American College of Physicians: Internal Medicine — Doctors for Adults ®

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Practice management

Ancillary services | Billing and coding | Buying, selling or merging a practice | Center for Practice Improvement and Innovation | Coding/documentation | Compensation | Home care | Liability issues | Marketing | Medicare policies | Pay-for-performance | Performance re-engineering | Practice briefs | Practice finances | Practice re-engineering | Quality measures | Reimbursement | Staffing issues | Tort reform


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Ancillary services

Readers Respond

Letters to the editor

Reader comments on the role of ancillary services in an internal medicine practice, and on the need for attention to nutrition and lifestyle in caring for rheumatoid arthritis. More

Consider offering in-office labs

Office-based labs increase efficiency, contribute to faster diagnoses and treatment and improve satisfaction. Increased regulation and reduced reimbursement should be balanced against new technology and a greatly expanded range of tests available. More

Web portals attract small groups, 'fanatical' patient interest
A physician relates how online communication with patients has streamlined his health care delivery and even provided a trickle of revenue. More

Adding cosmetic procedures lifts internists’ sagging incomes
Stagnating incomes encourage some primary care physicians to add botulinum toxin injections and chemical peels to their menu of services
February '08

'Want a stress management class with your physical?'
Bringing ancillary services in-house offers patients one-stop shopping while boosting your bottom line. (January-February 2006)

For these internists, in-house ancillary services can boost revenue—and physician morale
A look at how some internists are bringing services like X-rays, treadmill testing and bone densitometry into their offices. (November 2003)

Coming soon: more changes to the CLIA regulations
A look at how the latest revisions might make life easier for physicians with labs (February 2003)

What internists need to know about the new Stark law
Final rules clarify when you can refer a patient for Medicare services and steer clear of anti-kickback problems (January 2002)

Is your waived lab compliant? Try these four tips
To avoid problems, know the limits of a waiver certificate and document well (September 2001)

With ancillary services, you can do well by doing good
New equipment like X-ray machines can boost your practice's bottom line (October 2000)

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Billing and coding

What practices need to know about transition care management codes

Two new codes allow for reimbursement for non-face-to-face care when patients transition from an acute care setting back to the community. Learn the fine print of how to properly use these codes. More

Transitional care management services change in 2013

Learn how to recoup the increased reimbursement offered in the 2013 Medicare Physician Fee Schedule by using two new codes and modifications.

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Four more screening, counseling services covered by Medicare

Alcohol, depression, sexually transmitted diseases and obesity therapy are now covered within the primary care setting. Learn how to incorporate these into a practice. More

Medicare pays for annual depression screening

One in six seniors suffers from depression. That rises to one in four with comorbidities. Tools and screens are available to help internists integrate this new focus of care into a practice routine. More

ICD-9 diagnosis codes updated for 2011-2012

The latest annual update of the ICD-9 diagnosis codes outlines many new codes that will be common to internal medicine. A comprehensive list outlines what's new. More

Learn about potential auditors to avoid becoming a target

Four programs overlook a practice's billing and coding efforts, and each has its areas of emphasis. There are seven simple steps to follow that will help a practice avoid incurring an audit. More

ACP disputes federal valuation of primary care observation codes

ACP disputes the relative values assigned to observation care codes, believing that they do not fully account for the physician work involved in providing the services. ACP advocacy and members' input are critical to helping improve internal medicine physicians' recognition for the care they provide. More

Well visits not just for kids any more

Medicare now reimburses for annual physical exams, so prepare your office, your patients and yourself for the best way to accommodate this into your practice. More

Assess your ability to comply with version 5010 requirements

The pressure is on to switch to version 5010, and the process will require identifying changes, testing transactions and minimizing disruptions. Also available are resources to help with preparation. More

Coding made easy for annual wellness visits

Health care reform now reimburses for annual exams under Medicare. Now, physicians have to reform their practices and prepare patients for them, as well. More

Internists need to know coding for CPAP, observation services

There’s more to internal medicine than evaluation and management services. Two of the more common of the uncommon services to code for include CPAP for sleep disorders, and guidance on billing for observation and same-day discharges. More

Home health and hospice eligibility now requires face-to-face encounter

Enforcement begins on a new Medicare rule that mandates a personal encounter for the initial certification of home health and hospice services. More

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Buying, selling or merging a practice

Success in ACOs depends on collaboration

Physicians should consider culture, autonomy and resources before jumping in. More

When negotiating contracts with ACOs, cover all the bases

Get specifics on access to data, and remember to plan for a possible exit strategy. More

Look before leaping into a large health system

Many physicians are leaving private practice and turning to large health systems to give them breathing room to care for their patients and restore work-life balance. But before making the leap, physicians should ensure that the move is the best one. More

