Posts Tagged MGMA


Texas Medical Association Video: Grandma and the Big Bad SGR

I haven’t written much about the impending 29% Medicare physician payment cut. This threatened cut has happened every year for the past 10 years. Every year at the last second, Washington is convinced that if cuts take place, physicians really will stop seeing Medicare patients and they halt the cut.

It’s not a bluff. Physicians can’t afford to see Medicare patients, TriCare (ex-military) patients and disabled patients with Medicare benefits now, and they will drop out by the tens of thousands if they get paid any less. Any businessperson worth their salt will tell you that when revenue does not exceed expenses, you do not have a sustainable business model. Physician have cut expenses to the bone, taken deep cuts in their salaries and ultimately have sold their practices when they just can’t make it anymore.

But never mind the doctor, what about the patients? What happens to them when physicians stop seeing Medicare patients? Texas Medical Association has made an outstanding video that explains it in language we can all understand.



Other organizations that are working to eliminate physician reimbursement being tied to the SGR are MGMA and the AMA.

Posted in: Headlines, Medicare & Reimbursement

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Physician Productivity Bonus Model: A Hybrid of Work RVUs and Encounters

Based on a great conversation I had on LinkedIn recently, I decided to write about physician productivity models and the hybrid model (encounters and work RVUs) I developed for a hospital-sponsored family practice program. This bonus model rewards providers seeing less patients with more acute needs as well as providers seeing more patients with less acute needs.

Here are the components of this model:

  1. SCHEDULE: The providers are available (have an open schedule) four 8-hour days per week, or 32 face-to-face patient hours per week. Providers are expected to work four 10-hour days, with the additional 2 hours per day used for reviewing records, approving prescriptions, etc. This was pre-EMR for this group.
  2. ENCOUNTERS: The providers have an agreed-upon schedule which averages 22 patients per 8-hour day. (In this model, new patient visits are 40 minutes and established patient visits are 20 minutes.) Subtracting the providers time off, the schedule works out to 3828 patients per year, or 957 patients per quarter. For every patient they see over 957 patients per quarter, they receive $10 per patient. The providers receive encounter credits for nursing home and indigent care clinic work during office hours.
  3. WORK RVUs: Based on the encounters, work RVUs are calculated at 4073 per year, or 1018.25 per quarter. Every work RVU over 1018.25 per quarter receives a bonus of $10.
  4. EXCLUSIONS: The providers did not get credit for anything they did not do personally – no credit for ear lavage, vaccines, allergy shots or laboratory tests. They did not get credit for any no charge visit, either as an encounter or as a work RVU.
  5. VALIDATION: Both encounters and wRVUs were also matched up to physician productivity surveys to make sure the base salary was comparable to the base productivity.
  6. EXAMPLE: A provider seeing the 23rd patient of the day  – perhaps a 99214 (work RVU 1.50) will get $10 for the encounter and $15.00 for the wRVU for a total of $25.00. By seeing an additional 99214 every day during the quarter, the bonus would be $1600 for the quarter. Because the appointment times were generous, there was a high probability that additional patients could be worked in daily, allowing the providers to see more than 22 patients per day without killing themselves.


Posted in: Finance, Physician Relations

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Maximizing Your Career Potential With Practice Management Credentials

In addition to onsite and online undergraduate and graduate programs in healthcare administration and management, there are a number of programs that offer certification and registration (both terms meaning the same thing) for career healthcare managers.

When researching programs, some questions you should ask are:

  1. How long has the program been in existence?
  2. How many people have been credentialed through the program?
  3. What are prerequisites (education, experience, references, other)?
  4. Does the program have an education component in the form of mentoring, coaching, conferences, webinars, online classes, or in-person classes?  Cost associated with each?
  5. What information is covered in the exam? How can I learn this information?
  6. What is the exam format (objective, essay, interview, presentation, other)?
  7. What is the exam media (paper & pencil, online at home, online at testing center, other)
  8. What are costs if the exams have to be repeated?
  9. Do you have any data about the earning power or success of those credentialed through your program versus those from other programs?


