Posts tagged with practice management

It dawned on me that it would be helpful to let people know about valuable pediatric resources. For example, I expect to do a quick review of groups like Physicians' Alliance and Pediatric Federation soon.

I'll start with a self-reference: PCC's Pediatric Practice Management Conference on July 19 in Vermont. We've got Donelle Holle, Drs. Hagan and Lessin, Rosemarie Nelson, and Carol Rutenberg. Big names, great topics. Plus, Vermont is beautiful in the summer time. Can't be beat.

Just ran into this fascinating site. It's the mp3-blog from the Journal of Medical Practice Management. Some of the pieces are excellent (though I don't think that small groups are going to become a novelty...).  The refers to a group of our customers later in his discussion, which is interesting.

First, the facts:

October 11
7-9 p.m.
$75/person
Doubletree Hotel Boston Downtown
Boston, MA

What are we covering?

PCC's Pediatric Solutions team will share current pediatric trends that drive bottom line change and show you where to look to evaluate the impact these trends have on your practice. Then, we'll teach you how to apply pediatric benchmarks and common practice management software reports to assess the financial health of your practice. The importance of insurance negotiations to your overall practice health will also be highlighted. Discover how to improve the clinical health of your practice to secure the financial footing of your practice.

Essentially, if you are the managing provider in your practice, consider this evening seminar in Boston.  Tim is doing it and will do an excellent job.

This month's AAP News has some great news and some congratulations are in order to some PCC friends and family.

First, Dr. Richard Tuck won the District V Vice Chairperson position. Wow! I can't think of a better person to lead a district.

Second, Dr. Phyllis Cavens won the 2007 AAP Local Heroes award. To quote: "Dr. Cavens leads the Child and Adolescent Clinic, a private practice of nine pediatricians, four pediatric nurse practitioners and 55 employees that cares for 20,000 children in southwest Washington. The group provides access to all children regardless of their insurance status. Besides her work on behalf of children in her community, Dr. Cavens has led medical teams to treat victims disasters in Cambodia, Ethiopia, Somalia, Mexico, Uzbekistan, Moldova, and Honduras." Awesome work.

She also does a killer talk about chronic disease management. Er, not a killer talk, you know what I mean.

Third, Dr. Anne Francis was recognized with the 2007 Charles "Buzzy" Vanchiere Award (sponsored by PCC, of course). "Dr. Francis is the managing partner of the Elmwood Pediatric Group in Rochester, NY...Past chair of the AAP Section on Administration and Practice Management executive committee, Dr. Francis chairs the AAP Private Payer Advocacy Advisory Committee. She played a key role in the launch of the Practice Management Online and continues to provide information on best business practices for pediatricians." Well deserved and rewarded even for PCC to see her win.

I'm also personally delighted to see Dr. Tayloe win the Presidency position after witnessing his behind-the-scenes effort to help someone over on PedTalk. The details aren't important, but I was blown away by the time he took to help a practice manager and an ill child from another state.

Congratulations to all.

By the time any reasonable person reads this, I will be giving or have given a talk at the local AAP VT Fall meeting here in Burlington. I am quite flattered that Dr. Aakre thought me capable of being sandwiched in among the likes of Drs. Barry Heath and Wendy Davis. My talk will be something along the lines of "Preparing for a Pediatric Electronic Health Record." I won't give away all the best lines, but the opening slide reads something like this:

The single biggest and most common mistake practices make when
choosing an EHR is to learn what they need after they purchase
the system.

The second most common mistake...

You'll have to ask me for the rest of that sentence.

Meanwhile, we are working with Dr. Lander and the helpful SOAPM admin folks (shout out to Heather to see if she's reading) to figure out where and what to do next after our kick-butt pediatric coding and practice management event in NYC in August. In addition to a practice management and clinical event our massive UC in late July, we're considering doing two more all-day events (with the same and additional speakers - how can we turn down Lander, Harbaugh, Tuck, and Bradley?!) and perhaps some 1/2 day events.

One of the first considerations in this process is where to do them. Using a cool map that I helped SOAPM put together to show the locations of all their members - Google is the coolest - we have a couple places in mind:

• Washington DC / Baltimore / Alexandria (somewhere in there)
• Cincinnati
• Detroit / Buffalo / Rochester
• San Francisco / Seattle
• Philadelphia

Here's what we're thinking:

The DC-metro area has a lot of pediatricians and, in particular, a lot of SOAPM folks. Plus, it's a family-friendly place. And maybe I'll stop by Volker's place and have the best beer in the world. We're looking there for an April meeting.

Cincinnati is smack in the middle of a lot of small hot spots and part of the country that the AAP and other educational resources often passes over. We have customers it would reach, too, which is always a bonus.

I don't know if Rochester will support a full-day meeting (~60-100 people), but we do have an amazing location and, though I haven't asked her yet, the support of Dr. Francis. I'm definitely interested in doing at least a 1/2 day there.

San Fran seems a little redundant, considering everyone was just out there, but we may get some local support and there are lots of pediatricians. Alternatively, we will shoot for Seattle, another corner of the world that doesn't get requisite AAP attention and has a good crowd. It would be a lot less expensive to simply stick to Philly, but we can't ignore the west coast.

Why do I ramble about this? Besides it being my nature, I'm looking for feedback and comments. You want the best Pediatric Road Show in your town? Let me know.

