Todd Shryock

Only 11% of medical practice owners said they did better in 2020 than in 2019, whereas 46% said they were doing worse, according to the 

Medical Economics® 2021 Physician Report

. The top reason listed was lost revenue and increased expenses because of COVID-19. Here are some strategies to boost your practice’s bottom line.

Successful practices track performance indicators to identify opportunities for improvement, said Andrew Hajde, assistant director of association content for the 

. These indicators include accounts receivable, insurance claims, reimbursement, denials, and patient satisfaction.

With those data, practices can not only track their own performance over time, Hajde explained, but also benchmark themselves against data from similar providers. He added, “It gives them [praactices] a bar to see if they’re doing well or if they have some opportunities for improvement in any of those areas.”

Similarly, it is also important to find out what other practices are doing to get positive patient engagement and quality ratings, Hajde told Medical Economics. “That’s where it is critical to work with your peers across the country that are achieving those best practices via conferences [and] member communities with associations and [by] researching, reading articles, [listening to] podcasts, or any way you can get in front of how people are achieving those things to bring to your practice.”

Additionally, thriving practices analyze their claims denials and take action to reduce them. It’s crucial to track which payers are denying claims and why they are doing so, Hajde said.

Likewise, Hajde suggested checking accounts receivable for possible causes. “Is it because you are not getting paid in a timely manner or that a lot of claims are being denied?” Hajde asked. To reduce denials, ensure information is entered correctly by office employees.

Claims should also be filed in a timely manner, and all denials that are deemed inappropriate should be appealed within the payers’ established deadlines. “Sometimes you only have 30 or 60 days, so make sure you are on top of that,” Hajde explained.

Every contract has unique details such as requirements for prior authorizations, medical necessity, and timely filing, in addition to the reimbursement agreement. Hajde recommended regularly reviewing contracts and payment rates. “I’ve talked to some practices that haven’t renegotiated with an insurance payer for 5 or 10 years,” he said, “and they are underperforming in terms of their payment rates.”

Also, verify payment compliance and do not assume the payer is always accurate. “Confirm the payment is actually for what your contracted rate is, because sometimes you are inadvertently underpaid,” he added.

Patients should be aware of which part of the payment is their responsibility and, if they cannot pay, how that will be handled, Hajde said. All payment policies and procedures also need to be clearly communicated to staff.

Rick Gundling, senior vice president of health care financial practices at Healthcare Financial Management Association, recommended surveying patients on how they wish to be contacted: text, phone, portal, or app. Different patient populations have different expectations, but knowing their preferred 

 type can help with billing- and care-related messages. An online payment portal is vital because patients expect the convenience, and it can speed up payment, Gundling added.

“You really need to…commit to customer service training to really create a high morale and great patient experience,” Hajde noted. “Patients really pick up on it, and anyone who’s been in a medical practice or other health care facility can tell when employees are dissatisfied. It doesn’t lead to a great experience. It won’t make patients want to tell their friends and family to go to this practice or organization.”

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Expert management tips can help clinicians ensure their practices thrive, even during the worst of times.   

Strategies for Successful Medical Practices

Medical liability insurance premiums are increasing after a decade of mostly steady rates, according to a new analysis from the American Medical Association (AMA). In 2020, more than 30% of premiums reported on a survey of 

 insurers increased from the previous year, the highest percent increase since 2005.

For a second consecutive year there has been an exceptional surge in the size of the increase. Between 2010 and 2018, the share of premiums that increased ranged from 12% to 17%. In 2019, that proportion almost doubled to 26.5% and rose in 2020 to 31.1%.

According to the AMA analysis, although some 2020 premiums may have been set after the onset of the COVID-19 pandemic, it was still too early for them to be affected by it.

“Increases in medical liability premiums compound the economic stress on medical practices as the 

 pandemic resulted in significant reductions to patient volume and revenue, and higher expenses for scarce medical supplies,” AMA President Susan R. Bailey, MD, said in a news release. “Practice revenue has not fully recovered as the pandemic has stretched on and a protracted upward trend in medical liability premiums will threaten the viability of many practices that already face a difficult road to recovery.”

The analysis identified the 14 states that had premium increases of 10% or more. Those states and their shares of reported premiums that increased by such magnitude in 2020 are: Kentucky (29.6%), South Carolina (27.8%), Maryland (18.8%), Nebraska (16.7%), Oregon (16.7%), Montana (16.7%), Georgia (14.8%), Missouri (14.8%), New Hampshire (13.3%), Illinois (11.9%), Michigan (11.6%), Texas (9.2%), North Carolina (6.7%), and Virginia (1.3%).

The AMA report also found striking differences in premiums by geography.

“Keeping medical liability premium growth in-check is imperative to ensure patient access to care is not jeopardized by unaffordable liability insurance costs that make it impossible for physicians to remain in practice,” said Bailey. “This concern is particularly pressing given the negative impact that the COVID-19 pandemic has had on access and practice viability, as many physicians have had to suspend patient visits or elective procedures, and some have had to close their practices.”

Together with state medical societies, the AMA is pursuing both traditional and innovative medical liability reforms to preserve premium stability. This includes limited and targeted emergency protections for physicians who continue to treat patients during the pandemic without adequate resources and support.

The newly released AMA analysis on medical liability insurance premiums is based on an annual survey of professional liability insurers conducted by the Medical Liability Monitor (MLM). The MLM reports base premiums for 3 specialties in each state where the responding insurers provide coverage. ❒

Between 2010 and 2018, the share of premiums that increased ranged from 12% to 17%. Are they continuing to rise? 

Medical Liability Costs Are on the Rise

An analysis of data from the US Department of Health and Human Services conducted by the security firm 

 that collectively affected more than 26 million people. The report resulted in 6 key findings.

Attacks are increasing each year.Since 2018, the number of hacking and IT incidents has increased. Last year, hacking was the top cause of breaches, leading to 403 and 599 breaches (67%).

Hacking is resulting in larger breaches.Hacking compromised 91.2% of all exposed health care records in 2020—24.1 million out of 26.4 million.

The cost of breaches is rising. The average cost per breached record increased from $429 in 2019 to $499 in 2020. Data breaches cost health care organizations $13.2 billion last year.

Hacking is not the only problem.The remaining breach categories—unauthorized disclosure of personal health information by internal parties or systems, loss of theft devices, and miscellaneous leaks—exposed the personal details of about 2.3 million people, exposing victims to identify theft, phishing, and other forms of cyberattacks.

Breach numbers are up everywhere. 37 of 50 states suffered more breaches in 2020 than they did in 2019. California had the most at 49, surpassing last year’s leader, Texas, which suffered 43 in 2020.

Recovery is slow.In 2020, the average health care firm took 236 days to recover from a breach. ❒

Hacking and security breaches are rising at an alarming rate.

Todd Shryock

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Medical Liability Costs Are on the Rise

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