American College of Healthcare Executives (ACHE)

Cost: Membership requires a Bachelor’s degree. Annual dues are tiered and escalate from $150/year to $325/year over five years.  Fellow exam is $450, recertification is every three years.

  • Fellow American College of Healthcare Executives (FACHE)


American College of Medical Practice Executives (ACMPE)

Cost: The education arm of Medical Group Management Association (MGMA), $275 annually (one-time $95 application fee), knowledge assessment $95, Body of Knowledge Review $29 each domain, exam workbook $119, objective exam $165, essay exam $165

  • Certified Medical Practice Executive (CMPE)
  • Fellow American College of Medical Practice Executives (FACMPE)


American College of Physician Executives (ACPE)

Cost: Membership $280/year, Master’s degrees for physicians only

  • University of Massachusetts, Amherst (online part-time MBA)
  • University of Southern California (Master of Medical Management)
  • Carnegie Mellon University (Master of Medical Management)


International Association of Registered Health Care Professionals (ARHCP)

Cost: $120/year for membership, $385 per exam

  • Registered Medical Manager (RMM)
  • Registered Medical Coder (RMC)


Physician Office Managers Association of America (POMAA)

Cost: Annual membership $110, study guides $100 each, exams $275 each

  • Certified Practice Manager (CPM)
  • Medical Coding Specialist (CPM-MCS)
  • Human Resource Specialist (CPM-HRS)


Practice Management Institute (PMI)

Cost: $799 – $999 for each program and exam – program available in-person, online or self-study.  Annual recertification $75/year

  • Certified Medical Office Manager (CMOM)
  • Certified Medical Compliance Office (CMCO)
  • Certified Medical Insurance Specialist (CMIS)


Professional Association of Health Care Office Management (PAHCOM)

Cost: $195/year membership, study guide $150, practice test $150, exam $385, recertification every 2 years $75

  • Certified Medical Manager (CMM)


The American Academy of Medical Management (AAMM)

Cost: $378/year membership – certification is available with or without exam for $259, recertification is $179 every 3 years

  • Certified Medical Staff Recruiter (CMSR)
  • Certified Administrator in Physician Practice Management (CAPPM)
  • Executive Fellowship in Practice Management (EFPM)
  • Physician Fellowship in Practice Management (PFPM)
  • Fellowship in Medical Staff Development (FMSD)


You may also want to read an earlier post on Manage My Practice: “How Does One Become a Medical Practice Manager?”
and read the other posts in the Category : A Career in Medical Management by clicking on the category on the sidebar to the right.

Posted in: A Career in Practice Management

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An Interview With Author and Conference Innovator Adrian Segar: Conferences That Work

I could write thousands of words about Adrian Segar and “Conferences That Work” because my conversation with him went that far and that long and he was that interesting to speak with.

Adrian told me “I am on my fifth career” and that “the arch of my life makes sense.”  What a wonderful thing – to have one’s life make sense.

He has been an academic, a physicist, an IT consultant, a conference developer, and now, a consultant to others searching for ways to make conferences work.  His book “Conferences That Work” was published last year and is now gaining the recognition it deserves.  Among others, he has been consulting with MGMA on the new “EDGE” program they are unveiling for 800 people in March 2011.

Adrian and I covered a range of topics and we discussed my dwindling interest in attending conferences for the past several years.  He, too, had been disappointed in conferences – even those he organized – and was determined to find why traditional conference aren’t making the grade any more.

His book outlines four assumptions that traditional conference planners make:

Assumption #1. Conference session topics must be chosen and
scheduled in advance.

Assumption #2. Conference sessions are primarily for
transmitting pre-planned content.

Assumption #3. Supporting meaningful connections with other
attendees is not the conference organizers’ job; it’s something
that happens in the breaks between sessions.