I was on the phone yesterday with a client from Rhode Island who was taking the time to tell me about his practice's search for an EHR. To my surprise, they had flown down to visit another customer of ours in Tennessee to see what they thought of an installation with one of our EHR partners. They gave him some interesting advice: take your time. Even though the TN practice is happy and up-and-running with the EHR, they realized that it has taken them a year or more to figure out what, exactly, they want and expect from it. And that has cost them time and money. [Note: the EHR company in question has served them well; this is a classic practice management issue.]

Which makes me feel that I know what I'm talking about sometimes.

You see, a few weeks ago, I was honored to give a presentation at the VT AAP fall meeting. My discussion was entitled "Choosing a Pediatric Electronic Health Record". Perhaps it was "Preparing for..." In fact, I think I can use Wordpress to post the presentation. In any event, the fundamental point from the entire presentation is:

The single biggest and most common mistake practices make when choosing an EHR is to learn what they need after they purchase the system.

Look at that!

Now, many of you read this blog have heard me speak, but there are plenty of you who haven't. Although common sense and not false modesty tells me that I'm far from the world's greatest speaker, I think I'm often better in person than I am in writing. My brain seems to enjoy the challenge of making things up on-the-fly, which means I sometimes end up saying things in a presentation that I would have never thought to communicate in writing. So, there, in the middle of my talk, I blurted out:

Purchasing an EHR before organizing your practice and knowing exactly what to expect is like having kids to save a marriage. Sometimes it works, but it usually doesn't. And it's always more expensive.

Now, maybe that doesn't ring as true in the middle of a blog as it did 45 minutes into a lecture about the subject, but I saw the lightbulbs turn on in the eyes all around the room, so I thought I'd record that analogy before I forget it. And extend it poorly with some comment about birth control.

So, if you're shopping for an EHR - take your time and prepare. Want some suggestions? Just ask.

All the RVU drama makes it hard for me to get to other things, but here is the latest from my generous and favorite inside source (instead of using an inappropriate 70s adult film nickname, we'll use "Siouxsie"):

1) The new CF for 1/1/08 through 6/30/08 will be $38.0870 [= 0.5% increase from the current CF of $37.8975; what happens after that point is anyone's guess] 2) The work GPCI floor (1.000) will be maintained through 6/30/08 [again, what happens after that point is unknown] 3) The bill did NOT include provisions to "alter or supplant the role" of the RUC

Attached with this cogent explanation was a memo straight from Michael Maves, the E-VP and CEO of the AMA. Now, let's all be tense for six months. Ready? Go! [I can actually update the RVU calculators, now.] Wow, Siouxsie kicks butt and sends me this important AMA Memo about the changes 2 minutes after I post this.

Today's missive has no practice management value.  It is pediatric related, though.

I travel a fair amount for work (how else would most of you know me?).  Which means I spend times in planes, airports, and hotel rooms.  As a result, in addition to my predisposition, I read a lot.

Most of the time, I try to read something of substance.  That is, I try to avoid the schlock...but sometimes, in between flights, you reach for the best seller lists and see what happens.  [Plus, I will admit, some of the schlock is a good break.]

I was coming back from El Paso two weeks ago and I picked up "Tell No One" by Harlan Coben.  It's not one of his Bolitar series, but a one-off about a widower who is suddenly struck with information that his wife may actually be alive.  Typical page-turning, made-for-movie material.  But not bad.  Turns out that it is a well-received French movie, now, too.

The interesting part, however, is that the protagonist is a pediatrician!  He practices at a clinic in "upper Manhattan."  Don't know if he's a pediatrician in the movie, but I have obviously read the "pediatric" moments of the book closely.  You won't be disappointed!

First one to ask me for my copy gets it.

Save the date: April 17.

It's not official yet - we're confirming a location - but we hope and expect to produce a pediatric coding and practice management seminar in the greater Washington DC area on or around April 17.  It will be nearly identical to the one we produced in NYC in August.  We hope to get AAP endorsement again and, if everything works out, we may even be able to acquire an educational grant from a generous source that might lower or eliminate the cost for AAP members!

That last item is a bit of a dream still, but it's not off the table.

Anyway, I thought I'd let everyone here be the first to know.  As soon as it's official - speakers, location, date, and content - I'll post it all here.

Need proof that this is the best pediatric practice management resource on the planet? Check it out.

Oh, first: major drama at PCC's office last night. Let's hope this post is the closest I come to being a war correspondent. I don't like the proximity of the event to yesterday's message about flooding.

Meanwhile...Igor and I were doing some work on our [secret project, still] and were looking at E&M distribution among pediatricians. Here's a trick question - should 9921X codes that result from an initial well visit be counted as part of your distribution? Most people say yes - but I'm not convinced. Sick codes discovered during well visits should, by their nature, have a different distribution. It's not as if, for example, Mom waits until next week for her scheduled physical to talk about that seizure or red, sore throat (ok, some wacky ones do, but you get the point). 99214s and 99215s come to the office as a rule. I believe that -25 modified codes will have a different distribution. I'll post the results later.

What we did look at, though, is how many pediatricians actually use the -25 modifiers in the first place and how often they do. Here it is, data you can't get anywhere else:

What this shows is that 2% of our clients put -25 modifiers on 40% (or more) of their E&M codes. 12% put it on 20% or more. Get it?

What the chart doesn't show is that 22% of PCC's clients never use a -25 modifier.
That's crazy. Especially when you consider the fact that we have good customers. So, how about you? How many of your E&Ms have -25 modifiers?