How to financially survive in a hospital-owned practice

As more and more practices move to a hospital-employed model, internists will have to engage in due diligence about how the change affects billing, service contracts and collections. More

Check finances, costs before consolidation

Financially stressed private practices are seeking shelter through acquisition by a hospital chain. But owners need to scrutinize their costs and expenses before entering into negotiations. More

Hospitals again look to integrate doctors

A new incarnation of hospital integration has sprung up, leaving some internists who were burned the first time around leery about jumping into the fray. But others are eager to set aside the increasingly onerous responsibilities of practice ownership. More

PMC Tips
Dividing the pie by keeping it simple
May '08

Look before you leap onto practice merger bandwagon (October 2007)

Practice Tips
Starting up: Make or buy? (May 2007)

Starting a new practice? Revised handbook can help. (June 2003)

Want to start a practice? The College has tools to help
A College guide explains how to plan for and build a successful practice (April 2003)

In tough markets, three primary care groups are learning how to make their size count
Making sure that bigger is better (October 2002)

As doctors leave hospital practices, some are finding a 'soft landing'
As they part ways, some hospitals are helping physicians make the jump to keep patient referrals coming (January 2001)

Uncertain times for doctors who sold
How some practices are being affected by post-acquisition blues (June 1998)

Building—and rebuilding—a physician group for the future
An area's gastroenterologists join to accept and manage single-specialty capitation for gastroenterology (March 1998)

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Center for Practice Improvement and Innovation

Why job descriptions matter

Job descriptions not only help practices hire and retain the right employees, they can also have a positive effect on productivity and profitability. More

Check finances, costs before consolidation

Financially stressed private practices are seeking shelter through acquisition by a hospital chain. But owners need to scrutinize their costs and expenses before entering into negotiations. More

Why accessibility matters

When deciding on how satisfied they are with a practice, patients look foremost to how quickly they can be seen, and how they can reach a physician for after-hours problems. Eleven quick tips can strongly influence the quality of care and how it's perceived by the patient. More

Set up your flu clinic now

Setting up an influenza vaccine clinic is a simple way to immunize all patients in a practice. It's easy to achieve that goal if the practice is well organized. Here is a step-by-step guide to running a successful flu vaccine clinic. More

Improve feedback with subspecialists

Take the time to improve communication and collaboration between your office and those to whom you refer your patients. More

Another security risk: The copy machine

Many office photocopiers permanently store every image they’ve ever scanned, copied or faxed. Those images stay with the machine after it’s re-sold, and the images can be easily hacked. Learn how to maintain security over medical records, taxes, bank statements—or any other document that’s ever been copied. More

Easy ways to ensure meaningful use

Preparing, selecting and fully implementing an electronic health record require time and money at a time when there’s not a lot of either. Six easy steps can prepare staff to meet the core sets of objectives and measures. More

A primer in safe vaccine management

Commonsense, easy-to-implement steps can be worked into a practice to ensure safety for patients, employees and the vaccines themselves.

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The confusing world of EHR incentives

The federal government’s substantial incentive program for electronic health records is no reason to rush out and buy one. Final rulings on how to interpret issues such as “meaningful use” won’t be decided upon until the summer. Diligence is needed to choose a system that matches the practice workflow. More

Start-up practice uses ACP’s marketing guides for quick growth

Leslie Saltzman, ACP Member, took advantage of some resources on hand and guidance from ACP’s Running a Practice section to quickly grow her solo practice into a full-service resource for women’s health. More

Practice uses ACP survey for peer review, quality improvement

True North Health Center in Maine surveyed every patient who came through their doors from March through May last year to let each if its 28 practitioners know outcomes for each provider. Proprietary surveys are expensive, so they turned to ACP’s tools. The results helped those performing best to teach their peers about best practices. More

Moving toward patient-centered care

Practice not currently considering the patient-centered medical home model can still position themselves for an eventual transition if and when the idea comes of age. More

Improving paper charts to prep for EHRs

Practices should organize their paper charts to ease to conversion to electronic health records. To ease the transitions, ACP has assembled useful forms to download and customize. More

Record retention made easy

Nothing raises more questions when closing a practice than what to do with the medical records. Practical tips explain how to handle these important documents. More

Consider offering in-office labs

Office-based labs increase efficiency, contribute to faster diagnoses and treatment and improve satisfaction. Increased regulation and reduced reimbursement should be balanced against new technology and a greatly expanded range of tests available. More

The stimulus package and buying EHRs

The recent federal economic stimulus package set aside more than $17 billion for doctors and hospitals to adopt EHRs. ACP has developed extended guides to answer physician’s questions about the incentives. More

Improving access tops list of small-office tips
The final part of a series on small practice issues advises tackling practice improvements one at a time and putting one person in charge of the process.
June ’08