Assumption #4. Conferences are best ended with some event that will hopefully convince attendees to stay to the end.

Adrian’s starting point was the current conference model of passive learning  – letting others choose the topics and speakers and offering attendees limited opportunities for anything besides pre-determined content.  He moved from the model of passive learning to peer learning – leveraging the power and knowledge of the attendees to harness the hot topics of THAT MOMENT, not the moment that the conference committee met to determine the educational content 12 months or even 6 months ago.  He noted that the best conference committees are able to guess less than 50% of what attendees really want from a conference.

Adrian uses the example of social media to illustrate the difference between broadcasting information (old) and partnering to share information (new), and notes that the goal of Conferences That Work is to “bring the resources of all attendees to each attendee.”  I’ve been to a one-day meeting that accomplished that goal and I left the “camp” feeling energized, overrun with ideas and already connected through Twitter with almost everyone at the well-attended program.  It was amazing.

If you are developing meetings or conferences for your church, your charity, your local or state managers group or for any other type of group, or if you want to see the future of conferences, you owe it to yourself to read “Conferences That Work” by Adrian Segar.  He’s on a mission and he’s going to design and rock a conference that you, if you’re lucky, will attend some day soon.

Excerpts from his book are available here.

Free downloads to assist in making conferences that work are here.

His blog is excellent and can be found here.

Posted in: Innovation, Memes, Social Media

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How Much Do Medical Practice Managers Make?

Read the 2011 update to this article here.

You’ve heard that healthcare is one of the few job markets that is still growing in a down economy and you think you might like to be a medical office manager.  The question is: how much do medical practice managers make?

The real answer to this question is  “it depends.”  Two people in different parts of the United States could have the same job description and one could make $50,000 and another could make $100,00.  Most experienced, capable medical practice managers make a good living somewhere in the middle.

What differentiates medical practice managers (and I use this term in a generic sense to cover the variety of titles used in the healthcare field) from other office managers is that they are expected to know something about almost everything.  A typical day in the life of a medical manager might well include tasks in the areas of:

  • human resources
  • risk management
  • coding and billing
  • credentialing
  • accounting
  • information technology
  • facilities management
  • conflict resolution
  • physician compensation plans
  • marketing
  • physician/provider recruiting
  • and more! (see my post on what managers do here.)

The medical practice manager is often in the unique position of both answering to the owners (physicians) and managing them – a phenomenon not seen in other industries.

What a medical practice manager earns relates to:

  • what the decision maker(s) believes the job is worth, or what they’re willing to pay
  • what a consultant or financial adviser has said the job is worth
  • what other local practices are paying their managers
  • what the previous manager made

Factors influencing the posted salary for a position are:

  • the specialty or specialties (single-specialty vs multi-specialty and primary care vs. sub-specialty care)
  • the number of physicians/providers
  • the number of sites or ancillary services (imaging, physical therapy , medical spa, ambulatory surgery center)
  • hospital-owned vs. non-hospital-owned
  • if hospital-owned, how the position is graded, or where it fits in the management structure
  • billing in-house or outsourced
  • financial soundness of the entity
  • the entity’s competition in the community
  • cost of living factor for region

Factors that might influence the salary ultimately offered YOU for a position are:

  • Years of experience in healthcare management
  • Years of experience managing the same or similar specialty
  • Years of experience managing the same or similar # of physicians
  • Stability of jobs over the past 10-15 years
  • Special degrees: Master’s, CPA, CPC, Compliance, RN, Lean, Black Belt (Six Sigma)
  • Having installed an EMR (electronic medical record)
  • References

Where does one look for specific information on what managers make?

