Saturday, January 5, 2013


Physicians:  Preparing for Uncertainty
He is no wise man who quit a certainty for an uncertainty.

Samuel Johnson (1704-1795). Dictionary
January 5, 2013 -  After the fiscal cliff resolution, if you want to call it that,  in which physicians again evaded the dreaded SGR cut, this time 27.4%, only two things emerge as  certain:
One,  Medicare will inevitably revisit physicians reimbursements again.  After all, Obamacare, which cuts $716 billion out of Medicare over the next decade, funds itself by systematically cutting hospital and physician reimbursements for the next ten years, to less than Medicaid by 2019.
Two,  this 2012-2013 go-around,  Congress, unceremoniously and without regard for the plight of Medicare and Medicaid recipients,  cut hospitals,  renal dialysis programs, and other ancillary provider programs.     Once the SGR crisis has blown over, physicians will surely  not be spared further cuts, particularly high tech specialists with high cost procedures in the cardiology,  orthopedic, and cancer fields.
If future physician cuts are a certainty, and I believe they are, given the fact that Medicare is the number one contributor to the escalating national debt,  how  can physicians due to prepare for the predictable.

To prepare, says James Doulgeris, in a January 13, 3003,  article in Physicians Practices.
Cut every expense that does not produce revenue, save money, and/or strengthen your private/public payer mix. Invest in those that do, particularly care coordination and patient communication technology;

Evaluate every operational process to gain efficiency and improve quality;

Establish and post cash pricing;

Set clear and measurable employee performance expectations, communicate them, and dispassionately evaluate every employee, retraining or replacing them if they don’t pass muster.

Match the right skills to the right job;

Evaluate every vendor and professional advisor (accountant, lawyer, etc.) and, if they aren’t a significant asset, replace them with experienced professionals who understand your business and provide an acceptable return. Learn value versus cost;

Drop by with a catered lunch to your best referral sources at least quarterly.

Tweet:   Physicians should anticipate further CMS (Medicare and Medicaid) cuts by  cutting expenses, gaining efficiencies, and posting cash prices.

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