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Big corporations are quietly taking over your medical practice. Some doctors and experts say it's ruining healthcare. Big businesses such as hospital systems, insurers, and PE firms are gobbling up medical clinics. Some doctors and industry experts fear corporate owners could prioritize profits ahead of patients. The federal government is dialing up scrutiny of PE firms and other corporate owners in healthcare. https://lnkd.in/g5eScsXh

In “Fulfilling the Growing Need for Primary Care,” published by Physicians Practice, Laura Kline, MBA, CPCU, Senior Vice President, Business Development, The Doctors Company and TDC Group, discusses how advanced practice clinicians are part of the solution to addressing the physician shortage. To access this article and more recent news from our team of healthcare experts, visit: https://lnkd.in/ghPub3ad #primarycare #healthcare #advancedpracticeprovider #APC #APP #physicianshortage #advancedpractice #nursepractitioner #physicianassistant #physicianassociate

UnitedHealth Group now employs or affiliated with over 90,000 physicians That is about 10% of all physicians in the US !!!! They have hired over 20,000 this year alone !! "There are roughly 950,000 active physicians in the country, according to the latest survey data from the Association of American Medical Colleges. With 90,000 physicians either employed or under its control, UnitedHealth has become arguably the biggest employer of doctors." "HCA Healthcare, the country’s biggest hospital chain, has only half as many as UnitedHealth, with more than 46,000 employed and affiliated physicians. But only about 20% of those doctors are employed." via STAT, article by Bob Herman https://lnkd.in/gEPAuwBQ #physicians #doctors #payers #medicine #healthcare #healthcarejobs #unitedhealthcare

🎇Crisis created by #cyberattack continues American Medical Association conducted an informal follow-up survey of the Federation on continuing impacts on #physician practices of the Change HC cyberattack. 👉tinyurl.com/2ayn49sh Included results in comments to Congress underscoring: ❗️Despite messaging from UHG, commercial health plans, & insurer associations this crisis is far from being resolved for many physicians. ❗️Overall, respondents reported continuing issues w/multiple operations, despite UHG saying restored service. AMA survey showed: 🔺60% continue to face challenges in verifying patient eligibility 🔺75% still face barriers w/claim submission 🔺79% still cannot receive electronic remittance advice 🔺85% continue to experience disruptions in claim payments 🔴 Service disruptions continue to severely impact practices’ financial well-being: 🔺90% of respondents are losing revenue from unpaid claims 🔺>25% of respondents report their practice revenue for the last week was ⬇️ by >70% compared to an average week before cyberattack 🔺 62% of respondents said they are still using personal funds to cover practice expenses 🔺34% not able to make payroll 🔷Despite these challenges, as on prior AMA survey results, only 15% of respondents reported reducing office hours in an effort to prioritize patient care. 🔴 Patients are also continuing to face challenges: 🔺42% of respondents stated that patients are unable to access coverage and cost information 🔺30% respondents stated that patients cannot pay co-pays at the time of service 🔴While some respondents said that they switched clearinghouses, many practices said that they are unable to switch or are choosing not to d/t substantial barriers: 🔺 54% of respondents who did not switch clearinghouses cited the time commitment required as a main barrier 🔺32% said a switch was not supported by their EHR or practice management system 🔺 25% shared that switching to an alternative clearinghouse was too expensive 🔺36% cited incompatibilities with payers’ systems or restrictions due to contract exclusivity 🔴 The information flow from UHG on when service is going to be restored is also leading to confusion for physicians. 🔺 84% of respondents are not receiving information, or are receiving inaccurate information, regarding service restoration from UHG and its subsidiaries 🔴 Respondents indicated health plans are NOT offering admin flexibilities in response to cyberattack: 🔺30% said they are required to complete prior auth on claims impacted by service outage 🔺27% said claims have been denied for failing to meet timely filing requirements When UHG CEO Andrew Witty testified this past week before Congress, he said “claims flow across the entire country is essentially back to normal.” ♦️HOWEVER AMA’s statement/letter strongly & convincingly argued physician practices—particularly small practices &/or those operating in rural areas—continue to struggle from the aftershocks.

Provider appeals are a critical challenge for hospitals, with many facing difficulties in recovering rightful reimbursements. A recent Becker's Healthcare article shed light on this issue, highlighting the financial strain ($43.84 per denial) it places on healthcare institutions. At Crosby Health, we've responded to this challenge by developing an operating system specifically designed for the complexities of provider appeals. Our system leverages data from hundreds of thousands of medical records and direct submission to major insurance companies, streamlining the process and improving success rates. For those interested in learning more about our approach and how it can benefit your hospital, we're here to provide insights and discuss potential solutions. #RevenueCycleManagement, #Healthcare, #ProviderAppeals, #MedicalBilling, #HealthTech, #CrosbyHealth, #InsuranceClaims