The Bureau of Labor Statistics’ (BLS) most recent information reports:

Median annual wages of wage and salary medical and health services managers were $80,240 in May 2008. The middle 50 percent earned between $62,170 and $104,120. The lowest 10 percent earned less than $48,300, and the highest 10 percent earned more than $137,800. Median annual wages in the industries employing the largest numbers of medical and health services managers in May 2008 were:

General medical and surgical hospitals $87,040
Outpatient care centers 74,130
Offices of physicians 74,060
Home health care services 71,450
Nursing care facilities 71,190

According to a 2009 survey by the Professional Association of Health Care Office Management (PAHCOM), the median salary for health administrators in small group practices is $56,000; for those in larger group practices with 7 or more physicians the median is $77,000.

The silver-back of healthcare salary surveys comes from the Medical Group Management Association (MGMA). The Management Compensation Survey is one of the “golden trio” of surveys that I’ve used throughout most of my professional life.  You can view a sample page here: Sample Table (pdf).  The survey information is free if you are a MGMA member and participate in the survey yourself.  You can purchase the Compensation Survey here.

Many state MGMA groups also sponsor state salary surveys and sell them to non-members.  In addition, some local manager groups do limited surveys and make the information available for a fee.

Job descriptions for medical managers can be found under the Library tab at the top of the page.

More articles on medical management can be found under the category of “A Career in Medical Management” on the right-hand side of the page, including A Day in the Life of a Practice Administrator” and The 5 IT Skillsets Every Physician Practice Manager Needs to Succeed in 2009 and Beyond.”

Posted in: A Career in Practice Management

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Electronic Medical Record Guru Rosemarie Nelson Reveals Best EMR Product on the Market Today

Okay, okay, so I shamelessly lured you into reading this post by telling you Rosemarie Nelson would reveal the “best” EMR product on the market, and she really does, only not in the way you wish she would.  Read on to the end of this post for her EMR advice.

It was my pleasure to talk with Rosemarie Nelson after she had given her third presentation (!) at the North Carolina MGM Fall Meeting at Pinehurst this past October.  As we visited, I realized I’ve been listening to Rosemarie talk about electronic medical records for at least 10 years.  If you don’t know Rosemarie, she’s a running fanatic, an EMR guru, Principal Consultant with Medical Group Management Association (MGMA) and she has 15 years of consulting in operations and technology under her belt.

When I asked her why it’s so hard to implement electronic medical records in a physician’s office she said: “Medical practices are a home-grown industry, really a cottage industry, so every single one is different.  There are specialty differences and workflow differences and many EMR vendors don’t know how to address this.”

Rosemarie particularly enjoys helping groups to fix poorly implemented systems and often finds that vendors have not carefully looked at the way the client physicians work before selling them a system.  She has experienced the many unique ways that practices operate, and why they operate that way, and has been able to bring EMR success to over 300 practices during her tenure.

Rosemarie recommends that practices take electronic records a bite at a time.  She suggests that groups start with one component, maybe ePrescribing, or messaging or electronic test results, and get it working really well. Although vendors might prefer that a group follow its timeline, there is no reason that a practice cannot set its own timeline.  Finding out if a vendor will be flexible to a group’s unique needs and timeline is a must-have question when developing a RFP (Request for Proposal.)

The dichotomy of the physician (“make it so”) and the administrator (“take it slow”) is another challenge medical practices face.  Many physicians want EMR to happen quickly and painlessly with no interruption of workflow. Rosemarie suggests to these physicians that they should “refer their business to a specialist (her), just as they would refer their patient to a specialist.” Working through the process takes time.

Here are some other observations from Rosemarie:

  • “Apply the EMR as a tool to the operations, it is not an end to itself.”
  • “Accept the incremental benefits” of the electronic medical record.  “All or nothing is a losing propostition.”
  • On the Stimulus Money for implementing EMR: “Do it because of the benefits and if you qualify for the stimulus, all the better.”
  • On preparing an RFP (Request for Proposal): “Define the deliverables, the timeline and the money and focus on your practice’s absolute needs.”
  • On scanning old paper records into the EMR, she says “Only 25% of documents stored are ever used again.”
  • On savings using ePrescribing (besides the Medicare bump): “ePrescribing can save each FTE provider $15,000 per year on average.”
  • On using electronics to make the medical practice more efficient, “A typical primary care practice might get 85-100 patient calls per day.  Try to offload 30% of those calls per day to electronics – ePrescribing, patient secure messasging, electronic lab results, appointment requests, etc.”
  • On her favorite client story: “A cardiologist who did not want to do ANYTHING differently, saw me two years later and told me that EMR was the best thing that had ever happened in his practice!”
  • Her favorite tip: “Add your website address to your appointment reminder calls!”
  • And…her most asked question ever – Tell Me Which EMR to Buy, to which she replies, “There really is more than one good product out there.  Buy the one that matches your needs and your workflow the best, and it will be the right one for you!”

