One of the best ways to find out whether your practice is achieving its objectives is to evaluate its performance. The 5th edition of the Assessment Manual for Medical Practices provides challenging, comprehensive questions for administrators, supervisors and consultants. Managers from all types and sizes of physician practices can gather crucial information about the organization by investigating the topics laid out here.
This versatile manual, organized by body of knowledge (BOK) domain, asks questions and provides tables and columns for self-assessment.
Including:
- External and internal environments
- Planning and marketing
- Financial management
- Business operations
- Human resource management
- Quality improvement
- Patient care
- And much, much more!
To give you an idea of how the Assessment Manual suggests monitoring patient access and services in your practice, it asks you these audit questions:
- Compare and evaluate the current typical appointment wait time. Does it show an increased demand for one service or a decline in another? Is the wait time long enough to affect patient satisfaction?
- What have been the factors in deciding whether to add new services or expand current services, including adding more providers?
- What were the financial, personnel and spatial constraints that limited the expansion of services?
- Are there cultural or language barriers that limit patients’ access to services?
- Are there physical barriers, including the practice’s location or proximity to parking, that limit patients’ access to service?
- Do inefficient appointment scheduling and follow-up care create barriers?
- Are you a patient-oriented group?
- Does the clinical and administrative personnel mix still support the service demand in your practice?
- Have there been changes in personnel when the services changed?
After conducting a practice audit, you will be able to identify areas of concern and areas to concentrate on for improvement.
So, take the first step toward challenging the status quo – find out what’s working and what not. Based on those results, you can decide what management areas to strengthen to ultimately improve your practice’s performance.
In addition, this revised edition contains an expanded section on information management and health information technology questions to help address your group’s compliance with various federal regulations.
MGMA, 2011.
Chapter 1 Business Operations
- Task 01: Develop, Implement, and Monitor Business Operation Plans
- Task 02: Develop, Implement, and Oversee Systems for the Purchase of Materials and Equipment
- Task 03: Manage Facilities Planning and Maintenance Activities to Meet the Organization’s Current and Future Needs
- Task 04: Manage Discernment Process for Identification and Utilization of Outsourced Expertise and Business Partners
- Task 05: Develop and Implement a Marketing and Communication Plan
- Business Operations Supplemental Notes Worksheet
- Business Operations Action Items Worksheet
Chapter 2 Financial Management
- Task 01: Develop and Implement the Organization’s Budget to Achieve Organizational Objectives
- Task 02: Establish Internal Controls for Cash Management
- Task 03: Implement and Maintain a Process for External Financial Audits
- Task 04: Develop and Implement Revenue Cycle Management and Accounts Receivable Management
- Task 05: Analyze and Monitor Financial Performance and Report Financial Results to Stakeholders
- Task 06: Direct the Payroll Process
- Task 07: Establish and Maintain the Organization’s Banking, Investment, and Other Financial Relationships
- Task 08: Develop Relationships with Individual Insurance Carriers to Optimize Contract Negotiations and Maintenance of Existing Contracts
- Financial Management Supplemental Notes Worksheet
- Financial Management Action Items Worksheet
- Worksheet FM-1: Payer Analysis
- Worksheet FM-1: Payer Analysis
- Worksheet FM-2: Administrative Complexity Worksheet — Individual
- Worksheet FM-3: Administrative Complexity Worksheet — Practice
- Worksheet FM-4: Fee Analysis Worksheet
- Worksheet FM-4: Fee Analysis Worksheet
Chapter 3 Human Resource Management
- Task 01: Coordinate the Recruitment and Orientation Process of Clinical and Nonclinical Staff
- Task 02: Manage the Retention of Clinical and Nonclinical Staff
- Task 03: Develop and Monitor an Effective Staffing Strategy
- Task 04: Develop, Implement, and Evaluate Performance Management Programs for Clinical and Nonclinical Staff
- Task 05: Develop and Implement Staff Compensation and Benefit Plans
- Task 06: Provide Systems, Processes, and Structure for Administrative and Clinical Training for Medical Providers, Employees, and Students
- Task 07: Establish Systems and Processes for Awareness, Education, and Compliance with Employment Laws and Regulatory Standards
- Task 08: Provide Personal Commitment to Enhance Knowledge, Skills, and Abilities in Healthcare Administration
- Human Resource Management Supplemental Notes Worksheet
- Human Resource Management Action Items Worksheet
Chapter 4 Information Management
- Task 01: Develop and Maintain Appropriate Internal Communication Pathways for Clinical and Nonclinical Staff
- Task 02: Develop a Technology Plan That Establishes the Criteria for Selection and Implementation of Information Technology, Including Computer Systems, Internet Strategies, and Telecommunications
- Task 03: Plan and Design a Technology Security Process to Protect Patient and Practice Data Systems
- Task 04: Manage Medical Information Systems Including Medical Records, Medication Administration, and Healthcare-Related Document Storage
- Task 05: Develop and Implement Processes to Comply with Mandated Reports of Specified Patient Issues to Regulatory Agencies
- Information Management Supplemental Notes Worksheet
