By Darren Whittemore, DO
To increase revenue and expand your patient base, you may have tried engaging with people on social media, advertising special service packages, or even parking a dancing balloon guy on the curb by your derm practice to drum up business. Nothing seems to work.
Serious change requires serious strategies. By tracking changes in billing and health insurance requirements and offering your resources and expertise to support pharmaceutical companies as they use technology to gather research data, you can uncover additional ways to help your practice grow. So give the dancing balloon guy the day off, and let’s explore four hidden revenue-building opportunities that can help point your derm practice in the right direction.
Outsource Medical Billing
Unless your accounts team has expertise in ever-changing CPT codes, AFA policies, and other Medicare, value-based care reimbursement guidelines, outsourcing medical billing is a popular and cost-effective option. Around 90 percent of healthcare leaders have considered outsourcing in both clinical and nonclinical functions to be more cost-efficient and better equipped to handle value-based care models. And here’s why:
A recent survey by Harmony Healthcare found that 33 percent of hospital executives reported the average claims denial rate hovering around 10 percent. In fact, across the nation, hospitals face average denial rates between 6 and 13 percent. When rejections occur, you need an experienced team that can respond quickly and are better equipped to handle changing requirements for medical reimbursements.
For example, board-certified dermatologist Dina Strachan, M.D., at Aglow Dermatology in New York, notes that every step needed to collect money from both patients and insurance comes with a cost attached. There is a huge time factor involved in understanding the fine print of the myriad high-deductible plans, and a lot of time is tied up in collecting and processing bills. By outsourcing billing, and placing a link on her website where payments can be made, a lot of time is recaptured.
“We don’t have to spend time opening and sorting mail, punching in, and processing credit card payments—it’s a time savings,” she said.
Apply to Host a Clinical Trial
Emerging cloud technologies are helping pharmaceutical companies tap into innovative alternatives for collecting rich, segmented research data. ClinicalTrials.gov currently lists 404,694 studies with locations in all 50 States and in 220 countries.
With in-person testing sites no longer being the only option for research, pharma can use both virtual and hybrid models to collect data.
Depending on the length of the study and the interaction levels required by the clinical trial directors, pharmaceutical companies will often pay clinics willing to dedicate their time and resources to help facilitate a relevant clinical trial.
Along with the revenue potential, most healthcare providers enjoy the option to provide their patients with the most recent treatments available, particularly in skin cancer and other chronic cases. According to the Dermatology Learning Network, interviews with dermatologists that have participated in clinical research show they can be professionally, intellectually, and financially rewarding.
“It allows you to give your patients cutting-edge treatment at a severely discounted price or for free,” said Dr. Mitchel Goldman, medical director of La Jolla Spa MD, in La Jolla, California.
In addition to the excitement of being involved in the development of new products and offering patients new treatment options, Steven R. Feldman, M.D., Ph.D., of Wake Forest University Baptist Medical Center in Winston-Salem, NC, noted the potential financial benefit to practices as well.
“In an era where managed care is paying less for each office visit, you can charge your usual office rate,” Feldman said in reference to patients enrolled in trials.
Reexamine Health Insurance Partnerships
Over the past 20 years, health insurance companies have consolidated to cut costs, meet higher demands, and, in some cases, move toward the government and individual health insurance markets under the Affordable Healthcare Act. This transition has given health insurance companies an advantage over physicians.
“Most dermatology practices lack the scale to negotiate with large health insurance companies on an even playing field,” Todd Petersen, CEO of Vitalskin Dermatology, explains. “These terms set year-over-year reimbursement rates and allow the insurance company to set billing, coding and utilization management rules. Consequently, nominal year-over-year increases can be largely offset by increased denial rates and tighter billing and coding rules.”
Although dermatology costs aren’t a high price point for health insurance carriers (accounting for less than 2 percent of medical costs), Petersen points out that pharmaceutical spending for dermatology-related drugs, such as psoriasis-related treatments, accounts for 6.5 percent of total spending with signs of future increases.
“For dermatology practices with market share and a large psoriasis patient population, using this strategy at the negotiating table may prove beneficial and provide the practice with improved revenues,” he says.
Invest in EMR Technology
Moving to digital-based technology, such as EMR or EHR, creates more efficient and profitable processes in a few ways:
- Participates in the Medicare Merit-based Incentive Payment System (MIPS)
Values-based care and reimbursements are growing and allow for additional revenue streams. EMR technology is required for billing compliance and patient dashboard access and to collect data and submit electronic data to CMS. According to Petersen, the initial investment cost of EHR technology will pay itself off down the road. “When considering whether to make the investment of complying with MIPS, consider the following: value-based reimbursement is not going away, and many practices have found the implementation of EHRs has helped them improve their billing compliance,” he writes.
