For the past six years, Cheris Craig has been Practice Administrator for Atlanta Women’s Obstetrics & Gynecology, PC, where she is responsible for almost everything aside from treating the patient medically, including financial management, marketing, collections and patient satisfaction. Craig, who recently took on the role of President of the National Medical Group Management Association (MGMA) Obstetrics & Gynecology Assembly (OBGA), spoke with M.D. News about increased expenses and decreasing reimbursement and how being a part of the MGMA helps her tackle daily challenges.
What challenges does your practice face in the upcoming year?
Practice management on a daily basis is like fire fighting. Dealing with staffing, cash flow, accounts receivable and operations every day is time consuming. However, there are definitely some hot issues on the horizon for not only OB GYN practices, but also medical practices in general. Continually decreasing reimbursements, increasing expenses, diverse workforces and increasing administrative burden are just a few of the hot topics headed our way for 2008.
Can you address one area of decreasing reimbursement?
Medicare is currently phasing in a 75% reduction in the reimbursement for bone densitometry scans, a screening test for osteoporosis. Reimbursement is slated to decrease from approximately $140 per scan in 2006 to around $35 per scan by the year 2010. Other insurance carriers will follow Medicare’s lead and so many practices like ours will be forced to make tough decisions about preserving osteoporosis screening as a service to their patients. Many practices, especially smaller ones, will be forced to liquidate or scrap their equipment and its associated staff because it won’t be financially feasible to maintain it.
Can you address one area of increasing expenses?
It seems there are cost increases around every corner. It shouldn’t be too hard to find one. Insurance premiums are a great example. Whether professional liability or health insurance, our premiums increase about 5% to 10% per year. Premium increases always have a direct impact on compensation. In the case of professional liability, the additional premiums are subtracted from the physician’s salary. In the case of health insurance, the additional premiums can be absorbed by the practice, which would further reduce the physician’s salary; absorbed by the staff, which would reduce their take home pay; or shared between the two. No matter how you divide them, premium increases are generally outside the manager’s control and negatively impact salary, employee retention and morale.
Can you address one challenge of a diverse workforce?
Today, we have many generations in the workforce. Managers cannot approach staffing in a cookie cutter fashion because employees want and need different things from their employers. The diversity forces managers to offer a myriad of schedules, benefits and training programs. Generation X employees are generally more computer savvy and often want to see instantaneous results from their work. Baby Boomer employees may need additional training on technology-driven components of their job. Women in the workforce are looking for flexible schedules to help them balance their professional and personal lives.
Can you address one way that your practice’s administrative burden is increasing?
The never-ending cycle of lab exclusivity agreements is a great example of increasing administrative burden. It seems now somewhat fashionable for insurance companies to restrict physicians to one preferred laboratory. Unfortunately, these restrictions add to a practice’s challenges rather than help increase its efficiencies. Practices are forced to deal with multiple labs and decipher which laboratory to use based upon the patient’s insurance coverage. Managing different forms, test codes, interfaces, tracking systems and result systems increase costs, decrease efficiencies and cause patient access and patient care issues. Patients have very limited knowledge of these restrictions, and the practice is left to absorb all the additional work and expense, which can include monetary penalties assessed by the insurance carrier for choosing the wrong laboratory. The system would run a lot smoother for everyone if the physicians were allowed to choose a laboratory based upon service, turn-around time and other clinical factors.
How does being part of MGMA and OBGA help you address the challenges you described?
MGMA is a great resource. The organization listens to its members and takes action. On a national level, MGMA influences many facets of the medical practice industry. Its influence and most importantly its understanding of our industry is imperative to the success of medical practice management. MGMA offers its members research tools, benchmarking tools, educational programs and most importantly networking. Networking by specialty such as OB GYN is offered through specialty societies such as the Obstetrics & Gynecology Assembly. Specialized list-servs, educational sessions and benchmarking tools are readily available online, which is essential to managing a successful medical practice in today’s healthcare environment and maintaining your sanity.
For more information on the Georgia chapter of MGMA, visit www.gmgma.com.