Healthcare on the edge

Practice Management in the

21st Century

Healthcare

Teetering on the Edge? Mark Stallwood

Dip Practice Management, B.V.Sc, Grad Dip Ed. MBA.

Macro View

WHO defines healthcare system as the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations.

Entitlements

• The right to a system of health protection providing equality of opportunity for everyone to enjoy the highest attainable level of health;

• The right to prevention, treatment and control of diseases;

•Access to essential medicines;

Healthcare Models

• Traditional

• Foundational

• Biomedical

• Social

• Economic

(Arbuckle 2012)

SO...

•Different countries approach healthcare in different ways and this determines how we manage practice…

• Government (Federal & State)managed • Includes Medicare, PBS, Public

Health • GP’s are gatekeepers • Taxpayer funded universal

system (levy), medical (pays 85% of costs) and some pharmaceutical & dental • Private system is ancillary,

insurance (52%) & provision of services.

• Government managed

• Includes medical, prescriptions, some dental

• Taxpayer funded universal system

• GP’s are gatekeepers

• GP co payment $30

• Private system is ancillary, insurance (32%) & provision of services.

• Government managed (Provinces and Territories)

• Includes medical, hospital, in patient prescriptions,

• Taxpayer funded

• GP co payment $30

• Private system is ancillary, insurance (66%) for additional services.

• Government managed

• Taxpayer funded universal system

• GP’s are gatekeepers

• Prescription co payment $15

• Private system is ancillary, insurance (11%) & provision of elective services.

• Fragmented management

• Mix of Private and NFP

• Private cover (56% -50% underinsured) ▫ 500 companies

• Govt. Public (27%)

• No Cover (16%)

• GP’s not gatekeepers

“In a perfect world, you would see a patient, submit a claim, and get paid. In a perfect world, what you charged for the procedure or service would reasonably reflect both the cost and the value of what you did, and you would, in fact, be paid what you charged” (Cohen 2011 Medical Economics)

What is Practice Management

• focus on the best use of resources to achieve the best outcomes for patients, in the most cost effective and efficient manner and provide an acceptable return to all involved in providing that service.

What many people think

• Focus on billing patients

• Ensure patients bookings are happening

• Basic administration

What it actually is…

•Human Resource Management

• Financial Management

• Risk and Compliance Management

•Marketing

• Logistics

• Planning

Practice is a business

Some interesting facts….

• 75% have no plan

• 80% have no budget

•Medical practices go bankrupt

•Accreditation is not best practice it is minimum standards

What else has changed

• Patients in many countries now have choice – Healthcare consumers

Issues are now:

▫ Time

▫ Convenience

▫Outcomes

▫ Perceived level of Service

http://www.youtube.com/watch?v=7_qwjcxwUqw&NR=1&feature=endscreen

So what are the issues for

my practice manager?

Human Resources

75 – 80 % of day to day issues are people related

• Lack of training

• Poor staff selection

• Lack of policy and procedure manuals

• Staff motivation

http://www.youtube.com/watch?v=u6XAPnuFjJc&list=PLEFA1641CDE7AFEA6

Financial Management

•No budget

•No cash flow management

•No asset management

• Few audit processes

Risk Management & Compliance

• Poor understanding of business risk

• 120+ pieces of non medical legislation

•OWH & S

• IR

Marketing

Applies to all practices

All about communication to:

• Patient

• Colleagues

• Potential Staff

Marketing (2)

• Practice Image

• Logo, Letterheads

•Newsletters

•Web Page

• Social Media

ICT

Keeping up to date

• Practice management systems

•Webpages

• Social Media

• Communication Systems

•Online Booking systems

Planning

•No shared values

•No shared direction

•No goals

•No succession plan

So where is the evidence? Department of Education, Employment and Workplace Relations funded a study by the Society for Knowledge Economics Leadership in 2011 Culture and Management Practices of High Performing Workplaces in Australia • Only service industries • 5600 employees

Findings

1. People management is a key priority

2. Involvement of staff in decision making process occurs

3. These organisations are more responsive to customers and key stakeholders

4. They have a learning culture

5. They enable staff to fully utilise their skills and abilities

Findings – Startling Bits!

•High performing workplaces generate 12% more revenue than similar businesses that were low performing.

• The profit margin in High Performing Workplaces (HPW) is nearly three times greater than in Low Performing Workplaces (LPW).

So what is your next step?

Questions?