practice management

I have to make it brief because today is my pesto run day. [See below for explanation.]

For a few months, I have hinted from time-to-time about some changes that we're making at PCC related to this blog. Even though we expected to be done in June, we're only now broaching the unveiling of our new pediatric resource. What the heck am I talking about?

For years, pcc.com has been a challenge because we have mixed our business information with our "community" resources in a way that makes it difficult for folks who don't know us well to understand what we do and how we keep our meager company in business. Some of those resources - especially PedTalk - have made it very difficult to work on our WWW site (PedTalk has GIGAbytes of archives to maintain and attracts tens of thousands of people a month).

We realized that, for the better of both our business AND the pediatric community, we needed to split the two. Have pcc.com focus on our core business (pediatric software, consulting) and create a new site - with new and different tools - to create the best on-line pediatric community in the world. Like Winston says at the end of the first Ghostbusters, "We had the tools, we had the talent!"

More concretely, the plan is: move PedTalk, the various PCC resources (pediatric benchmarks, form letters, white papers, etc.), and this blog over to a new site and allow the community to contribute. Take advantage of the many new community building resources available that were not around when we started PedTalk. And see what happens.

Like I said, the door isn't open yet...but I'm allowing blog readers a SNEAK PEAK. That's right. If you want to see where we're headed in a week or two, check out PedSource! You can't sign up yet - in fact, please don't. And you'll see lots of little things that we're cleaning up - we're not open yet for a reason. And most of the goodies require you to log in, but you can't yet. But you'll be able to get a good sense of where this blog will be in a few weeks (don't worry, I'll make sure to minimize any changes you have to make). Yes, it's going to remain free - PCC is stupid that way. Check it out, get ready, and sometime in September, expect a big change!

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What's pesto run day? My family belongs to a local community farm that raises, among other things, a lot of basil. Every year, I make a few giant pesto batches and freeze them. Frozen pesto is about 95% as good as super-fresh. At least it seems that way when it's -20F in January. Today, I figured I'd whip together lunch for the rest of PCC while doing so - in theory, all I have to do is cook some pasta and slap it on. Oh, here's my advice: most pestos call for pine nuts. They're good, but they're also $20+/#, often. My Vermont/Irish cheapskate kicks in and I have discovered that much-less-expensive CASHEWS not only work well, but are more interesting. You don't end up with a overpowering-cashew taste at all, just a sweetness like the pine nuts.

Now, exactly how many blogs do you know combine such high level pediatric practice management advice with cooking tips? Tell your friends!

Off to the farm. I'll have to fight mosquitoes, but it will be worth it.

As I work on my great content for tomorrow, I just realized that I haven't blogged about the upcoming Primary Care Audio Conference Series sponsored by Physicians Alliance and produced by PCC.

You can read about the entire thing (including full course descriptions and bios) on our WWW site, or peruse below. I am excited, as I think these teleconferences are a great way to reach a lot of practices without having to pay for gas...

Physicians' Alliance is pleased to introduce this Audio Conference Series on Primary Care Practice Management Topics. This series consists of six one-hour audio conferences designed to help you maximize revenue for the important work you do in primary care practices. Three national experts will cover topics that will help you save money and increase reimbursement.

In just one hour, you can explore solutions to important practice management issues that affect your office every day. You'll master insurance negotiation, learn the value of pricing using RBRVS, and explore physician compensation models. Our expert panel of instructors includes Susanne Madden of The Verden Group, Penny Noyes of Health Business Navigators, and PCC's Chip Hart. Click here to REGISTER NOW!

Admission to each audio conference session is $49 for Physicians' Alliance Members and $149 for non-members.

Not a member? Membership is Free! Click Here to become a Physicians' Alliance Member Today!