In-office lab tests augment patient self-education efforts
Fifth in a six-part series on small practice issues.
May '08

Managing risk: a little attention equals a lot of prevention
Fourth in a six-part series on small practice issues.
April ’08

The front-office bottleneck: schedules, phones and refills

Third in a six-part series on small practice issues
ACP’s Center for Practice Innovation found that about half of the practices it observed as part of its quality improvement project had problems with phone communication, scheduling and the prescription refill process. The good news is that the bottleneck can be loosened with some relatively simple changes.
March ’08

Staffing can make or break a small practice
In a quest to unveil common problems for small practices and offer solutions, the College's Center for Practice Innovation visited 34 practices across the U.S. over a two-year period. Part one of the six-part series looks at the unique staffing issues faced by small offices. (January 2008)

New ACP center kicks off second phase. (May 2006)

CPI now accepting practice applications. (March 2006)

Help is on the way for small-physician practices
This month, the new Center for Practice Innovation opens its doors for business. (January-February 2006)

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Coding/documentation

ICD-10 is still on the way, and readiness remains key

Although the transition to ICD-10 is 15 months away, physicians planning for the conversion should have already passed important milestones. Here’s how to ensure a smooth conversion. More

ICD-9 diagnosis codes updated for 2011-2012

The latest annual update of the ICD-9 diagnosis codes outlines many new codes that will be common to internal medicine. A comprehensive list outlines what's new. More

Prepare for this year’s significant changes to PQRI reporting

Now in its fourth year, the Medicare Physician Quality Reporting Initiative continues to adjust its parameters. ACP’s Running a Practice section offers resources to stay atop of the changes, or join the program this year. More

Prepare for Recovery Audit Contractors as they come online

Medicares new audit program is ramping up, and the College offers practical advice onhow to reduce the administrative cost of compliance. More

Practice Rx
February '08

Tamper-resistant Medicaid prescriptions, billing for PAs (November/December 2007)

'Modest' ICD-9 updates must go into effect on Oct. 1 (October 2007)

Reimbursement relies on timely processing by others (September 2007)

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Compensation

Planning ahead for successful PQRS participation

A new online registration tool may help internists avoid looming penalties by helping them to enroll in the Physician Quality Reporting System. More

Distributing pay for performance

Once a practice receives pay-for-performance bonuses, how should they be distributed? Do they go to the treating physicians, the entire practice or some kind of hybrid? There options aplenty to consider. More

Hopes and fears abound at National Bundled Payment Summit

Expansion of bundled payments to chronic disease treatment for internists would be complicated, but it's garnering interest. Demonstration projects show that hospitals that reduced the cost of care were able to pay physicians up to an extra 25% of what they would normally earn for their services. More

Letters to the editor

Readers respond to the ACP InternistWeekly item about lower pay driving physicians to cut their hours, and to the cover story that questioned the value of the annual physical exam. More

Physician is final arbiter on accuracy of EMR coding
Also, admissions, observation and discharges can span multiple days—the code depends on the cirumstances. (July-August 2007)

More tips and pearls to participate in Medicare’s PQRI (June 2007)

Medicare’s new bonus program offers chance to profit (June 2007)

Groups unite for PCMH (June 2007)

Physicians adapt offices to cope with Medicare Part D
Many practices have appointed 'Part D specialists' to handle prior authorizations and drug formulary plans. (March 2007)

Access fees have physicians moving cautiously
Doctors considering access fees are concerned about legal questions, patient backlash and getting ahead of the pack. (April 2004)

Group visits can save time, but are they right for you?
The new trend in scheduling group visits makes both physicians and patients happy. (April 2004)

Internal medicine takes a hard look at itself during summit on revitalization
Leaders at a two-day meeting on revitalizing the specialty discuss ways to re-tool education, reimbursement and the practice environment. (December 2003)

Small-group strategies for revamping physician pay
Basing pay on collections, not charges, and dividing expenses fairly can help avoid infighting (December 1999)

Changing physician pay can boost autonomy
Experts say 'gainsharing' and other strategies get physicians more involved in how care is managed (December 1998)

Pointers on how to divide income among physicians
From 'eat-what-you-kill' plans to incentives for attending meetings, groups are creating new ways to pay (November 1998)

Getting your fair share? Tips on distributing income
Develop a payment system that rewards hard work (October 1996)

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Home care

Home health and hospice eligibility now requires face-to-face encounter

Enforcement begins on a new Medicare rule that mandates a personal encounter for the initial certification of home health and hospice services. More

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Liability issues

Reducing the risks of opioid management

Patients with known drug-seeking behavior can be managed by establishing and closely following office procedures. More

What’s your malpractice risk? Depends on your specialty

A research letter uncovers how often physicians face malpractice claims, and builds a case for policy reform that ensures fair compensation for patients who are harmed and less time spent on cases that are eventually dismissed. More

Information plus documentation a must for informed consent

Documentation of informed consent is an important deterrent to malpractice and negligence claims. One physician describes how his informed consent process was the deciding factor in a missed case of prostate cancer, and outlines how any physician can accomplish it. More

PMC Tips
Follow a few simple steps to ensure safety
March ’08

Why the nation's toughest elder abuse laws make some California physicians nervous
Problems include onerous reporting requirements and threats from malpractice attorneys (March 2003)

As the malpractice crisis enters year two, doctors and insurers flee some markets
In addition to facing double-digit premium hikes, doctors in some states are losing access to malpractice coverage as insurers flee (April 2002)

With malpractice costs skyrocketing, some physicians are talking 'crisis'
Fallout of the litigious environment includes recruiting problems and defensive medicine (April 2001)

How to make sure your archived records are safe
Soggy or lost records not only jeopardize patient care—they can also lead to legal headaches (July/August 1999)

Guidelines from malpractice insurers?
New protocols designed to counter lawsuits from 'errors in diagnosis' (November 1998)

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Marketing

Hang out a digital shingle

Establish your practice in the digital world as well, using a website and social media to bolster your presence. More

Medicine and Social Media

Should doctors worry about online ratings?

Consumers have free rein to anonymously post negative comments online about their physicians. Some are fighting back, while others learn how to turn potentially negative postings into a positive promotional tool for their practices. More

Start-up practice uses ACP’s marketing guides for quick growth

Leslie Saltzman, ACP Member, took advantage of some resources on hand and guidance from ACP’s Running a Practice section to quickly grow her solo practice into a full-service resource for women’s health. More

After watching others, doctor pitches himself to local news
Inspired by some famous names, an internist pitches his expertise to local TV news stations. More

Patients examine doctors through online rating services. (December 2006)

New Feature - Practice Tips
Low-budget tools to market your practice
"PMC Tips" is a new regular feature on small-practice management from ACP's Practice Management Center. (November 2006)

'Want a stress management class with your physical?'
Bringing ancillary services in-house offers patients one-stop shopping while boosting your bottom line. (January-February 2006)

CCA publication can help you market your practice
Learn more about marketing medical services to managed care plans, patients and employers in order to bring new patients to your practice (December 1999)

10 tips to make marketing work for your practice
In addition to drawing new business, a good marketing plan can help keep existing patients happy by making them feel good about their physician (September 1998)

How to increase your referrals—and your revenue
For subspecialists, personal relationships tend to generate more referrals than professional reputation (January 1998)

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Medicare policies

Spotlight cast on industry gifts, payouts to physicians

The Physician Payments Sunshine Act goes into effect Aug. 1. We detail what physicians need to know. More

Tools to screen for alcohol abuse

Medicare now reimburses for problem drinking as part of its Annual Wellness Visit, and a few easy-to-follow tips can help doctors screen for alcohol abuse and get paid for doing so. More

CMS aims to prevent fraud while protecting ‘the good guys'

Medicare is focusing heavily on preventing fraud, but with an eye toward not burdening legitimate providers. Learn three things a practice can do to reduce its chances of being audited. More

New tool for Annual Wellness Visits

The Health Risk Assessment is a winning proposition for practices to incorporate into their workflow to offer patients a personalized preventive plan and specific action steps to take. More

Home health and hospice eligibility now requires face-to-face encounter

Enforcement begins on a new Medicare rule that mandates a personal encounter for the initial certification of home health and hospice services. More

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Pay-for-performance

Distributing pay for performance

Once a practice receives pay-for-performance bonuses, how should they be distributed? Do they go to the treating physicians, the entire practice or some kind of hybrid? There options aplenty to consider. More

When will the lights go out on fee-for-service?

Reimbursement for medical care should be based on value, not on procedures. A long-term solution must include pilot programs of new approaches and stabilized reimbursement during their rollouts. More

Qualify for quality: CMS offers 1.5% reporting bonus. (May 2007)

Is P4P the next great idea or a passing fad? (May 2007)

Don't wait for all the answers to start measuring quality
Practices should lay the groundwork for quality measurement as College and others grapple with logistics. (June 2006)

Pay for performance disrupts the physician patient relationship. (May 2006)

How to stay ahead of the curve on quality improvement
To keep overhead costs from spiraling way out of control, practices must start small and embrace change. (May 2006)

Teamwork is the new mantra for quality improvement
Getting staff working to the 'top of their license' can make or break quality and pay-for-performance projects. (April 2006)

What can go wrong with pay-for-performance incentives
Because the road to quality improvement contains so many pitfalls, here are some traps to look out for. (March 2006)

College taking lead role in pay-for-performance planning
Physicians need to have a decisive voice in how these programs are designed. (March 2006)

CMS initiative paves way for physician pay-for-reporting
The voluntary program allows doctors to test the waters without a big investment in information technology. (January-February 2006)

Want patients to keep coming back? Ask for their input
Scoring well on patient satisfaction surveys can improve care and boost your pay-for-performance rewards. (January-February 2006)

Letters
Readers discuss pay for performance. (January-February 2006)

Minimizing the hidden costs of quality improvement
To hold on to the maximum amount of performance incentives, physicians take steps to streamline workflow. (December 2005)

Wrapping physicians' minds around quality improvement
Anger and denial can be major barriers to improving patient care and gearing up for pay for performance. (November 2005)

Setting the pay-for-performance bar: simple is better
The hard part is getting physician consensus—and making sure teamwork supports the standards you choose. (October 2005)

Online editorial addresses performance measurement. (July-August 2005)

Alliance adopts a uniform set of clinical pay-for-performance measures
The measurement set could be incorporated into nationwide pay-for-performance programs by next year. (June 2005)

Market forces push pay-for-performance
College takes leading role to make sure physicians help craft national standards. (May 2005)

Pay-for performance takes off in California
First bonus checks are slim, but physicians plan to stay the course to improve quality. (January-February 2005)

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Performance re-engineering

Evaluating what is important about performance measures

Connecting with patients and improving their health should be the key factor behind implementing performance measures in the health care system. More

The stimulus package and buying EHRs

The recent federal economic stimulus package set aside more than $17 billion for doctors and hospitals to adopt EHRs. ACP has developed extended guides to answer physician’s questions about the incentives. More

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Practice briefs

Planning ahead for successful PQRS participation

A new online registration tool may help internists avoid looming penalties by helping them to enroll in the Physician Quality Reporting System. More

New year brings big, small changes to practice administration

Federal regulations will change how internists practice this year. Learn about the primary care incentive program, the annual wellness visit and medical savings accounts. More

A primer in safe vaccine management

Commonsense, easy-to-implement steps can be worked into a practice to ensure safety for patients, employees and the vaccines themselves.

More

CPII Tips

A practical guide for creating and maintaining a 'red flag' program

Federal regulations require doctors' offices to set up written procedures to protect against identity theft. Practice pearls outline steps to follow to comply with the new law. More

Practice Tips
Mind your reminders … (November/December 2007)

Practice Tips
Getting paid for mobility (October 2007)

Practice Tips
E&M billing by the hour (September 2007)

Practice Tips
Ring! Ring! Ring! Ring! (July-August 2007)

Practice Tips
'Anything else?'—The secret to effective communication (June 2007)

Practice Tips: This clause should give you pause before taking the job. (April 2007)

Practice Tips: Waived Testing—What is that?? (March 2007)

Five simple ways to smooth scheduling. (January-February 2007)

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Practice finances

Business experts urge small-practice doctors to take action

Speakers at a recent Business of Medicine Summit had some grim predictions and urgent alerts for attendees: “Start preparing for that storm that’s partly on the coast but not here yet.” More

Value-based payments a new source of reimbursement, penalties

Value-based payments are meant to adjust Medicare and Medicaid payments according to performance. Take concrete actions to recoup more reimbursement and avoid nonparticipation penalties. More

Check finances, costs before consolidation

Financially stressed private practices are seeking shelter through acquisition by a hospital chain. But owners need to scrutinize their costs and expenses before entering into negotiations. More

Cut costs without cutting corners to keep the office efficient

Today’s health care environment demands that physicians wring every last drop of efficiency from their practices. Here are five easy ways to accomplish that. More

RVUs—the common denominator in financial management

In today's economy, tight financial management is more important than ever. Relative Value Units can be used as a powerful tool for financial management in medical practices. More

Teen vaccines

Expensive vaccines may wipe out wrong target—the doctor

New and expensive vaccines added to the schedule for adolescents, adults and children over the last several years have created a crisis in the delivery system that threatens to reduce or eliminate the private provider's role, say experts following the issue. More

The Medicare e-prescribing incentive—a carrot and a stick

A how-to column on earning an additional $4,000 this year, and practical tips on choosing an electronic health record system. More

Research reveals reasons underlying patient no-shows
It's the $19 million-dollar question: How do you get your patients to show up for their appointments? Easy-to-follow tips can increase practice revenue. More

‘Show me the money’—by maximizing accounts receivable
Make sure your practice is collecting payments from patients and insurers. More

Solo doctors take aim at non-billable tasks
Time-strapped practitioners share their tips for working smarter instead of harder. (May 2007)