- Enables faster turnaround times for lab test results
For Allen-Taintor Dermatology, not only did partnering with a lab that specializes in digital dermatopathology provide a faster turnaround time for lab results (turnaround time is now 75 percent faster, with results often received within two days of submission), but it also enabled their dermatologists to use a digital slide to encourage a conversation about the patient’s biopsy results and possible cancer care. As faster turnaround time increases the speed of business, more patients can flow through the practice with increased revenue as a result.
- Expands access to care
Digital-based patient files mean doctors aren’t limited by location to reach out for expertise on a patient’s case. With digital technology, a specialist in Boston or Switzerland can securely review a patient file and discuss a diagnosis in real time with the dermatologist. That leads to quicker results and prompt patient care, which again improves revenue.
With the dermatology field expected to grow by almost 11.4 percent by 2026, dermatologists can leverage revenue-building strategies by reducing overhead costs through outsourced billing services, research reimbursement rates with health insurance and government health program partnerships, participate in clinical trials, and expand digital patient care services. By tapping into these revenue outlets, you can help to prepare your derm practice for a future of growth.
Since the pandemic’s onset, we’ve learned a lot about the impact of digital technologies like telehealth services and remote patient care models. These services have been pivotal for ensuring the nearly 78 million people who live in rural communities across the US have access to a healthcare provider.
But telecommunications and digital pathology capabilities within rural clinics also benefit primary healthcare providers by elevating the quality of patient care they can provide with no heavy investment in lab equipment or additional staff.
With a digital pathology workflow, your patient’s lab results are sent electronically directly to each patient’s EMR. Plus, a digital image of your patient’s results makes it possible to collaborate with expert dermatopathologists from all over the country to utilize their expertise for the best care options possible.
Let’s talk about the current state of healthcare in rural communities and how the need for alternatives in delivering patient care, including specialized care, is in sync with digital technology capabilities. Then, we’ll explore how transitioning to digital technology doesn’t require more overhead costs. Instead, it empowers your rural clinics to expand accessibility and be more effective with existing staff. Here’s how.
Understanding the Doctor-to-Rural-Patient Ratio
First, let’s understand what doctors in rural communities face. The National Rural Health Association says the ratio of doctors to the population in the rural communities they serve averages around 39.8 physicians per 100,000 people. This is compared to 53.3 physicians per 100,000 in urban areas. Access to specialized care is even lower, with only around 30 specialists serving 100,000 people in rural areas. These facts underline how critical it is for technology to bridge the gap between modernized healthcare and America’s rural regions.
Comparing General Clinical Care to Specialized Care
In many cases, rural clinics staff medical school residents who can provide effective general care. On any given day, these busy rural clinics respond to various patient care needs ranging from setting bone fractures and running a lab test for a bladder infection to vaccinating an infant.
But what about chronic skin conditions? An NIH study found that rural communities in Texas, for instance, experience higher incidences of cancer than urban areas, particularly melanoma, which accounts for over 7,000 deaths each year. And in Utah—which holds the rather dubious honor of reporting the highest incidences of melanoma and mortality rates in the US (80 percent higher than the national average)—96 percent of its land is rural or frontier.
“Patients from rural and frontier counties may have different pathways of care to a melanoma diagnosis,” explains Tawnya L. Bowles and her research team. “Rural patients may not have proximity to a diagnosing provider and the specialty of the diagnosing provider may be different compared with urban patients. Furthermore, patient and tumor characteristics may also be influenced by rural residence.”
With early detection playing such a huge role in successfully treating chronic skin diseases, how can rural clinics best deliver optimal care without increasing overhead costs? Simple: Bring the dermpath lab and their team of specialists to the clinic. And that’s where digital technology comes into play.
Digital Technology: A Modernized Tool for Accessible Specialized Care
In any pathology case, tissue samples of the affected area must be collected, then processed in a pathology lab. Digital dermpath specialists add an additional process of digitizing slides in a scanner, which allows for improved access to whole-slide images for both the requesting physician and the dermpath lab, typically resulting in a shorter diagnostic turnaround time.
But here’s where rural clinics benefit from this technology: Since the process is virtual, slides can be instantly shared with specialists anywhere in the world. Some dermpath labs—including PathologyWatch—also have specialists in other fields on staff, allowing them to have even more immediate access to virtual slides after they’ve been digitized without needing to send glass for a consultation.
A dermatopathologist’s understanding of skin diseases includes knowing which ones can indicate something else, such as systemic diseases found in other parts of the body that may present dermatologically. Through digital dermatopathology, dermpaths can conveniently review and share slides with specialists familiar with these indicators and include those specialists’ findings as part of their report.
Enhanced Patient Care
Understanding the correlation between dermatopathology findings and disease with readily available access to specialists can ultimately result in improved patient care. Once a diagnosis has been established, a primary care physician can take a swift and appropriate course of action. With digital technology, doctors can treat patients anywhere without requiring more full-time staff or expensive lab equipment.
Compared to traditional pathology practices, digital pathology provides a strategic resource in qualitative analysis and reduces errors through the conversion of slides into digital imagery.