You can reach Rosemarie Nelson here:

Posted in: Electronic Medical Records

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Guest Post: MGMA’s Bill Jessee Discusses How MGMA Can Help You Meet 4 Key Medical Practice Trends

By William F. Jessee, MD FACMPE
MGMA President and CEO

Spend one day in the shoes of an MGMA member and you’ll experience the challenging, changing environment of a practice administrator. Our industry is always in flux: new healthcare information technology to implement; new CPT and ICD codes to bill; new insurance plans to support. MGMA is changing, too, to support new and current members and help them thrive in the face of change.

While 70 percent of our membership remains directly employed by medical practices, new member trends indicate that about a quarter of all MGMA members who joined in 2009 came from other types of healthcare organizations, including integrated delivery systems (IDS). Also this year, more than half our new members are 45 or younger. More current and new members are attaining or have attained Master’s degrees.

As our membership changes, so does the state of healthcare. Members frequently ask me about current healthcare trends. Here are four we’re watching and what MGMA is doing to support our members during these changes:

  • Larger systems, influenced by the government, to become the norm

In 1975, 68 percent of physicians worked in one- or two-person practices (1).  By 2005, that proportion had fallen to 32 percent and has probably declined more since then (2).  I think group practices will increasingly merge to form larger groups, integrate with other specialties to form multispecialty groups or become fully integrated with hospitals (our new membership numbers reflect this) in order to compete in the marketplace.

Also, much of the Federal reform legislative language favors larger, more complex practices, e.g., incentives for implementing electronic health records, electronic prescribing and quality reporting.  Penalties for not adopting new technology could hit smaller practices harder. There is even talk of exempting physicians in systems from any Medicare Part B payment caps that might otherwise apply.

  • Hospital-owned groups already on the rise

MGMA’s physician compensation survey data indicate the proportion of physicians working in hospital-owned groups has steadily grown over the last several years. Both primary care and specialties are affected. The economic reasons for this are clear: Between 2001 and 2009, the Medicare conversion factor rose only 1.1 percent, while the consumer price index rose 24.2 percent; and median practice operating costs (for multispecialty groups) went up 43.1 percent. No matter the business, it’s a challenge to remain a viable, free-standing practice when revenue is flat and expenses increase by 6 percent or so a year.

This year we’ve ramped up efforts to provide practice management support for organizations that are part of  IDSs. In our various print and electronic member publications, we’re featuring more stories and examples of what it takes to successfully run these health systems, and we recently published a book dedicated to the topic. At the MGMA 2009 Annual Conference, Oct. 11-14, we held IDS-specific sessions that drew more than 900 people, proving this aspect of practice management is here to stay.

  • Practices increasingly collecting from patients

MGMA polled members earlier this year about their top challenges, and collecting from self-pay patients landed at number four (3).  As high-deductible health plans, health savings accounts and uninsured self-pay patients have increased in recent years, collecting the patient’s share of the bill has become a greater challenge. MGMA is completing research on patient collections and we will release results early next year.

  • Healthcare reform on the mind

We couldn’t forget about this topic. Impending healthcare reform legislation means even bigger changes to come ”“ ones that require adaptation so healthcare management professionals and their organizations won’t become irrelevant.

