By the Numbers: It's Always Budget Season!

Depending on your fiscal year, in the past month you either completed half of your fiscal year, started a fiscal new year or have budget deadlines ahead. Regardless of your fiscal cycle, revenue tops the list of data points on your radar every day.
Looming ahead are three multi-million dollar revenue issues at stake that require hospitals to increase their engagement with physicians. Let’s look at the numbers and put the swarm of stats into context to support actionable decisions.

Fall Physician Contract Renewals

Post-training “recruits” begin to hit contract anniversaries this time of the year. And if you are struggling to retain them, you aren’t alone. According to the American Medical Group Association (AMGA), turnover surges to 12.4% for physicians between the second and third year post-hire, compared with 4.6% for those who are past the ten-year mark. Exiting physicians can leave a million-dollar hole in your revenue budget and cost $250,000 or more to replace.

Disengagement and turnover results from lack of work-life balance and frustration with administrative burdens. Especially for young physicians, disillusionment happens when the recruitment honeymoon is over, and they enter the reality of medical practice. You are in a key position to make this transition an experience that confirms their career decision and delivers a more well-balanced, productive and rewarding experience for young physicians.

Best practices for onboarding include 1) streamlining the process for getting physicians productive quickly drive revenue and 2) a year-long engagement strategy for the physician and family. These measures can actually reduce turnover rates by as much as 40% during the critical early years.

And, here’s another number for you: According to the same AMGA survey, 88% of respondents said they onboard physicians, but only 33% have a formalized process with a task force or committee.

Which group are you in? Is physician onboarding a robust program or something in between?

ICD-10 Countdown It is one big headache that can directly threaten future cash flow for physician offices. ICD-10 by the numbers looks like this:

• ICD-10 includes about 80,000 diagnostic codes, compared with the 14,000 in ICD-9
• Less than 30 days are left until the implementation deadline
• There have been two extensions (so far) to the implementation date, and…
• It is the number one challenge for many medical groups, but they may not realize it yet

Medical Economics listed ICD-10 as #1 among 15 challenges facing physicians in 2015, and it represents an opportunity to deliver value by minimizing the burden and helping them prepare for possible impact on revenue.

What are you doing to engage physicians and their staff to build training, testing, and documentation protocols that will best serve their practices when the transition occurs? Are resources available to help them plan for a slowdown in payments due to miscoding or other bumps during implementation?

Your field team can be deployed to raise awareness about the importance of ICD-10 and connect practices to resources that will help them train, test and transition effectively.

Three short HCAHPS questions introduced in 2014 may impact your value-based reimbursement (VBR) program revenue in 2016 and beyond. More importantly, low scores may indicate there are gaps in communication between hospitalists and non-rounding physicians that can impact patient safety and continuity of care.

Hospitals can remove the barriers to timely, accurate information exchange between the referring physician and hospitalists improve patient care before, during and after hospitalization.

Taking a page from the playbook of other industries, Value Stream Mapping is one tool in the Lean toolkit that works. With the right team members at the table, you can implement change that will show immediate results. For example, a direct admission process, enabling patients with emergent but not critical symptoms to be admitted and seen by the hospitalist, eliminates the long and uncomfortable wait in the emergency department.

An approach like this enhances physician engagement, lowers readmission rates and improves patient satisfaction scores calculated into VBR: that’s a win/win/win opportunity.

The Bottomline

For any number of reasons, physicians are looking to your hospital for leadership, training resources and support. You cannot control many factors that influence your budget. But you can control your response to these uncertainties and turn them into opportunities to deliver value and improve physician engagement.