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Five Key Trends for 2022

2022 is off to a roaring start, and it pays to be mindful of the external pressures on your practice. Start with this checklist of key trends to consider regarding your medical practice.

Keep abreast regarding the dynamic nature of your market. Change abounds in the healthcare delivery system, driven by the pandemic. Retailers, fueled by partnerships with well-funded, early-stage companies like OneMedical, are pushing into the medical practice space. They are joined by companies focused on virtual care -- like Best Buy Health. Dollar General is the latest to jump in, with a focus on so-called “healthcare deserts” in rural communities. Keep an eye out for the new competitive landscape, as care access points and referral patterns are shifting in rapidly. 

Recognize forthcoming reimbursement changes. The government halted a nearly 10% cut expected to hit medical practices in 2022; however, Medicare reimbursement is scheduled to decline this spring as sequestration is phased back. (See Table: Medicare Reimbursement Cuts 2022 below.) Each quarter this year will bring a small cut to Medicare payments; these reimbursement dips are often mimicked by commercial insurers. Insurance companies like United Healthcare performed well during the pandemic -- premiums were stable, while pay-outs for healthcare services declined substantially with patients putting off care. With Wall Street hungry for sustained profits, commercial insurers will be seeking ways to bring down reimbursement now that demand for services is rising. Watch out for more claims denials; put your business office on the alert to submit appeals to stave off financial losses for your practice at the hands of the insurers. 

Automate. It's a message you've been hearing for years now, but the promise of technology is finally being realized today. Self-serve scheduling, registration, and check-in allow your practice to harness your patient’s love of new consumer-focused tools and their inevitable convenience. Consider, also, the promise of being able to automate transactions like claims appeals, prescription refills, and prior authorizations for medications. Technology is enabling more and more practices to realize these opportunities.

Consider telemedicine opportunities. The government’s recent extension of the public health emergency provides the runway for continued use of the telemedicine CPT codes at the same levels of reimbursement for in-person care. Dozens of codes remain payable by audio only – including psychotherapy, health risk assessments, smoking cessation counseling, and nutrition services. Further, 99441-3 (phone calls with physicians or advanced practice providers, billed based on time) continue to be payable from Medicare for the now. Even better, many of the 200-plus CPT codes are available for Medicare payment through the end of 2023. This list is for Medicare, but many commercial payers have extended reimbursement for virtual care as well.

Show your appreciation. The ongoing pandemic, staffing shortages, and the multitude of other challenges being faced by your practice have had a toll on you and your team. Make a mental note to thank every employee today – and at least once a week. A personal, handwritten note expressing your appreciation for their efforts goes a long way. Perhaps add a gift card, or a coupon for an extra hour of leave (e.g., rotate early departures on a slower afternoon). Many non-profits and school groups are hosting efforts to bring goodies to hospital workers. Consider making a call to such groups and inquire as to whether your team may benefit from their generous efforts.

 

Table: Medicare Reimbursement Cuts 2022

 

Cuts

Phase 1 (Q12022)

Phase 2 (Q22022)

Phase 3 (Q32022)

MCR Physician Conversion
Factor Reduction

-0.82%

-0.82%

-0.82%

MCR Sequestration
(2% on Payments)

0%

-1%

-2%

PAYGO Sequestration

0%

0%

0%

TOTAL

-0.82%

-1.82%

-2.82%

 

About The Author

Elizabeth Woodcock is the founder and principal of Woodcock & Associates. She has focused on medical practice operations and revenue cycle management for more than 25 years. She has led educational sessions for a multitude of national professional associations and specialty societies, and consulted for clients as diverse as a solo orthopaedic surgeon in rural Georgia to the Mayo Clinic. She is author or co-author of 17 best-selling practice management books, to include Mastering Patient Flow and The Physician Billing Process: Avoiding Potholes in the Road to Getting Paid. Elizabeth is a Fellow in the American College of Medical Practice Executives and a Certified Professional Coder. In addition to a Bachelor of Arts from Duke University, she completed a Master of Business Administration in healthcare management from The Wharton School of Business of the University of Pennsylvania. She is currently a doctoral student at the Bloomberg School of Public Health of Johns Hopkins University.

The contents of The Sentinel are intended for educational/informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice, as specific legal requirements may vary from state to state and/or change over time.

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