- Information Management Action Items Worksheet
Chapter 5 Organizational Governance
- Task 01: Facilitate the Establishment and Monitoring of the Appropriate Corporate Legal Structure for the Organization
- Task 02: Facilitate Organizational Governance Structure and Maintain Proper Corporate Record-Keeping of Strategic Decisions
- Task 03: Lead the Integration of the Corporate Mission Statement into All Aspects of the Organization’s Culture
- Task 04: Lead Development of the Organization’s Strategic Plan and Its Implementation
- Task 05: Establish, Communicate, Implement, and Monitor Production and Compensation Standards for Physician and Mid-Level Professional Staff
- Task 06: Implement and/or Support Organization Leadership Management of Clinical Staff Conduct and Performance Expectations or Programs
- Task 07: Foster the Growth and Development of Physician Leaders as Knowledgeable, Participative Stakeholders
- Task 08: Encourage and Lead Participation in Advocacy Endeavors at Local, State, and National Levels
- Organizational Governance Supplemental Notes Worksheet
- Organizational Governance Action Items Worksheet
Chapter 6 Patient Care Systems
- Task 01: Establish and Monitor Business Processes to Ensure Effective and Efficient Clinical Operations
- Task 02: Provide Relevant and Accurate Resources to Enhance Patients’ Knowledge, Understanding, and Participation in Their Medical Care
- Task 03: Develop and Implement a Referral Management Process
- Task 04: Design Efficient Patient Flow Patterns to Maximize Physician Schedules
- Task 05: Manage Front Office Operations to Maximize Patient Satisfaction, Collection of Payments, and Customer Service Efforts
- Task 06: Implement a Plan to Control Pharmaceutical Supplies
- Patient Care Systems Supplemental Notes Worksheet
- Patient Care Systems Action Items Worksheet
Chapter 7 Quality Management
- Task 01: Design and Implement a Quality Management System That Leads to the Improvement of Healthcare Delivery and Ensures Patient Safety
- Task 02: Monitor the Peer Review Process for Clinical Staff
- Task 03: Develop and Oversee Patient Satisfaction and Customer Service Programs
- Task 04: Identify, Develop, and Maintain Benchmarks for Establishing Practice Performance Standards
- Task 05: Create Internal Processes and Systems to Participate in Pay-for-Performance Programs to Enhance Healthcare Quality
- Task 06: Develop and Monitor a Program for Staff, Business, and Equipment Credentialing and Licensure
- Quality Management Supplemental Notes Worksheet
- Quality Management Action Items Worksheet
Chapter 8 Risk Management
- Task 01: Develop and Implement a Risk Management Plan to Ensure a Safe Environment for Patients, Staff, and Visitors
- Task 02: Develop and Implement Policies and Procedures to Manage the Impact of Adverse Legal Events
- Task 03: Establish a Plan for Disaster Response and Recovery
- Task 04: Develop and Implement a Compliance Program for Federal and State Laws and Regulations
- Risk Management Supplement Notes Worksheet
- Risk Management Action Items Worksheet
Summary
Carolyn Pickles, MBA, FACMPE, a consultant specializing in medical practice management, has more than 20 years of experience in the industry, both in private practice and hospital settings. Her experience includes operations, systems, billing and finance, risk management, governance, information management, and human resources. Her projects have included practice growth and expansion, implementing and integrating systems, developing an in-house billing system, implementing financial systems and controls, developing coding review processes, improving operational efficiency, minimizing risk, integrating information management systems, recruiting, and developing human resource protocols and systems.
In 2006 she started her own consulting firm to provide project-based consulting for single- and multispecialty physicians and physician groups as well as interim practice management services. Pickles earned both her MBA degree from the University of Massachusetts at Amherst and her Fellowship in the American College of Medical Practice Executives in the year 2000. She is a past president of Massachusetts/Rhode Island Medical Group Management Association and has served on both the Medical Group Management Association Eastern Section and American College of Medical Practice Executives boards of directors. She holds memberships in MA/RI MGMA, MGMA, and the ACMPE.
Alys Novak, MBA, has a private consulting and publishing practice. Her many assignments in the healthcare field have focused on medical practices, home health, and rural health. Her areas of expertise include human resource management, organizational governance, strategic planning, and marketing/ communication. For many years she served as adjunct faculty at the University of Colorado and Metropolitan State College of Denver, teaching a variety of business topics.
Novak has coauthored several books, including MGMA’s User-Friendly Psychology for Medical Practices and Financial Management for Nonprofits (Discovery Communications, Inc., 2005). She is also the author of MGMA’s Governing Policies for Medical Practices. Novak coauthored MGMA’s The Medical Practice Performance Management Manual, Job Description Manual for Medical Practices, 3rd Edition, the HR Policies and Procedures Manual for Medical Practices, 4th Edition, and Staff Handbook for Medical Practices, with Courtney Price, PhD. For more than two decades she has edited publications for MGMA on the full range of Body of Knowledge topics.
Until recently she served as an administrator for the Visiting Nurse Corporation of Colorado, specializing in quality management, patient satisfaction, volunteer resources, marketing, healthcare ethics, and business planning.
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