payment environment. Hosted by Daniel J. Marino, the VBCI podcast highlights recognized experts in the field and within Lumina Health Partners.

Episode Overview:
In today’s environment, independent physicians and solo practice providers are becoming a thing of the past. However, physicians who have a business-minded focus are looking at different opportunities to grow their practice while remaining independent. In this episode of Value-Based Care Insights with host and Managing Partner of Lumina Health Partners, Daniel J. Marino, internal medicine physician Dr. Asad Zaman discusses developing his practice, being true to his vision, and growing opportunities that help his practice remain independent.

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Episode Discussion Areas:

  1. How have the changes in reimbursement services affected your practice over the years?
    • Everybody says reimbursement has gone down, yet, reimbursement is improved, if you are focusing on the true concept of value-based care.
    • If you are focusing on pay-for-performance, payers are giving the back-end performance improvement or related bonuses. The margin between income and practice expenses has reduced so the challenge is to maintain the same standard of practice.
  2. The independent physician must have the right level of support to really maximize their practice potential.
    • The leadership role is key to success.
    • The right level of resources and technology is key.
    • It’s important to keep a good relationship with the PHO (physician hospital organization), because it’s mutually beneficial.
  3. How do you create financial opportunities to increase or boost your revenue?
    • Diversify and provide more service line offerings.
    • Create partnerships with local colleges and universities.
    • Invest in continued medical education.

7 Key Takeaways: Opportunities and Challenges of Independent Providers

  1. Reimbursement has changed dramatically over the years.
    Reimbursement has decreased, and the delta between reimbursement and the cost of operations is reduced. Providers must evolve their ways of thinking around different payment models.
  2. Stay ahead in the patient care game.
    Adopting technology early on (including electronic health records) can help you provide better care — even if it seems like extra work. Focusing on the relevant metrics also helps.
  3. Key to a successful business is knowing what to outsource.
    Many independent physicians feel like they must do it all — like negotiating contracts, billing, and collections — to maintain control. Successful physicians know what they can do well, what they can’t do well, and what they should outsource.
  4. How can providers grow their practice?
    They can grow new revenue streams and create other financial opportunities — like diversifying and providing more service lines. Also, practices can partner with medical education with medical leadership offers the opportunity to promote practices and serve as a recruiting opportunity.
  5. How can providers improve quality in post-acute networks?
    Analyzing data lets you see who’s costing the system money and how you can improve patient care.
    Improving nurses’ understanding regarding effective management of patient care including appropriate medical direction can improve patient outcomes, reduce litigation, and increase reimbursement.
  6. Nurse practitioners can help practices remain independent and grow.
    They can help manage patients, including the transition from the hospital to the nursing home. They’re not competition to physicians; instead, they can support your practice and help you expand faster and in an economically smart way.
  7. There are several key strategies for physicians who want to remain independent.
    One is developing relationships with hospitals, providers, and post-acute networks. Diversification of revenue and finding new revenue streams are also important, as is medical education.

About The Show
From HealthcareNOW RadioValue-Based Care Insights is a podcast that explores how to optimize the performance of programs to meet the demands of an increasing value-based care payment environment. Hosted by Dan Marino (@DjmarinoHD), the VBCI podcast highlights recognized experts in the field and within Lumina Health Partners (@LuminaHP). Join the conversation on Twitter at #VBCInsights. This article was originally published on the Lumina Health Partners blog and is republished here with permission.