With an extensive network of specialists in multiple fields, digital dermpath labs can generate more detailed reports based on additional findings through collaboration achieved by sharing these high-resolution digital slides with specialists. That means a rural clinic in Hurricane, UT, can feel confident that they are providing the same caliber of specialized care for their patients as those treated in larger cities.
Digital pathology can transform your rural clinics by offering patient care services that weren’t possible a decade ago. With digital technology as the foundation of your care delivery process, your staff will provide the most innovative dermatological care available, partnered with a personalized and caring patient experience.
Contact us today for a free demo if you’re interested in learning more about how PathologyWatch, our team of dermatopathologists, and our network of dermatopathologists can help you.
Running a promising dermatology clinic means continuously seeking ways to enhance patient care quality and maximize staff efficiency. For proof, consider that over 40 percent of practices claim to have implemented EMR systems to help them grow.
While implementing an EMR system for dermatologists has many advantages, there are still some disadvantages to consider. This article will look at the pros and cons of electronic medical record systems for dermatologists, including reducing paper, image management, billing, lab interaction, and EMR limitations to ensure you have the facts when considering ways to maintain quality diagnosis and patient care.
One main advantage to an EMR is the ability to access your notes and patient information anywhere. In an increasingly digital world, we are often communicating with patients while out of the office. Still, 25 percent of dermatologists continue to use traditional paper systems to support their operations.
Here are some of the standard paper shortcomings and the ways an EMR system solves them:
- Repetitive tasks: Completing the same functions repeatedly takes time and energy away from vital patient interaction. In addition to autopopulating fields, an EMR sends data electronically, so it doesn’t have to be re-entered.
- Errors: Entering and re-entering data into the LIS introduces the possibility of human error. Entering data one time using an EMR removes the chance of making mistakes on repeat entries.
- Access: Pulling a patient’s paper file can only be done in the office, requiring time and physical space to store the physical records. Using electronic medical records means patient information is stored securely in the Cloud, which providers can instantly access from anywhere with a Wi-Fi connection.
Unlike paper, EMR systems make it increasingly advantageous for dermatologists and their staff to do things more efficiently and conveniently. It is important to ensure staff is adequately trained on a new system and receives regular review sessions to maintain a good standard of EMR charting, as updates occur several times per year.
Patient images in dermatology are valuable, as much of the specialty relies on visual recognition. It is also important when tracking the correct site of a biopsy, especially for referring to other providers like Mohs surgeons.
Digital images are easy to capture, but often cumbersome to organize. If not using an EMR, these will have to be organized in folders with patient name and date and kept in a secure digital environment. Many EMRs resolve this arduous process by allowing you to take photos within the patient chart and automatically assigns the images to the correct biopsy location. These images can be accessed immediately, making it easier for dermatologists to share them with partners and patients or review them on the next visit. Also, being able to review them in the context of your visit with relevant labs and other notes helps in diagnosis, especially of difficult cases.
While necessary, billing is not the favorite activity of most providers. However, billing takes time and diligence to communicate with insurance companies and resubmit claims when appropriate. With that in mind, another benefit of electronic medical records is the autobilling feature.
Many EMRs will issue invoices based on coding applications. In addition, some EMR systems claim up to 98 percent first-pass claim acceptance, which means you and your staff can spend time focusing on patient care instead of going back and forth with insurance companies.
Also, EMRs automatically track any changes to Medicare’s Merit-Based Incentive Payment System (MIPS), ensuring your practice receives accurate reimbursement for qualifying services. This eliminates manual tracking and helps you to maintain focus on patient care.
Communication with your dermatopathology lab partner is vital to ensure the highest quality of diagnosis for your patients. Full-service dermatopathology labs like PathologyWatch will integrate an EMR interface, which allows them to access the data and fields entered into your EMR system.
Equally important, an EMR interface grants you instant lab results and images sent directly to your device. The EMR also helps you send e-faxes to providers or drop notes directly to the patient’s record, instead of requiring your staff to print out, fax, scan, and wait for a confirmation.
While EMR systems embed many time-saving and workflow advantages, they also contain quirks and constraints that users learn to navigate. For instance, 82 percent of physicians indicate it takes too long to enter data that isn’t directly related to patient care.
The EMR could also make it difficult to communicate outside of the prescribed default descriptions. Thus, if you indicate eczema when you’re trying to describe a rash, it may take you longer to type in a custom description than selecting the available options. To make the system work right, you have to be willing to customize your process with templates, adding quick text or macros when possible to aid in customizing each note, and take time to delete unused or irrelevant items within your templates.
Sometimes, adding digital elements can create slow-downs if the interface is down or you experience an error after an update, for instance. This can be challenging if you can’t print out a requisition from your EMR or can’t access patient records while you are seeing patients in the clinic.
In the end, the benefits of implementing an EMR into your dermatology practice often outweigh the disadvantages. By understanding how EMR systems can reduce your reliance on paper, manage images, increase billing efficiency, and boost lab communication, your clinic can make a qualified decision that can help you continue to provide quality care for your patients.