Audio Conference Series Schedule

Session 1	Session 2	Session 3
Thursday, August 21 12 p.m.-1 p.m. ESTInsurance Negotiation: Get a Competitive Edge	Wednesday, September 10 3 p.m.-4 p.m. EST It Took Two Decades for Private Payer Contracts to Erode the Bottom Line. Plan on a Two + year Comeback. Here's How!	Thursday, September 25 5 p.m.-6 p.m. ESTSeven Steps to a Successful Insurance Negotiation
Session 4	Session 5	Session 6
Tuesday, October 7 5 p.m.- 6 p.m. EST Don't Be Paralyzed - Analyze!	Friday, November 14 10 a.m.-11 a.m. EST Use the RBRVS to Set Your Prices Fairly	Friday, December 5 12 p.m.-1 p.m. EST Primary Care Compensation Models

The blog is going to be thin this week because I'm dawn to dusk at the Users' Conference. Today is our official Practice Management Conference and I still have to get my "keynote" speech together within the hour! Time to get out of my bathrobe.

It has been a pleasure seeing all the familiar faces, many of whom have posted here. One insight that I am brooding on is the growing focus on Medical Home/Chronic Disease Management/etc. I think there is a opportunity for a consultant to help practices develop effective Chronic Disease Management plans and connect them to the money in a way that benefits practices and the patients. Of course, the practices can do this themselves and it would be great if the AAP could map out a few examples (we did a good obesity/BMI one in class yesterday).

I also heard from an old friend yesterday who happens to be nominated for AAP President. I really like her ideas related to improving the media-savvy of the AAP, a concept that is loooong overdue. Anyway, check out Dr. Kraft's WWW site and consider voting for her! I am a strong proponent of having real, practicing pediatricians in key positions like this and it's nice to see we might have a chance to extend that streak.

Long overdue, but I did try to get them right. Thanks go out to Donelle Holle as well as Igor and Q who helped check them out before posting.

If you'd like a nice, neat copy, you can download the PDF. I was going to post the entire thing here, but it is much too long. Here is a sample Q/A:

1. What RVU is associated with 99058 (emergency)? Do insurers pay?

The 99058 CPT code has no RVUs. There are, indeed, many insurers that pay the office emergency code however. Of course, payment will vary from one carrier to another – payments are usually between $20 and $75. When using this code, remember to document the fact that the service was indeed an emergency, as we all know that not all walk-ins are emergencies.

Don't forget that we have another AAP-endorsed event scheduled for September!

The Verden Quarterly Report (Q2 2008) has been released! This is an amazing resource and the little comments about each ranking (in the blue box, off to the side of each page) are quite enlightening. And the price is right. Note that Oxford gets a most improved award, a distinct example of what I call the Verden Effect.

Make sure you have the latest copy of this guide when you do your insurance contract negotiations.

Oh, here's the press release:

The Verden Group Releases Second Insurer Ranking Report

Nyack, NY, 07/22/08 - The Verden Group has converted its proprietary Verden Alerts data into a single, free report that assesses the financial impact of thirty four major medical insurers' policy changing on their networked physicians and practices.

The report is available at http://www.theverdengroup.com/Reports/ManagedCareReport_Q208.pdf

The goal of the Verden Ranking system is to evaluate how insurance companies (payers) behave from the perspective of physician practice management. The data used to rank the payers comes directly from the companies themselves, as gathered by the Verden Alert subscription service. The Verden Alerts monitor insurer sites for any policy and procedure changes and alert subscribers based on their participation and specialty whenever changes are posted.

"Until now, medical practices who accept insurance have been working mainly in the dark when it comes to the policy and procedure changes insurers make," says Susanne Madden, Verden Group CEO. "The stakes are too high to allow it to continue. Insurers make astronomical profits by not passing through premium dollars to those that render care to insurers' members. Before we analyzed our Verden Alert data and created this report, there was no source for identifying policy modification trends - and the impact on physicians - except through anecdotal evidence."

The Verden Group summarizes the results into five key metrics important to any medical practice: Cost to Provider, Volume of Change, Clarity of Communication, Notification Period, and Posting Integrity. Then, a score is accumulated for each insurance company depending on the severity of the issue. For example, points are added as the volume of policy changes increases or as the changes negatively impact medical practices. Ultimately, the payers with the most points are, at least, the most cumbersome with which to do business.

