Wellington, FL — (SBWIRE) — 06/21/2013 — The Wall Street Journal recently published an article that expressed two distinct points of view regarding financial incentives for physicians. The first opinion was that some companies believe that it would be suitable to pay physicians based upon outcome because there are sufficient quality benchmarks in place to do this. The second opinion is supported by the Cochrane Collaboration’s review which did not find any evidence that patient outcomes are improved by financial incentives.
According to Health Systems Management Network Inc. (HSMN), “When payment is based upon performance it can lead to a reduction in the quality of care that a patient receives because this contributes to a non-optimal mentality on the part of the doctors. Adding a financial incentive into a doctor’s considerations can shift that doctor’s attention away from where it should be focused.”
HSMN has been providing healthcare consulting services for 30 years and their experience in helping facilities improve reimbursements and patient care is nearly unprecedented. One of the common problems that they have found is that clinicians do not have the proper metrics to measure their own performance despite their genuine desire to help their patients.
The electronic medical record has played a large role in improving the scenario, but this still has not yet solved the issue of measuring performance. Many clinicians are still relying on patient feedback as a primary method of measuring performance and success.
HSMN believes an even larger issue that clinical practices often face is the lack of accurate clinical documentation that allows them to receive proper reimbursement. HSMN has examined data from hundreds of different practices throughout their 30 years of operation, and a representative from the company recently stated that physician practices that had a strong focus on improving clinical documentation were able to increase their physician practice reimbursements by 5% to 10%.
It should be noted that this increase did not come as a result of purchasing new billing software or utilizing the electronic medical record, but rather from careful analysis and improvement of clinical documentation. This is the main key to success. However, the needed improvements cannot be achieved without a staff that has been properly trained. The physician/clinicians must take it upon themselves to ensure that the staff truly understands what they do in order to see clinical documentation improvements.
There are several options that can be considered logical with regards to addressing the issue discussed above. HSMN frequently recommends that staff members should be hired who have the appropriate coding certifications and are also capable of doing chart reviews about the documentation in addition to the coding. There are many clinicians who want to do their clinical work as their own boss rather than feel as though they are owned by anyone. In those types of scenarios, the programs that are endorsed and implemented by HSMN have proven themselves to be extremely beneficial.
About Health Systems Management Network
HSMN was formed in 1987 and continues to be a leading hospital consulting and health services management company. Their client list includes hospitals, medical practices, medical staff and clinical departments of large academic medical centers throughout the country. Core services are revenue cycle management, clinical documentation consulting, ICD-10 implementation and post Epic workflow consulting.
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