Letters
Readers discuss orthopedists and internists, MKSAP, and the rising costs of physician services. (October 2005)

Letters
Readers discuss overhead, internal medicine crisis, performance measures. (May 2004)

Physicians try to rein in runaway overhead
Innovations to cut overhead include scheduling software and fielding patients' phone calls at home. (March 2004)

Need practice management help? Try new ACP newsgroup
A new online discussion forum gives internists in small groups a place to share their solutions to everyday problems. (March 2004)

Letters
Readers discuss revitalization, performance measures, reimbursement. (March 2004)

Fine-tuning your practice's finances? Try these tools
A new ACP publication can help you improve the way you collect and use financial data. (November 2003)

Taking a tough stand on nonbillable care
Fed up, some physicians are charging patients for services they once gave away (February 2003)

Claims denied? Take steps to get what you're owed
Try these strategies to keep claims from being denied and appeal those that are rejected (December 2000)

Tips to detect—and prevent—theft in your practice
Divvying up financial duties among your office staff can help keep embezzlement at bay (November 2000)

New solutions to an old problem: health plans that pay too slowly
Doctors are using new techniques to fight delayed payments that cripple their cash flow (September 2000)

Afraid to ask patients for co-pays? Try these tips
Educating both patients and staff can boost collections without making you look like the bad guy (September 2000)

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Practice re-engineering

Toward a patient- and family-centered practice

A physician in the process of transforming his practice into a medical home discovered a resource that was already at his fingertips: patients and families who could help apply patient- and family-centered care concepts to primary care. More

Internists should pursue innovative practice models

The patient-centered medical home and the accountable care organization allow internists to do a better job caring for patients, and there is at least some early evidence that they may reduce the costs of care. More

Pilot program offers a road map for PCMH model of care

Internists who have attempted to convert to a patient-centered medical home model have quickly learned the process isn’t always easy. But a pilot program found the results appeared worth it: fewer emergency visits and patients who take better care of their own health. More

Small practices prepare for ACOs

Small practices are wondering how they will fit into the larger networks of accountable care organizations that are springing up nationwide. There are three small steps practices can take as the issue sorts itself out. More

Chronic disease model helps improve smoking cessation efforts

Smoking cessation programs are traditionally treated as discrete, standalone attempts. One program applied dedicated counselors who could form a relationship with the patient over long stretches of time, resulting in better success. More

Changes to a practice also provide personal transformation

The change to a patient-centered medical home model enabled one internist to practice medicine to his fullest extent. The extra income and relaxed atmosphere are added benefits. More

Evaluating what is important about performance measures

Connecting with patients and improving their health should be the key factor behind implementing performance measures in the health care system. More

Building the medical home starts in school

Four medical schools revamped their residency programs to include concepts of the patient-centered medical home. The changes resulted in teamwork, continuity of care, and more intense clinical rotations. More

Integrate mental health into medical practice

Partnerships between internists and mental health professionals are rare but proving their worth. Advantages include recognizing symptoms in a primary care setting and easing co-management for physicians and patients alike. More

Simple tools, teamwork manage depression in primary care

Embedding mental health professionals directly into a primary care setting threatens to add complexity to primary care’s already hefty ‘to do” list. Clinics that have accomplished that task explain how not only was it easier than expected, but it adds tremendous benefits to the practice. More

Medical home model might be health care’s next great change

The patient-centered medical home might be health care's next transformational innovation, one that will allow primary care to survive and thrive. More

Practice achieves NCQA’s highest recognition without an EMR

An internal medicine practice followed evidence-based diabetes care guidelines and achieves honors from the National Committee on Quality Assurance, despite not yet having an electronic medical record. A lot of thinking and a dedicated team allowed the group's paperwork to accomplish the same goals. More

Understanding EHR certification

Certified electronic health record systems are crucial to qualifying for extra reimbursement and complying with upcoming government regulations. But there are two types, each assessing different aspects of how the system will function in an office. More

Wisconsin clinic’s patients save time by ‘rooming’ themselves

An outpatient family practice clinic tries to reduce wait times by letting patients direct themselves to open exam rooms. As a result, wait times fell by half and patient satisfaction rose to its highest levels in 11 months. More

ACP can be a medical home for all aspects of internal medicine

Physicians with widely disparate backgrounds and interests can function together and share a passion for expanding primary care under the auspices of a patient-centered medical home. More

Moving toward patient-centered care

Practice not currently considering the patient-centered medical home model can still position themselves for an eventual transition if and when the idea comes of age. More

Get time on your side: expert tips to eliminate waiting

Resolve to solve the waiting-room back-ups. Find out where the practice falls behind and implement solutions, including time studies, prior preparation and using medical assistants to their highest level of practice. More