Madden believes that having quantifiable data about how payers treat their networked physicians is a vital piece of knowledge to any medical practice. "Physicians should use this data to help challenge policies as they are being made, rather than just letting Payers set the agenda based on their own business initiatives. Not all payers are the same. Some

networks are managed worse than others and physicians can now make strategic decisions about which ones to participate in. The Rankings are an accountability tool to help aid in that decision-making."

For additional information on The Verden Group and the Verden Alerts, contact Susanne Madden or visit

www.theverdengroup.com.

Whew, we have finally gotten our ducks in a row and announce our Fall Pediatric Coding and PM conference in Columbus, OH on September 17. It's the usual deal: AAP endorsed and AAP members get in cheaper. The individual class titles include:

• Free Online Practice Management Tools
• Coding Primer
• Give Me the Money: How to Decrease your A/R
• The Codes You Leave on the Table
• Pediatric Physicians' Compensation Models
• Vaccine Coding: Preventive Medicine for a Healthy Bottom Line
• The No Surprises Chart Audit

Please check out the promotional site or register ASAP!

It's been tough getting to the blog the last week or so.

Every year, Physician's Practice magazine runs a series of surveys focusing on certain practice management issues - I've referenced their income report more than once - and they are running two more right now:

• The Annual Fee Schedule Survey
• The Annual Technology Survey

I strongly encourage folks to take the 5 minutes required to complete each survey - you have a chance to win $500 and, more importantly, it's an opportunity to feed a public source of well-needed information. The Fee Schedule survey (which is slightly mis-named, as it also focuses on reimbursement) is particularly important, imo. Sure, PCC customers can get this information with amazing accuracy and detail - for themselves and other PCC clients - but that's the rub...it's only for themselves and other PCC clients. Even though our sample size is a lot bigger, it's a biased sample.

Physician's Practice is the only real open source for this information beyond PCC customers.

I have noted that PCC continues to track a consistent reimbursement increase among our customers while PP notes a downward trend. I'd love to understand what the reality is - are our customers actually that much better off?

Head over, fill out the data!

Whew - after the conference on the 21st, I then spent a week in DC with my family (woohoo!) and have returned to over 160 follow-up questions that PCC has promised to answer. Those who attended the conference will receive a password-protected URL, just like last time, in a few weeks when we're done.

How'd we do? Thanks to 75+% of the folks who completed our brief survey, here are our scores (using a standard CEU survey):

Question	Score (1-4)
Knowledge of Subject	4.00
Preparation/Presentation	4.00
Class Materials	3.85
Time Spent Covering Information	3.86
How would you rate seminar overall	3.94

Not bad, if you ask me. A nearly perfect score from the attendees, overall. Of course, I note the "nearly" - something to strive for, I guess. Space-wise, this was a big improvement over NYC (which, given the cost, is a good thing).

Thanks to the AAP and Drs. Tuck and Lander for their help.

Meanwhile, if you missed this event, please note that we are hoping to continue this event in the fall (Cincinnati, Rochester) and next spring (Seatlle?). Any input on times and locations requested. However, you can also come to beautiful, summertime Vermont and get a full-blown pediatric practice management extravaganza, too.

More when I catch up, plenty of goodies to share.

Awesome, just awesome. I love it.

Over at The Verden Group, they've been busy working on their quarterly ranking program of the 160+ managed care organizations they track. They've developed a unique scoring system that allows you to see, in a wonderful graphic, exactly which insurance companies stink the most.

Perhaps I'll go on in detail later, but don't waste your time reading me today. Read the report. I'll just hit some of the text from the description:

The goal of the Verden rankings system is to evaluate how well or poorly managed care companies (Payers) are performing from the perspective of physician practice management...Our analysis is composed of five categories in which each insurance company was given a score. The more points accumulated, the worse the company fared. Points were designated based on multiple criteria, with each metric carrying a different weight.

You'll be surprised at a few of the rankings, but not all. You can finally quantify your instincts, though! Sneak peek: