For decades, nearly all practices were privately owned. Providers were tightly connected to their communities and knew their patients personally and professionally. Over the years, the independent practice owner has become a rarity, with increasing numbers of clinicians opting for employment within larger systems. Patients too began pursuing care from large, integrated healthcare systems, seeking convenience and coordination of care.
However, patients and providers alike soon realized the grass is not always greener on the other side. Now, as patients seek more personalized and attentive care – and physicians seek greater autonomy and flexibility – we see the return of the independent practitioner.
But how is an independent practice owner expected to compete with the large hospital systems, retail clinics, and private equity-backed practices that continue to flood the market?
Being independent does not have to mean doing it all or doing it alone.
Deciding What to Outsource – and to Whom
The pursuit of independent practice can be inspired by many things, including:
- An entrepreneurial spirit
- The desire to innovate care delivery
- The need for greater autonomy
- Burnout from employment within the system
- The desire to connect with patients more personally
Whatever the inspiration, one underlying factor rings true: independent practitioners want ownership of decision-making. While ownership of decision-making is important, execution can often be outsourced to free up additional time to focus on patient care and business strategy.
There can be uncertainty with outsourcing, especially for entrepreneurs who have invested their savings into opening an independent practice. Tasks must be outsourced to trusted healthcare experts who have experience supporting independent practices and understand your mission.
5 Things to Outsource as an Independent Practice Owner
These five things can be outsourced for execution after an independent provider has made strategic decisions as the business owner. Owners should remain involved and informed during the different stages of execution, but trust in their partners, vendors, or organizations to handle the details, paperwork, and processes.
Credentialing
When employed by a system, credentialing is often managed on your behalf. The first step independent practitioners should take in terms of credentialing is ensure they have access to their CAQH account and all documents within the account are up to date. Next, the practice owner will need to evaluate the commercial and federal payers available in their area and evaluate which payers they would like to be credentialed with.
“Credentialing is often cumbersome and tends to delay the launch of independent practices,” shares Kristen Lynch, RN, Clinical Consultant at NP Advantage, “We’ve had a number of clinicians turn to us for help after becoming frustrated with the credentialing and enrollment processes.”
Once these strategic business decisions are made, the credentialing process can be delegated to a vendor of the practice owner’s choosing. The vendor will manage the administrative processes of credentialing and renewals on behalf of the clinician, enabling the clinician to focus time and attention on other tasks.
Payer Contracting
Like credentialing, payer contracting is often managed on the provider’s behalf by an employer. Once credentialed with payers, clinicians must secure fee-for-service and/or value-based care contracts. The goal in this process is to negotiate for higher reimbursement for the services rendered within the practice. However, independent providers often have smaller patient panels, making it more difficult to secure higher reimbursement rates.
Here, there is strength in numbers. Independent clinicians should seek out local Physician Organizations (POs), Accountable Care Organizations (ACOs), and similar aggregations of providers who will negotiate with payers on their behalf. When negotiating with the payers together, these groups often can secure more lucrative contracts.
“We’ve gathered practices across the state, the majority of whom are independent providers,” shares Megan Sheridan, Director of the Consortium of Independent Physician Associations (CIPA). “Together, we have been able to greatly increase the fee schedules for our members, resulting in over $70 million in additional revenue for our clinicians.”
Practice Marketing
One of the greatest challenges independent practices face is growing and retaining their patient panel. Even with an increasing number of patients seeking attentive care, it is difficult for independent providers to break through the clutter of hospital systems, group practices, and retail clinics.
“Relying on practice staff to run your digital marketing as one of their many responsibilities is no longer an option for medical practices,” says Doug Boehm, Healthcare Digital Marketing Specialist at iHealthSpot. “Running a successful patient acquisition campaign takes the know-how and time that most independent practices lack.”
A well-established, unique online presence is paramount in helping patients find an independent practice and demonstrating the knowledge and experience of the provider. Outsourcing marketing efforts ensure practices have a high-quality website, regular social media cadence, online reviews, and more.
EHR Selection & Set-Up
With the growing number of electronic health record (EHR) software options, it can be difficult to identify the EHR that will best suit your practice’s needs. While there are a number of “budget-friendly” EHRs available, these tend to lack key features like customization, telehealth connectivity, and attentive support.
“Without the proper customization, efficiencies, and workflows in place, patient outcomes, and reimbursement tend to dip,” explains Lori Mohr, Director of Practice Solutions at Medical Advantage, “This can lead to shrinking profit margins, and worse, adverse patient outcomes.”
Experienced consultants pair the requirements of an independent provider with their vast knowledge of EHR systems to select an EHR that can support current needs and scale as the practice grows. Consultants also can help customization the EHR to streamline workflows so providers can focus their attention on patients.
Billing
Billing is the lifeblood of your practice. Without proper documentation, accurate claims, and timely reimbursement, independent providers can quickly find themselves strapped for cash. For smaller independent practices, it often is more cost-effective to outsource the billing process, typically charged as a percentage of billable revenue, rather than to hire an in-office billing staff.
“It’s not uncommon for independent practices to do their billing in-house, often managed by a friend or family member with no previous billing or healthcare experience,” shares Brandy Smuzeski, Clinical Manager with the Medical Advantage TDC ACO, “This often results in delayed reimbursement, denied claims, and poor value-based care performance.”
By outsourcing billing, practice owners can trust they are getting fully reimbursed for the services rendered in a timely fashion. As an entrepreneur and independent clinician, profitability is critical to maintaining and growing your practice.
Stepping Back
With so much on the line, it can be extremely difficult to let go of ownership of some tasks. However, there is no shame in seeking out help – especially when that help leads to less frustration, a larger patient panel, an improved financial position, and a better work-life balance. Have confidence in your vendors. Just as you are dedicated to optimal outcomes for your patients, your vendors are dedicated to successful outcomes for your practice.
ANGIE HOWARD is Vice President of Practice Solutions at Medical Advantage, which is a national healthcare consulting firm serving independent practices, practice groups, Managed Services Organizations (MSOs), and health plans and is a subsidiary of the TDC Group, the nation’s largest physician-owned malpractice insurer. For more information visit the company’s website at https://www.medicaladvantage.com/solutions, or contact Angie Howard directly at [email protected].
Angie Howard is Vice President of Practice Solutions, Medical Advantage.
