“There are few hard and fast rules that Medicare and the other payers are willing to tell us about,” said Dr. Hunter. “We don’t know that if we do these exact things, we are going to get X amount of dollars. As this evolves, it is imperative that we keep the staff up to date and be upfront about what we do, or do not, know.”
Explore this issue:June 2013
Remind staff that there is a time lag before finding out how much money, if any, was awarded. This lag can make it harder for both staff and physicians to stay focused.
“These incentives are usually not awarded until the end of the year,” said Witt. “It needs to be reinforced, probably multiple times, that we won’t know the results, or see the fruits of our labor, until next year. If possible, the practice may want to spread the bonus throughout the year, possibly quarterly, to maintain momentum and continually reinforce the need to focus on patient satisfaction.”
Another concern is that there may not be feedback from the various payers on how well a group is doing. It is very likely that the practice may not hear from the insurers until the notification that they have, or have not, qualified for the money.
Communicating what the payers are basing their reimbursement or bonus decisions on should be a priority. To meet the criteria, the staff has to know what it is going to be. This, too, may turn out to be a moving target as many payers roll out what are likely to be different programs.
“As the information on these plans is released, embrace them and do the best job you can implementing them within the office to take care of our patients,” said Dr. Smith. “With great change comes great opportunities, and the ones who embrace them are the ones who will be successful in the new health care system.”