Balancing patient experience and patient outcomes requires improved communication and patient education to set achievable expectations and deliver better overall outcomes. It’s also essential as the entire healthcare community goes through much-needed transformation. We understand the importance of strengthening current methods of patient engagement while we innovate with digital tools such as apps and other integrated solutions that can meet and exceed expectations. Missed expectations for care are a major barrier to patient satisfaction—and it’s one we work hard to avoid. Among many strategic initiatives our private practice has undertaken to improve patient experience, the leading ones are: - Establishing collaborative relationships with payers to advance value-based care and population health management - Creating an accessible and equitable platform, enabled by technology, that supports better access to care and remote patient monitoring - Building time in our schedule for same-day appointments for immediate care needs, with most non-urgent needs treated within a week - Focusing on continuous process improvement to speed patient response times and appointment availability - Incorporating patient education regarding their own health ownership and the new technology-enabled models of care - Leveraging remote patient monitoring and chronic care management  to facilitate high-touch interactions with patients who are living with chronic and complex disease - Assessing traditional phone calls with built-in KPIs to analyze and improve operational efficiencies - Incorporating pain management and physical therapy within our primary care practice continuum As this article in Physicians Practice notes, “Investing in enhancing the patient experience should lead to improvements in all areas of your organization — providing evidence for the aphorism ‘a rising tide truly lifts all boats.’" Our work to increase availability of same-day appointments through operational efficiencies reflects our commitment to enhance patient experiences. “I was in severe shoulder pain and didn't have an appointment. Dr. Tilak's office took such great care of me,” one patient recently shared. “Dr. Kaur was absolutely amazing. I left in almost no pain, with a course of meds to make sure I heal properly. Thank you so much!” As a patient, what do you most value in the patient experience? And as a healthcare provider, what steps are you taking to strengthen the patient experience, including with technology? #healthcare #healthtech #ptexp #chronicdisease #primarycare #physician #physicianpractice Mary Tilak MD, MBA

Thursday Thoughts: 12 healthcare trends and issues we are following for 2024. “The year begins with a number of challenges that have only intensified for U.S. healthcare providers.” Patterns and shifts observed in 2023 will “directly or indirectly influence how healthcare providers fare in 2024, and ultimately affect how Americans access, afford and receive care.” MedCom Solutions is here to help you boost your revenue in 2024. We provide a unique combination of clinical expertise and proprietary technology to help medical service providers meet rapidly escalating and changing medical billing demands. For over 35 years, our chargemaster, pricing, and compliance solutions have yielded hundreds of millions in net revenue for healthcare providers across the country. Contact us today ☎ 412.481.7710 or 📨 [email protected] #healthcare #revenuecyclemanagement #contactus #wecanhelp

We are thrilled to share highlights from our recent Healthcare Rebel Alliance interview with Garrison Bliss, widely recognized as the godfather of Direct Primary Care (DPC). Dr. Bliss's journey from creating the first DPC practice in 1997 to leading a movement of thousands is truly inspiring. 🚀 Here are 5 key insights from the interview: 1️⃣ Patient-Centered Care: "Healthcare should never be driven by money, fame, or ego. Our care should be tailored exclusively to the needs of our patients." 2️⃣ Transformative Model: DPC has consistently improved lives of both patients and doctors, reducing healthcare costs by 15-50%. 3️⃣ Culture Creation: DPC is about designing a healthcare model that prioritizes doctor-patient relationships and autonomy. 4️⃣ Future of Primary Care: DPC could make primary care a popular option for medical students, potentially balancing the workforce to 50% primary care / 50% specialty care. 5️⃣ Innovation: The DPC movement is attracting vendors and technologies that further enhance accessibility and quality of care. Dr. Bliss's vision aligns perfectly with what we're building at Decent. As he told our founder and CEO, Nick Soman, "I've been waiting for someone to come and do what Decent is doing." Read the full interview here: https://lnkd.in/g7Sqgc9n

A recent survey by the American Medical Association highlights the significant challenges posed by #PriorAuthorization on both patient outcomes and physician wellbeing. Below are just a few of the staggering statistics reported by physicians. PA Impact on Patients: • 94% of physicians reported that prior authorizations cause delays in care. • 22% noted treatment abandonment due to prior authorization issues. • 24% observed adverse events, with 19% linking these to hospitalizations and 13% to life-threatening situations. • 79% indicated patients often pay out-of-pocket for medications due to prior authorization delays. PA Impact on Physicians: • 95% of physicians report burnout attributed to prior authorization requirements. • 35% of practices have staff solely focused on prior authorizations. • 27% of prior authorization requests are often or always denied. • 87% noted that prior authorizations lead to higher overall healthcare utilization, including ineffective treatments, additional office visits, emergency care, and hospitalizations. These findings underscore the urgent need for reform in the prior authorization process to enhance patient care and reduce the burden on healthcare providers. Automating the prior auth process is a step in the right direction towards reducing abandoned treatments, boosting provider and staff wellbeing, and increasing revenue. Learn how automation can streamline your operations through Valer’s customizable workflow solution made to fit your organization’s needs. https://valer.health/ To access the full AMA survey, follow this link: https://lnkd.in/eZmxTzNT

Unleashing the Potential of our Health Workforce Scope of Practice Review Reforming our healthcare landscape is full of barriers however I respectfully disagree with this statement by RACGP president Dr Nicole Higgins which was in relation to scope increase for allied health professionals. “GPs are trained to know when to not order a test and when to not prescribe,” RACGP president Dr Nicole Higgins told The Medical Republic. “Opening up the MBS to professions that haven’t had this integrated into their training throughout medical school and throughout their postgraduate training is going to cost a lot of money. “It’s going to increase the ordering of tests and increase the prescribing of medications, and that’s going to have huge implications to the budget bottom line.” Whilst this is a risk to be managed, allied health professionals are unbelievably evidence based, holistic and multidisciplinary in their model of care. They are also "trained in when to not order a test" and their clinical reasoning and critical appraisal skills can be reasonably expanded to not only decrease costs for consumers and the economy but improve healthcare outcomes. Our population is ageing quickly and we have a shortage of skilled healthcare professionals, both medical and allied health. We desparetly need reform. What are your thoughts on scope of practice reform? https://lnkd.in/gcCn9ckV