Future of healthcare demands providers become 'physicians of choice'

Change can be unavoidable, constant and ominous, regardless of what kind of medicine you practice or where you practice it.

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Such appeared the illusive portrait of healthcare as painted by Marc D. Halley — President and CEO
 of The Halley Consulting Group, LLC — during his MGMA 2012 conference session on “Physicians of ‘Choice.’” But while Halley’s picture captured the current provider and economic landscape to a ‘t’, he was the first to point out that it certainly wouldn’t stay the same for long. In fact, if ideologies don't change, it’s sure to get worse, the consultant leader insisted.

“The game is changing,” Halley said. “The fundamentals of the game are changing. We’ve got to be very astute as practice managers or system managers, network managers, large mobile specialty group managers — we’ve got to be very careful because all of us are vulnerable.”

Presently, the storm is only brewing. The long and short of it comes down to two demographics not meant to contend — patients and physicians. But with a shortage of caregivers already underway and a massive baby boomer population fixing to be cared for, the two allies will soon be reluctantly at odds.

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“78 million baby boomers,” Halley emphasized. “And everything descended on in terms of the business side, or marketing or anything else in this country over the last 40 years, we [baby boomers] have obliterated just by our sheer volume. What’s going to happen to healthcare over the next decade? Where will those baby boomers be? In your offices. And we [baby boomers] are a nasty bunch. We’re not nice people necessarily. We’ve had it good for a long time, we think that’s the way it ought to be because of who we are. We’re going to overwhelm the healthcare system. I hope your hospital has a low average length of stay because we’ll need every hallway we can find unless we do something clinically smart over the next little while. You think primary care is in short supply today? Just wait.”

What’s more, two other entities remain in contention — reimbursement and regulation. 

“Which direction is reimbursement going? Down. We had the Robin Hood syndrome here a few years ago. They were going to take from the rich specialists and give to the poor primary care physicians. They got the first part right, but they forgot the last part.”

And “in addition to reimbursement coming down,” Haley noted, “the very people who are trying to keep that coming down [regulators] are actually also increasing the cost of doing business. And the fun thing about regulators is that when they show up at your door, you are guilty until proven innocent. They show up with guns on their hips sometimes.”

Halley included these other industry trends and implications as factors set to re-color the fabric of healthcare:

  • Increased financial risk for all healthcare realms;
  • Fewer, larger systems of providers;
  • Market management;
  • Increased competition for the “right” patients, meaning patients who can pay;
  • Emphasis on cost and productivity performance improvement;
  • Technology-driven marketplace; and
  • More business “rigor” needed than ever before to stay afloat.

Add those all up and you get what Halley called “the perfect storm.”

To prepare for this swirling tempest, Halley pointed to four strategic imperatives all practices must make sure they possess: a controlled market share, demonstrations of quality in both the clinical and service contexts, firm access to capital (such as technology, human resources and facilities) and continuous productivity (promoted via efficiency, effectiveness and access).

Additionally, Halley insisted professionals, or physicians of choice, avoid the following Ostrich tactics for utmost readiness:

  • Don’t act (ignore the threat).
  • “They need us...” (until they hire our replacements).
  • “Wait and see” (while the teams form).
  • Stay “neutral” (choose me last).
  • “Gonna get mine!” (the special deal).
  • Refuse to deal (historical animosity).

By employing measures or “tactics to improve service quality and remain in the referral path” Halley said there is no reason physician practices of all sizes should not prevail in the upcoming healthcare climate. Such tactics include listening to patients until they are finished before speaking, maintaining strong payer access and payer mixes, ensuring a capable receptionist "lifeguard" and emphasizing the importance of word-of-mouth referrals. 

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