From peer review to practical application

While using the Epley Maneuver undoubtedly relieves benign paroxysmal positional vertigo, training staff in a new method presented obstacles. One physician explains how he implements dedicated teaching time for staff. More

Span gaps between physicians, patients

Use active lisenting, self-management and other communications tools to provide better care for patients.ment in medical practices. More

If you can't make the wait shorter, make the waiting room nicer
Patients' perceptions of waiting are key to their satisfaction, and therefore return and referral business. Making waiting rooms more like living rooms is one way to increase patient satisfaction and reduce frustration with delays. More

Research reveals reasons underlying patient no-shows
It's the $19 million-dollar question: How do you get your patients to show up for their appointments? Easy-to-follow tips can increase practice revenue. More

All together now: Teamwork
A cohesive and efficient team can make all the difference between a practice limping along and one that is willing to try new ideas and work flows. More

CPII Tips
ACP’s Center for Practice Improvement and Innovation suggests simple tips for creating a more efficient practice and happier patients, in turn. More

PMC Tips
February '08

PMC Tips (January 2008)

Wrapping physicians' minds around quality improvement
Anger and denial can be major barriers to improving patient care and gearing up for pay for performance. (November 2005)

Redesigning an office? Opt for simplicity and comfort
You don't have to spend a lot of money to create a calmer, more attractive and productive office. (July-August 2005)

Caring for seniors: making the most of 20-minute visits
Innovative ways to save time while improving patient care for the elderly. (July-August 2003)

Three doctors share innovative strategies for tackling common practice challenges
How physicians used Web-based scheduling, group visits and digital transcription to improve their practices. (May 2003)

How one project is helping doctors improve patient scheduling, more
Physicians are joining an ambitious effort to improve access to care and reduce delays in appointment scheduling (April 2001)

Three free tools to help you build a better practice
The College just made it easier to find new sources of revenue, improve efficiency and boost patient satisfaction (March 2001)

Problems with patients? Fine-tune your front desk
Training in customer service and billing can improve patient satisfaction and office efficiency (March 2001)

Running behind? Try re-engineering
Redesigning your practice's patient flow can save time—and money (July-August 2000)

Does your practice measure up? Try benchmarking
Collecting and analyzing data can help uncover problems—and make your practice run more smoothly (March 2000)

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Quality measures

Set up your flu clinic now

Setting up an influenza vaccine clinic is a simple way to immunize all patients in a practice. It's easy to achieve that goal if the practice is well organized. Here is a step-by-step guide to running a successful flu vaccine clinic. More

Practice uses ACP survey for peer review, quality improvement

True North Health Center in Maine surveyed every patient who came through their doors from March through May last year to let each if its 28 practitioners know outcomes for each provider. Proprietary surveys are expensive, so they turned to ACP’s tools. The results helped those performing best to teach their peers about best practices. More

CMS program gives doctors a glimpse of P4P future
While it lacks financial incentives, the program gives volunteers a trial run in reporting performance data. (May 2006)

The September ACP Observer kicked off a new series with how-tos on launching quality improvement initiatives and participating in pay-for-performance programs. See "Patient registries: a key step to quality improvement." (September 2005)

Working smarter and safer for quality improvement
To spearhead successful QI efforts, hospitalists say you need the right project—and a versatile team. (September 2005)

College calls for physician friendly quality measures. (June 2004)

Letters
Readers discuss overhead, internal medicine crisis, performance measures. (May 2004)

ACP's response to the performance measure movement
Regents' Chair Mary T. Herald explains how the College is tackling the performance measure trend that makes many internists nervous. (January-February 2004)

As NCQA turns its attention to physicians, performance measures find some ready takers
Why six internists volunteered for performance measurement programs—and how those programs affected their practices. (December 2003)

Strategies to tackle outpatient errors
Tracking test results, referrals and even no-shows can help keep you out of trouble (June 2002)

As they struggle to improve quality, HMOs try a new incentive: bonuses
Insurers have learned that financial rewards are an effective way to encourage innovation (June 2001)

Patient satisfaction surveys: how to do them right
You need to ask the right questions, get enough responses—and then put the information to good use (April 2000)

Efforts to prevent prescription errors heat up
A different look at the problem and what physicians can do to avoid making the most common mistakes (June 1998)

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Reimbursement

Medicare clarifies, updates several claims payment issues

The Centers for Medicare and Medicaid Services has released statements regarding claims payment issues that it will be correcting in the near future, including enforcing coding conventions and restructuring system edits. More

Review Medicare incentives and penalty programs for 2013

Many Medicare programs offer incentives for e-prescribing or quality reporting, or have penalties for failing to comply. Review the many ups and downs of the many programs in place. More

What practices need to know about transition care management codes

Two new codes allow for reimbursement for non-face-to-face care when patients transition from an acute care setting back to the community. Learn the fine print of how to properly use these codes. More

Transitional care management services change in 2013

Learn how to recoup the increased reimbursement offered in the 2013 Medicare Physician Fee Schedule by using two new codes and modifications.