No matter what the outcome, health insurance is likely to expand, and new taxes and/or payment cuts seem likely. MGMA is monitoring the latest developments and sending weekly e-newsletters to members through the MGMA Washington Connexion (membership required.)  Our public policy and advocacy staff in Washington, D.C., is advocating on behalf of medical practices and has sent numerous comments and letters to Congress and the Administration regarding proposed legislation, especially to assure that administrative simplification measures are included in any bill that is eventually passed.

1.    Goodman L, Bennet E, Odem R. Current status of group medical practice in the United States. Public Health Rep., 1977;92 430-433.
2.    Cook R. Finances driving physicians out of solo practice. American Medical News, Sept. 10, 2007.
3.    Schneck L, Margolis J. Medical Practice Today: What you have to say. MGMA Connexion, July 2009, Vol. 9, No. 6, p. 28.

Posted in: Headlines

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16 Tips for Landing Your Next Healthcare Management Job

I wrote this post for the MGMA In Practice Blog and have republished it here for my readers.

I resigned from my job managing an orthopedic group on Jan. 20, 2009, and I remember thinking, Who leaves a job during a recession? Well, I did, and what follows is what I learned on my three-and-a-half month journey to my new position.

  1. Visit the MGMA Career Center job search site often. Try different categories and occasionally check categories you don’t think you fit in ”“ you never know. I don’t suggest this because I am writing for the MGMA blog, I suggest it because it is a resource that I believe in.
  2. Four state MGMA sites integrate their “jobs boards” with the MGMA Career Center: Colorado, Georgia, New Jersey and Montana. Search other state MGMA sites; some allow non-members to access the job listings.
  3. Get a LinkedIn account (free) at and complete your profile, connect with colleagues, join groups and start networking. There are healthcare jobs listed exclusively on LinkedIn, as well as an aggregation of jobs listed elsewhere. Joining MGMA’s new LinkedIn group will help expand your network even more.
  4. In addition to LinkedIn, be sure to have your expanded resume on the web. MGMA provides a platform for this, as does (free). I use because it allows me to include articles I’ve authored, recommendations from former employers and even video. I’ve gotten a number of quality calls from recruiters who saw my expanded resume online.
  5. Contact consultants to let them know you are in the market. MGMA has a consulting arm that often places healthcare executives, and you can also search for consultants via the MGMA Member Directory (members only) which at last count numbered about 640.
  6. Contact your colleagues and MGMA friends to let them know you’re looking. If you are looking for employment in a particular region or community, contact managers working there and let them know about your search.
  7. Look on Yes, really! You would be amazed who advertises there.
  8. If you expect to relocate, having a home to sell may be a hiring stumbling block because of the housing market. Employers want to know you’ll be available to work when they want you. If you don’t have a home to sell, mention that in your cover letter/e-mail.
  9. When you apply for a position, ask the receiver to let you know that your e-mail arrived. If they respond, take the opportunity to respond back, which helps you to stand out from the pack and gives you a name to follow up with in a few weeks by e-mail.
  10. There is a pack! Some employers told me they had received more than 200 mostly qualified applications for open positions. How do you stand out in that kind of a crowd? Network, network, network. Find out whether you or someone you know knows someone at the potential employer and work it.  LinkedIn has an excellent system for finding out who you know that works at the employer you are targeting.
  11. Join more listservs on the MGMA Member Community (members only). Step outside your current/past specialties and join other professional e-mail lists to listen and contribute to the conversation. Respond when someone talks about a job opening.
  12. Talk to recruiters. Recruiters don’t owe you anything, but they are worth including in your search. Get into the minds of a recruiters and see what tactics they’re using on social networking platforms to fill jobs.
  13. Don’t spend much time on non-healthcare job boards. The likelihood that you will find the job of your dreams on or is low.
  14. Don’t be afraid to look for a job on Twitter. This is what I tweeted: “Calling on the Power of Twitter: looking for new job: private (phys) practice mgmt/other healthcare opp. Innovator, Blogger. DM me – Thx.” If you want to jump into Twitter but don’t know what it’s all about, read this post at my blog, Manage My Practice, or MGMA’s Twitter guide. Twitter has recruiters, consultants, employers, job boards and colleagues and is one of the fastest-growing social networks. It can significantly expand your networking scope.
  15. Share information with other job seekers in your market. Don’t be afraid to share your leads with others ”“ it’s good networking karma!
  16. Two sites I found useful during my job search are and Career Alley is a good all-purpose site with lots of job search information and resources, such as a tracking spreadsheet that helps you document your leads. Alltop is an ever-growing aggregator of other sites ”“ try looking under “jobs” and “careers.”

