Providers’ Guide to Best Practices for Revenue Cycle Management

The Healthcare industry doesn’t only have hospitals and large medical practices. There are some medical practices that function in only one specific medical area and consult medical billing companies for reimbursements.

P3 healthcare solutions being a medical billing company has years of experience in medical billing services. We have come across many independent or stand-alone medical practices and well-established hospitals.

How Independent Healthcare Providers Are Coping Up With Changes?

One thing we understood in all these years is that the norms of the modern healthcare industry are changing. The focus has shifted to a value-based healthcare system instead of volume-based care services.

It also leads to structural changes in the progressive healthcare industry. According to the American Medical Association (AMA), physicians having independent clinics cover less than half of the total US doctors’ population. However, this trend of owning personal medical practice was high back in the 1990s.

Reason for Reduced Rate of Independent Healthcare Practices

The declining practice of independent healthcare providers owes to many reasons.

Some observers of the healthcare industry state that independent healthcare providers are forced to join larger healthcare systems as the earned revenue is not sufficient for survival.

Why do medical billing companies Can’t Support independent healthcare providers?

Independent healthcare providers don’t meet up with their cost expenditure due to inflation and price surge. The increased administrative burden of MIPS QPP increased the price of surgical hospital admissions, emergency room visits, and drugs, which has caused major problems for independent healthcare providers.

Thus, in recent years, due to low reimbursements, around 22% of the independent clinicians reduced their office support.

Impact of Low Reimbursement Rate

Low reimbursement rate from insurance companies has also damaged this industry. Even hospitals and large medical practices are not safe from the changes in the healthcare industry.

The healthcare providers when unable to cover expenses within earned money, get in touch with huge healthcare networks. Thus, the amalgamation of large and small healthcare practices has led to low competition in the healthcare industry.

In addition, often patients don’t pay deductibles or the extra amount other than their insurance benefits to independent medical practitioners. This way, independent healthcare providers never really compete with bigger healthcare organizations.

Reservations of Solo-Medical Practitioners

One concern that the solo-healthcare services show is the unreasonable reimbursement standards of insurance companies. Big healthcare organizations can better negotiate their demands with the increased volume of patients, which is a profit source for insurance companies.

All these issues make it impossible for small independent healthcare providers to stay in the industry. QPP MIPS has also fueled the declining trend of independent health services. Patients want access to top-quality healthcare, which a separate-working medical provider may not be able to provide. Consequently, the doctor doesn’t find a large share of incentives and bonuses.

To keep an independent medical practice, most solo physicians function as a group outside the hospital circle. It has also helped medical billing companies to get high reimbursement for them as well as offered shared administrative responsibilities and resources over the network.

This might be the only surviving option left for independent healthcare service providers.

As large medical practices are dominating the healthcare industry, it is evident that revenue cycle management has not remained easy for solo practitioners. However, with little adaption to change and a professional medical billing company, independent healthcare service providers can work their way up the success ladder.