The American Institute of Certified Public Accountants (AICPA) recently held the 2008 National Healthcare Industry Conference in San Diego, California. Included were workshops on topics related to physician practices and related activities including joint ventures with hospitals, and opening surgery and imaging centers. Below is information on a few interesting topics and trends we feel may provide value to you and your practice.
The general theme of the overall healthcare environment is one of uncertainty and complexity. The upcoming elections will certainly give us some idea as to the overall direction, that is, whether we will have more or less government intervention and the role of the private sector.
During the conference, a representative from the Office of the Inspector General (OIG) gave an excellent presentation on their initiatives to combat Medicare fraud and abuse. The current efforts of the OIG include targeting new businesses, primarily medical equipment distributors, in various geographical areas that have large initial Medicare billings with no proven track record. Site visits have become commonplace. In addition, “kickbacks” to physicians from pharmaceutical companies and medical device makers are being watched very closely. Many times these “kickbacks” are hidden as management fees or other compensation arrangements. Physicians should be very careful before entering into any type of agreement that may be viewed as “kickbacks.” If caught, the consequences may be harsh.
Another popular subject was physician compensation arrangements. As practices become more diverse, the “older” types of arrangements are inherently unfair. The most typical arrangements include structures allocating costs by variable and fixed components, by number of procedures and by relative value units (RVU). Any systems based on charges should be critically examined and changed.
Practice reviews were also discussed in great detail. After participating in the conference, one thing is clear: if doctors do not receive patient satisfaction feedback on a regular basis, they are making a mistake. Physicians should survey patients on specific questions including wait times, paperwork, transportation to the office and even how much effort it takes a patient to walk through their office. These may all be important points for a physician to know about. It was also suggested that the best people to address many of these issues are those directly performing the work.
Overall, it seemed as though most of the conference participants, including practitioners and CFOs/practice administrators, left feeling positive but still uncertain as to the future of the overall healthcare system.
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