Remember, the Internet doesn’t replace traditional networking ”“ it supercharges it! The important thing is to get out there and make connections, share information and let people know what value you bring to a practice. Even with all the social networking I did, my opportunity came the old-fashioned way: A colleague and consultant I knew well from the state and regional levels of MGMA recommended me for a job, and here I am. Good luck!

Posted in: A Career in Practice Management, Innovation

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Talking With Steve Malik of Medfusion: What Has Your Website Done For You Lately?

I recently had the pleasure of speaking with Steve Malik, the CEO and Founder of Medfusion.  Medfusion offers an array of products to the healthcare industry including physician websites and patient/provider portals.  With a background in healthcare billing and eligibility, Steve has been in a unique position to guide his company to solutions that make good sense financially and efficiency-wise for physician practices.  Steve predicts that Medfusion will be serving more than 40,000 physicians by the end of 2009 and says that “patients are used to the world of self-service, and physician offices want to offer that option.”  He sees practices ultimately offering completely automated check-in (including collecting payments) prior to the office visit similar to airline kiosks.

Based in Cary, North Carolina, Medfusion enjoys the distinction of being named the leader in patient portals by KLAS, a company which independently monitors and ranks healthcare technology vendor performance.  The HIPAA-compliant patient portal developed by Medfusion allows patients and providers to communicate and share protected health information and private identifiers such as social security and credit card numbers via a secure portal.  Medfusion’s secure portal empowers patients and practices in a number of ways including:

  • Secure online bill pay.
  • Appointment reminders and lab results messages.
  • Patient registration, demographic and health history completion online.
  • Completion of a history of present illness prior to the visit.
  • eVisits or Virtual Office Visits for established patients. Patients may pay out-of-pocket for the visit or pay a co-pay and the practice can file for the balance of the reimbursement (note: payers, most notably BC/BS, are starting to pay for virtual visits.)
  • Shared patient communication between practices.  Practices that refer patients to a specialty practice can make that referral electronically and can follow-up on the patient’s progress via the portal.
  • “Chat with a Biller” function.
  • Appointment requests and requests for prescription refills.
  • Credit card payments without the use of a credit card machine; online payment plans that automatically drafts the patient’s credit or debit card monthly.
  • Patient refunds via the web portal.

Medfusion has strategic relationships with the American Academy of Family Physicians (AAFP) and the Medical Group Management Association (MGMA) to provide website services to their member practices.  Steve is an active speaker and presenter on technology in healthcare , and is widely quoted in industry publications. The company also has a relationship with Allscripts and Origin Healthcare Solutions and provides connectivity to those products to import information from the patient portal into the practice management system.

Recently Medfusion enhanced its existing Symptom Assessment and Virtual Office Visit solutions to include H1N1 Influenza (Swine Flu) screening.  Medfusion’s press release from May 2009 states:

Without having to come into the office, the patient can log into the practice’s secure HIPAA-compliant patient portal, select either Symptom Assessment or Virtual Office Visit, and type in Swine flu when they are prompted for a condition. The patient then responds to a series of interactive clinical questions relative to their symptoms so that the doctor can provide a secure online consultation, prescribe the appropriate anti-viral drug, if necessary, or determine if the patient needs an in-office visit.

