The Verden Group

Patient Portals Can Help You Meet Medical-home Criteria

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Pearl | October 08, 2014 | Patient PortalsMeaningful UsePatient RelationsPearlsPractice Models

If you are thinking about implementing a patient portal, or already have one in place, you may not realize that this is a great tool to help you meet certain criteria necessary for achieving Patient-Centered Medical Home (PCMH) recognition.

Many portals offer the components required to meet part of the National Committee for Quality Assurance’s (NCQA) PCMH Standard for patient-centered electronic access. The purpose of doing so is to allow the practice to offer information and services to patients and their families via a secure electronic system whereby patients can view their medical record, access services, and communicate with the healthcare team electronically.

Providing electronic access to this information also enables practices to meet meaningful use requirements, so you get a double return on your portal investment if you are attempting to meet requirements for both the NCQA PCMH and meaningful use programs.

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New Practice Models Are Gaining Acceptance in Primary Care

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August 20, 2014 | Great American Physician SurveyPatient RelationsPhysician CompensationPractice ModelsWork/Life Balance

Manhattan cardiologist Arthur Weisenseel has enjoyed a long and satisfying medical career; one that encompassed teaching at New York-based Mt. Sinai Hospital, running a successful cardiology practice with another physician, and stewarding his aging patients into a healthy old age. But, somewhere in the last five years to 10 years, his practice became problematic. Weisenseel says that despite working as hard as he could, he wasn’t able to consistently pay both practice expenses and himself. He says of that time, “I worked awful hard to get [there]. And to go home without reimbursement was becoming demoralizing.”

So, like a growing contingent of like-minded physicians, Weisenseel decided to explore other practice models. Encouraged by his patients and positive conversations with colleagues, he has now successfully converted his practice to a hybrid-concierge model, where patients can choose to pay an extra fee for concierge services or continue to reimburse him through traditional insurance plans like Medicare and third-party payers. Now he couldn’t be happier: Relieved of worries about financial and regulatory burdens, he says, “I come to work with joy and confidence.”

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Patient-Centered Specialty Practice for Specialists

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While still in its infancy, word about the National Committee on Quality Assurance’s (NCQA) medical home program for specialists is spreading fast. The program was released last March and appears to be gaining considerable momentum. We receive inquiries daily from practices asking how we can assist them with meeting the program’s standards; from gastroenterologists, oncologists, nephrologists, orthopedists, even ophthalmologists.

Unlike the primary-care Patient-Centered Medical Home (PCMH) program that has taken several years to become firmly established, it appears that specialists are “early adopters” of this new similar program — Patient-Centered Specialty Practice (PCSP) — designed especially for them.

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NYS Insurance Price Wars

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One of the puzzling questions about the Health Insurance Exchanges (a key component of the Patient Protection and Affordable Care Act) is, “How can the same products have such variations in premium pricing?” Differentials of between $200 and $500 a month are noted for the same metallically labeled products.  Why the difference? Answer: the insurance carrier.

The lowest prices have been associated with the newest entrants into the NY market, Heath Republic and OSCAR. The established payers, such as Empire and, in particular, United Healthcare, were priced at the high end.

Since all products are essentially the same in terms of benefits, the difference would be in the costs of the network that supports the payer’s product and the pricing philosophy of the company.

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The Verden Group is delighted to welcome Paul Vanchiere, MBA, and Sumita Saxena, JD, to our consulting team.

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With over 15 years of healthcare management experience, Paul Vanchiere joins The Verden Group to provide our clients with financial and operational practice consulting; Sumita Saxena, admitted to the California State Bar in 2000, brings her legal focus to the Group in the capacity of business consulting services.

“The addition of specialized consultants Paul and Sumita means our service offerings are more comprehensive than ever,” says Susanne Madden, CEO and founder of the Verden Group. “Their combined expertise ensures our clients have the benefit of expert business advice and practice management tools. Sumita’s focus ranges from guidance on employment laws, to negotiation and language interpretation for insurance contracts. Paul offers a unique financial analysis of Pediatric practices, including onsite assessment, that gives our clients the tools to meet every day challenges more efficiently at a price they can afford.”

To learn more about Paul Vanchiere and Sumita Saxena, and to read more about these new offerings from The Verden Group please click on the links below.

More on Paul Vanchiere:

www.theverdengroup.com/articles/verden-group-welcomes-paul-vanchiere-team/

More on the Complete Pediatric Practice Assessment:

www.theverdengroup.com/services/practice-management/

More on Sumita Saxena:

www.theverdengroup.com/articles/verden-group-brings-legal-context-guidance-business-matters/

 

 

 

 

 

The Verden Group welcomes Paul Vanchiere to our team.

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The Verden Group is pleased to welcome the founder of the Pediatric Management Institute, Paul Vanchiere (MBA) to our team. With over 15 years of healthcare management experience, Paul joins The Verden Group to provide our clients with financial and operational practice consulting.