More

Tool simplifies quality measure reporting

The Physician Quality Reporting System recently switched from incentive payments for adopting it to penalties for not doing so. To avoid future penalties, use ACP’s registry tool, the PQRIWizard, to fulfill the requirements. More

New tool for Annual Wellness Visits

The Health Risk Assessment is a winning proposition for practices to incorporate into their workflow to offer patients a personalized preventive plan and specific action steps to take. More

Incentive programs yield mixed results for expectant internists

Three programs that promised more reimbursement for primary care delivered mixed results. The Centers for Medicare and Medicaid Services laid out who actually received more for participating in these programs, and how much. More

Well visits not just for kids any more

Medicare now reimburses for annual physical exams, so prepare your office, your patients and yourself for the best way to accommodate this into your practice. More

Assess your ability to comply with version 5010 requirements

The pressure is on to switch to version 5010, and the process will require identifying changes, testing transactions and minimizing disruptions. Also available are resources to help with preparation. More

Coding made easy for annual wellness visits

Health care reform now reimburses for annual exams under Medicare. Now, physicians have to reform their practices and prepare patients for them, as well. More

Much of the time physicians spend on patients' paperwork is uncompensated, but insurers usually will reimburse physicians for filling out forms, such as home health plans and copying medical records, that require a significant investment of time. More

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Staffing issues

Scribes: A write way and a wrong way

Taking a patient's history is considered an intimate part of the exam process, one long-cherished by traditionally minded physicians. Like much of the traditional practice of medicine, it's facing a new model for efficiency. Should doctors delegate the dictation? More

EHR training is mission critical

Don't skimp on the training when it comes to implementing an electronic health record system in a practice or facility. Basic functionality may require two weeks, and advanced functions may require another week to learn. More

Tips and tricks for hiring the right people

Hiring new staff costs both time and money, and frequently a 30- to 45-minute interview is the only opportunity to determine whether a person will succeed in your practice. Here are some tips on ways to increase the odds of making a good hire. More

Letters to the editor

Readers object to coverage on cost-cutting measures in practice management. More

Hire NPs, PAs to boost revenue, accessibility

A dependent practitioner can increase a practice’s accessibility, productivity and revenue while contributing to quality and patient satisfaction—and at half the cost of hiring a physician. More

Get time on your side: expert tips to eliminate waiting

Resolve to solve the waiting-room back-ups. Find out where the practice falls behind and implement solutions, including time studies, prior preparation and using medical assistants to their highest level of practice. More

To catch a thief (before theft happens)
Don't let employee theft happen to you. Simple internal controls and checks prevent temptation. More

PMC Tips
Hold to a higher standard for hiring
June ’08

PMC Tips
A road map can guide locum tenens travels
April ’08

Staffing can make or break a small practice
In a quest to unveil common problems for small practices and offer solutions, the College's Center for Practice Innovation visited 34 practices across the U.S. over a two-year period. Part one of the six-part series looks at the unique staffing issues faced by small offices. (January 2008)

Physicians adapt offices to cope with Medicare Part D
Many practices have appointed 'Part D specialists' to handle prior authorizations and drug formulary plans. (March 2007)

New Feature - Practice Tips
More hands make light work
"PMC Tips" is a new regular feature on small-practice management from ACP's Practice Management Center. (December 2006)

With doctors and housestaff in short supply, physician assistants help fill the coverage gaps
PAs can handle routine patient care, freeing physicians for more complex cases. (October 2005)

Need help hiring new staff?
The College's Small Practice Newsgroup is discussing what you can—and cannot—ask candidates in a job interview. (May 2004)

Letters
Readers discuss the future of physician assistants. (September 2003)

10 recruiting tips to stay fully staffed in a tough market
You can find a good fit with planning, perseverance and patience (February 2003)

Tips to survive when a physician retires
With an aging workforce and tight reimbursements, practices face some tough choices (September 2002)

Rightsizing, not downsizing, is key to staffing success
Moving staff to the right tasks and benchmarking can help the bottom line more than cutting positions (May 2002)

How to integrate a midlevel into your practice team
Physicians often either give their midlevel providers too little responsibility and autonomy, or they expect them to do too much (Web Only)

Problems retaining physicians? Try these strategies
A little education and support at work and home can go a long way in keeping new recruits happy (February 2001)

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Tort reform

Texas tort reform: One year later, some physicians say they're reaping big benefits
However, not all liability carriers here have dropped premium rates. (January-February 2005)

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