Large Health Systems Combine Software and People to Face Administrative and Regulatory Hurdles — Independent Practices Should Do the Same

Many physicians want to maintain their independence, but they face cost pressures and administrative burdens that doctors who work in managed-care systems are shielded from. This means it’s getting tougher every year to run an independent practice.

Diagnosing illness and prescribing a course of treatment is enough of a challenge for any clinician practicing in any setting. But for the independent doctor, this challenge is just one of many.

Unlike doctors who work in managed-care settings, physicians in independent practice must struggle on a day-to-day basis with issues nearly as complex as human health, including HIPAA compliance, the meaningful use of electronic health records, the shift to value-based reimbursement, the implementation of the ICD-10 and the costs and time associated with the maintenance of certifications.

Other daunting challenges that threaten the bottom line and take doctors away from patients include the collection of co-pays and deductibles, increasing amounts of paperwork, rising operational costs, the growing influence of payers on treatment decisions and the need to keep up with rapidly evolving information technology.

Doctors who practice in larger care networks do not feel these pressures as acutely as the independent physician does, because the larger health networks have staff whose time is devoted to overcoming those hurdles to providing care. Those doctors can focus all their attention on patient care.

But smaller clinics and independent practices do not have teams of experts who focus on regulatory and compliance issues. The doctors in these settings must add these duties to their already considerable workloads.

Today, many independent physicians are using sophisticated software to address many of these challenges. Many are hoping that software-as-a-service (SaaS) offerings will ease the strain of remaining HIPAA-compliant, collecting co-pays, maintaining certifications and keeping up with the growing pile of paperwork.

But the SaaS-based solutions they are working with today are not addressing most of the actual pressures that are bearing down on independent practices. Most SaaS-based products, in fact, only help with ICD-10 implementation, the meaningful use of electronic medical records and the adoption of “lean business processes.”

The other challenges cannot be fully addressed with technology alone. Larger health systems do not even attempt to address the challenges that way, instead they put teams of consultants and experts to work on the problems.

Since independent practices are not in a position to do that, it’s time they start demanding more from their practice-management systems. If they cannot afford to hire teams of experts to address administrative and compliance burdens, they should at least have access to that expertise.

This is what the practice-management system of the future must be able to do. Rather than just streamlining operations and helping save time, a robust system must put the independent physician in contact with the human experts who can truly solve problems.

This way, the independent physician can do the more pressing work: healing the sick.

Read more by Dr. Adam Tabriz of eHealth Solutions

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