Additionally, physician practices have been able to use Medfusion’s Secure Patient Messaging solution to mass broadcast the availability of H1N1 influenza online screening and to keep patients informed about the latest news regarding this outbreak or any other dire health issues. ‘We immediately launched Webinar training session’s specific to Swine flu patient messaging and Virtual Office Visits, and the response from the practices was overwhelming,’ said Crystal Upson, Vice President of Client Services. Medfusion continues to hold these training sessions regularly. Also, physician practices that have a website powered by Medfusion have complete control over their content management, which means they are able to post and change messaging at any given time about their services and the latest health issue developments.

After all the excitement of the products described above, it seems a little anti-climatic to discuss Medfusion’s website design and hosting offerings, but it is well-worth mentioning as the products above can be integrated into a custom-designed website by Medfusion, or an existing website.  Medfusion will take the look and feel of a practice’s current website and replicate it so the patient always feels that they are “inside” the practice’s site.

What doesn’t Medfusion do?  I recently saw the Medfusion product line again and was a tad disappointed that the referral portal does not have the ability to use custom forms.  It would be ideal to refer a patient to another practice or a test facility and be able to complete the order electronically including an electronic signature.  Referrals are one of the most time-consuming functions of a physician’s practice (primary care practices particularly) and can significantly impact patient care and reimbursement when done incorrectly.

What’s in Medfusion’s future? It was recently announced that Medfusion purchased Medem and their iHealth personal electronic record.  As personal health record capability  is included in definitions of “meaningful use” of an electronic health record eligible for the ARRA stimulus money, it looks like Medfusion will be well-positioned to help its strategic partners meet that definition.

By the way, I have used Medfusion at three different practices in the past and am evaluating it again for my current employer.  I’ve not received any consideration for this article.

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Listservs vs Twitter: Are You Ready to Make the Step into a Brief New World?

Brief But Meaningful Communication

Brief But Meaningful Communication

One of the most valuable, if not THE most valuable, resource a healthcare executive has are colleagues and their collective experiences.  The issues that we confront daily are what we need and want to discuss with our comrades-in-arms.

The listserv is the most direct way of sharing information between colleagues.  I belong to a number of MGMA (Medical Group Management Association) listservs and to the AAOE (American Academy of Orthopedic Executives, formerly BONES) listserv.  These listservs are amazingly helpful and I have more often been the benefactor than the provider of information there.   But listservs have their limitations.

You have to be a member of these organizations to participate in their listservs.  This is not unreasonable, as the infrastructure and management of a listserv is not without cost.  As healthcare continues to get squeezed, however, managers will have to make harder choices about which resources and memberships they and their practices can afford.  Membership requirements also screen the participants, which may be important to some.  The screening, however, may limit the amount of participation and the diversity of participation.  Healthcare is becoming global, as any medical practice competing for the medical tourism dollar will tell you.

Listservs can also take time to read and delete or store.  I have not found an easy solution to arranging the information I want to retain, although there is always deleting the listserv emails and searching the archives later.

I am finding Twitter to be a no-cost solution to many of my needs not fulfilled by listservs.  I have access to thought leaders in and outside my field, and the conversations we have can be on or off the grid.  Although it was initially difficult to constrain myself, I now find the limitation to 140 characters to be very liberating.

Tweets are brief pointers to people, conversations, blogs, and resources across the world.  As Kenneth Yu says on his blog MindValley Labs:

…Twitter is currently the closest app on Earth that replicates the actual thought patterns of the human mind. You see, the human mind does not really think in blog and article form. It does not think in huge chunks of information.  Instead, it thinks in a stream of consciousness way, random disjointed thought layered upon random disjointed thought.

Twitter also has a number of applications designed to organize information, contacts and conversations in ways that make information easy to retrieve. To follow me on Twitter, use my Twitter name @mpwhaley.  To join a brand-new community of discussions around medical practice management, use the #medpractice hashtag to search and join the conversation.

Posted in: Innovation, Learn This: Technology Answers, Social Media

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