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October 4, 2011
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PBN Minute Fall Series: The "So What?" Guide to Changes in Healthcare Regulations and Practice
Beyond an ACO: You're Already Accountable
Central to the healthcare reform movement and related regulatory efforts is a push for transparency and accountability in the healthcare industry. You may see this as something new and an added burden brought on by new regulations . . .
But, really, ever since the advent of widespread use of the Internet and especially social media, you and your practice, clinic, or hospital have already been publicly accountable. You have an online reputation that you may currently have very little control over, and that will become increasingly important to your success.
Today, with highly credible sites on the Internet regularly rating doctors, nurse-practitioners, hospitals, medical groups, and their staffs, there's just no way for anyone to hide from accountability.
Some Examples . . . Clicking through the links available on this Robert Wood Johnson Foundation National Directory reveals vetted surveys and studies in nearly every state. These studies include patient experience surveys, general survey results with ratings and ranking results for individual doctors, practices, clinics, and hospitals in any given region in the country.
For most doctors and practices, though, there's less risk from vetted, reliable information than there is from unreliable, unvetted sources . . . like that grumpy old man you treated last Thursday. He was really mostly just upset about his poor insurance coverage and the cost of his prescriptions. But, he can't find where online to complain about that--at least not with the same kind of impact posting a poor rating for his doctor has had.
So What? A Google search on "doctor reviews" generated almost 19,000 listings--so there are an impossible number of pages to keep track of. Trying a different tack, a search on a specific doctor's name (she's a rheumatologist and general practitioner with a stellar reputation) returned over 40 separate sites that listed something unique and specific about her conduct as a physician (everything from a simple "rating" to specific anecdotes about working with her as a doctor, to a detailed and complete review of the history of her entire career since medical school).
So she or someone in her office would have to regularly check each of those 40 sites to keep track of any new comments. And that's what a "good" doctor has to deal with. Imagine if she ever actually made a serious mistake or someone had an issue with her office staff--guess which comments would appear first in a search (and people are more likely to click through on).
So . . . you should regularly check that there's not a significant problem. In the modern business world, both businesses and individual professionals in any field need to track their online reputations--this is especially important in professions that come into regular contact with the general public.
You can do it yourself . . . The simplest thing is to assign someone you can trust to periodically check online and report any findings. Beyond doing the logical thing and searching on your name and the name of your practice, group, or hospital (or all of the above), setup a Google Alert. Google Alerts "listen" for any new online postings or other new Internet content containing specific phrases (like your name or the name of your business), then send an email whenever one is detected. Also remember the old adage, "an ounce of prevention is worth a pound of cure" and share and follow common sense advice about what and where you and others in your organization post online.
Or get some help . . . There are literally hundreds of software tools that can help with maintaining or repairing your online reputation , so if you decide you need help, shop around .
Crisis management . . . If you find a problem or suspect you'll need to do some damage control soon, you can step up your efforts by working with a reputation management consultant or firm who will use SEIP (Search Engine Image Protection) tactics to supplant negative information with more positive information, general PR and reputation management strategies (including off-line, real-world tactics) to try to contain and repair the damage.
PBN Business Development, 800.288.4901 or
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Inside the
A Reminder . . . We don't like to nag our clients at PBN, but every now and then there's something important enough for more than a gentle reminder. Here's one . . . if you aren't ready for transitioning to HIPAA 5010 codes and haven't tested across your entire payment network (care providers, billers, payers, clearinghouses, pharmacies, and health plans), drop what you're doing right now and start working full-time on making the transition and you might just make the January 1, 2012 deadline .
You've had fair warning from CMS for several years now, and PBN has been diligent about keeping you informed and up-to-date . . . so if you've been waiting until the last minute, this is it--now's the time .
The point is, after January 1, if you submit Medicare claims using Version 4010/4010A of the electronic transaction standards, your claim will be ignored and you won't be paid. (The same is true for eligibility determinations, remittances, and referral authorizations.)
If you don't think you can make the transition in time, the good news is, PBN can offer guidance, consulting, advice . . . you can even temporarily outsource your revenue cycle management to us until your internal team is up to speed.
P.S. PBN has also recently had some good news. You can read more about it on the News page of PBNMed.com.
Call us. We can help.
— Jud
Visit us online at the new PBNMed.com.
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