Currently working exclusively with Pediatric practices, Paul’s past experience with cardiology and pathology practices, as well as physician practice acquisitions for the largest non-for-profit hospital in Texas, adds a unique depth to our client services. For the past five years, Paul has worked on financial and management issues for a physician group of over 200 general Pediatricians.

Paul_Vanchiere“Paul brings considerable experience to our group. As a speaker on a range of pediatric practice management issues and with a national portfolio of clients, his extensive knowledge of practice dynamics will play a pivotal role in our efforts to provide unparalleled service to our clients,” says Susanne Madden, founder of The Verden Group. “Paul’s seasoned practice management expertise allows us to provide our Pediatric clients with the tools to not only meet every day challenges, but to do so successfully as the healthcare environment continues its dizzying pace of change.”

Paul will focus on a unique service that provides a full financial analysis of Pediatric practices along with an onsite assessment for a nominal fixed price. According to Paul, “Pediatricians often have limited resources to invest in such engagements. I am extremely sensitive to their investment of time and resources in what we do for them. I strive everyday to provide tangible advice on how to manage their practice properly.”

Paul can be reached at paul@theverdengroup.com and more information about these services can be found here.

The Verden Group Brings a Legal Context to Guidance on Business Matters

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The Verden Group is very pleased to announce the addition of Sumita Saxena, Esq., to our consulting team. Admitted to the California State Bar in 2000, Sumita brings her legal focus to the Group in the capacity of business consulting services, specializing in matters such as practice agreements, guidance on employment laws, and negotiation and language interpretation for insurance contracts.

“The addition of Sumita to our team brings the level of services we provide up another notch,” says Susanne Madden, CEO and founder of the Verden Group. “We’re not a law firm. We work in a strictly non-legal, business-only capacity when advising clients but the fact is that legal issues are a part of doing business in healthcare today. Sumita’s expertise ensures our clients have the benefit of expert business advice on these matters and are guided appropriately as to when to seek legal counsel.”

With current experience as in-house counsel for a medical group, Sumita has the hands on expertise required to confidently advise Verden’s clients on the development of sound business operating procedures and practices from a legal perspective. Sumita also has extensive experience working on employment matters, workforce & performance management, and human resources management.

She is located in Redwood City, CA, and can be reached at sumi@theverdengroup.com

 

 

 

How You Can Successfully Participate in P4P Programs

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Pearl | April 30, 2014 | PerformancePayersPearlsPhysician Compensation

 

Participating in pay-for-performance (P4P) programs can work out well for both provider and payer. By “performing well” on certain clinical and administrative measures, savings are created that can be shared with both parties. That is, if providers can meet specific metrics that appear to produce some savings by, say, coordinating patient care better or ensuring that the population is receiving timely preventive care, then everyone wins and costs go down.

However, it can be a little perilous to participate in these programs if you don’t have a good understanding of your own data. Signing up to meet specific goals without first knowing where you currently stand or without being able to monitor progress as you go along a defined time period can mean falling short of expectations and losing out on additional revenues. So, it is vital that you must be able to run reports in your own system to either validate or dispute the data that the payer will be producing, in terms of how your providers have performed. Depending on your IT infrastructure, this may or may not be an easy task!

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Participating in New Healthcare Exchange Plans

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Pearl | February 19, 2014 |

It is early with regard to the healthcare exchange plans and yet practices across the country are already feeling the impact. It’s not just consumers who have experienced problems while attempting to sign up for the exchange plans on the healthcare.gov website; providers too are dealing with major headaches as they navigate through the first couple of months of this new system.

Looking for more information about the effects of healthcare reform on your medical practice? Join us May 2 & 3 in Newport Beach, Calif., for Practice Rx, a new conference for physicians and office administrators.

Let me explain. The insurance companies created something called “narrow networks” within their full network of providers. What that means is that only a subset of physicians within any given insurance company’s network “qualified” for participation in the exchange plans. The result is that while some physicians got rolled into these plans, others were excluded, even though they participate in some of the other products with that particular insurance company. For example, a physician could be participating with an HMO and a PPO-type product, but be excluded from the exchange product. This has created a dilemma for many practices. On the one hand, it means no new business coming in from new exchange members. On the other hand, it also means scrambling to hold onto existing patients that have switched to these new, lower-priced health insurance products.

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Medical Practice Super Groups, Are They for You?

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PHYSICIANS PRACTICE Pearl | November 20, 2013 |

Practices today are facing challenges such as lower earnings, more complex regulations, higher costs, obligations to create higher-quality care and produce better outcomes, all while they see other colleagues merge or become acquired by local hospitals or healthcare systems. So at least once a week I get an inquiry from a physician asking, “Should I sell my practice?”

There is no single answer to that question. It depends on many factors, including whether or not the practice is in good financial shape and if it is well managed. I do consider those to be two of the strongest indicators for successfully remaining independent. However, the options shouldn’t be limited to either selling or remaining independent.

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