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PubMed1984

Group practice accounting: up close and personal.

There is a distinct need today for timely, consistent, and accurate accounting methods for tracking the financial health of modern medical group practice. For all but the largest groups, the personal computer is the answer. Personal computers are powerful, dependable, and inexpensive, and for accounting, cost projection, inventory control, word processing, and data base analysis, they can outperform all the alternatives and pay for themselves in one year or less. Given the profusion of products on the market, however, it is essential that careful consideration be given to the areas of cost, time, software, hardware, and applications when making a personal computer purchase.

Accounting↗
PubMed1975

Lack of effect of an experimental prepaid group practice on utilization of surgical care.

The utilization of surgical care in an experimental period group practice for a 3 year period is reported. In contrast to what was expected, prepaid enrollees used the same or more surgical care than did control enrollees. The same proportion of emergency, urgent, and nonurgent admissions, occurred in both groups. Likewise there was no difference in the proportion of various procedures often thought to be overutilized in the traditional medical care system. High quality of surgical care in the area where the study was conducted was considered the most likely explanation for failure to show differences in the prepaid growth practice. Few, if any, unnecessary operations were performed in either group studied. Thus, under the conditions of this study, no significant measurable effect on surgical utilization by a change in the method of medical care organization and payment could be demonstrated.

Adult↗
PubMed2002

Cost analysis can help a group practice increase revenues.

Undertaking a cost analysis to determine the cost of providing specific services can help group practices negotiate increased payment and identify areas for cost reduction. An OB/GYN practice in Pennsylvania undertook a cost analysis using the resource-based relative value system. Using data from the cost analysis, the practice was able to negotiate increased payment for some of its services. The practice also was able to target some of its fixed costs for reduction. Another result of the analysis was that the practice was able to focus marketing efforts on some of its most profitable, elective services, thereby increasing revenues. In addition, the practice was able to reduce the provision of unprofitable services.

Abstracting and Indexing↗
PubMed1994

Functional disability screening of ambulatory patients: a randomized controlled trial in a hospital-based group practice.

The authors conducted a randomized controlled trial of functional disability screening in a hospital-based internal medicine group practice. They assigned 60 physicians and 497 of their patients to either an experimental or a control group. Every four months the patients in both groups completed a self-administered questionnaire measuring physical, psychological, and social function. The experimental group physicians received reports summarizing their patients' responses; the control group physicians received no report. At the end of one year the authors found no significant difference between the patients of the experimental and control group physicians on any measure of functional status. Functional disability screening alone does not improve patient function.

Activities of Daily Living↗
PubMed1992

Employee v. independent contractor: tax and other considerations for group practices.

The classification of physicians and associated health care professionals as employees or independent contractors in a group practice context is an important and frequently misunderstood issue, with many traps for the unwary. This article discusses the effect of classification on a group's responsibilities, the factors to consider in determining whether a health care professional should be classified as an employee of the group or an independent contractor, and the practical considerations involved in reclassification of an improperly classified worker.

Contract Services↗
PubMed1984

Marketing audit in group practice.

The marketing audit, whether large-scale or small-scale, will soon be critical to the success of every medical group practice. This dynamic process, in which the many components of a group's marketing efforts are analyzed, is examined from the perspective of ideal circumstances and unlimited resources, and more pragmatically, from the perspective of various-sized groups, with different resources and marketing talent. The audit components are prioritized, possible adaptations and combinations are presented, and reasonable implementation mechanisms, designed to address audit outcomes, are suggested.

Group Practice↗
PubMed1995

Primary and preventive care in a university obstetrics and gynecology group practice.

OBJECTIVE: Our purpose was to determine whether primary and preventive care is practiced by a university obstetrician-gynecologist group practice. STUDY DESIGN: A retrospective chart review spanning 2 years of four academic physicians' private practices was performed. A total of 335 patients were reviewed with 739 patient encounters and 1032 patient problems identified. The definition of a primary care physician according to The American College of Obstetricians and Gynecologists was used to standardize data collection and evaluation. RESULTS: Obstetric complaints accounted for 27.7% of all visits, whereas 65.4% were for gynecologic problems. Almost 7% of all complaints were neither obstetric nor gynecologic, and of those 74.6% were primary care problems completely managed by the obstetrician-gynecologist. Only 19.7% of these were referred for management. More than 89% of all encounters (659/739) involved some element of primary care. CONCLUSION: This study provides evidence that the majority of health care provided by the obstetrician-gynecologist is primary care.

Adolescent↗
PubMed1996

Current issues in multispecialty group practice: the Lahey Hitchcock Clinic merger experience.

The merger of two large not-for-profit multispecialty group practices in 1995 forced the two founding organizations into a deeper understanding of their heritage and mission. Common features of Lahey Hitchcock and similar organizations of their vintage are discussed. Issues addressed include governance, desirable leadership characteristics and growth, "incentivizing change," and workforce planning.

Governing Board↗
PubMed2000

Benchmarking medical group practices using claims data: methodological and practical problems.

As claims data for physicians and groups of physicians has improved in quality and quantity, health information vendors have begun marketing information about medical groups' productivity, utilization, and quality. Based on interviews with product developers and our understanding of the evolution of their products, several methodological and practical issues remain. For now and the immediate future, health information vendors will continue to face the limitations of physicians' claims data. Vendors and purchasers should be aware of common data shortcomings such as inadequate monthly enrollment figures, possible physician upcoding to circumvent utilization management restrictions, and incorrect coding when a test is used to rule out a disease. In the longer term, several avenues seem likely to make medical groups' data better and richer because of computer-based medical records and efficiencies possible from the Internet. The field of benchmarking products for group practices is still an immature market. However, several trends suggest such products are highly desirable. Provider organizations which bear medical risk need benchmarking data to help improve their efficiency. There are many important nonprovider organizations that need good information on group practices' utilization patterns and outcomes to help them plan new products and negotiate with physicians.

Benchmarking↗
PubMed1993

Frequency and determinants of screening for breast cancer in primary care group practice.

BACKGROUND: Many studies reporting the frequency of breast cancer screening have been based only on physician and patient surveys or on data from quality assurance studies and do not assess the reliability of information obtained from these various sources. METHODS: To obtain more complete data we studied mammography performed in a 3-year period, 1988 through 1991, in 24 nonacademic primary care group practices by both auditing the medical records and obtaining questionnaire responses from 1819 women aged 53 to 62 years and from their 98 physicians in the nonmetropolitan Midwest. RESULTS: Medical record data indicated that mammography was performed in all 3 years in 16.7%, in at least two of 3 years in 49.8%, and in at least one of 3 years in 81.7% of women. While patient reports of a family history of breast cancer, health insurance coverage for mammography, and greater annual household income were each significant predictors, a patient report that a clinic staff member had discussed mammography was the strongest predictor of greater frequency of mammography. CONCLUSIONS: In this study of self-selected physicians and their patients, record-documented mammographic examinations were considerably more frequent than has been reported in some studies, but occurred at rates consistent with quality assurance data for the region. These data suggest that clinic staff initiatives with screening mammography have a large impact.

Breast Neoplasms↗
PubMed1975

The Health Maintenance Organization Act of 1973 (P.L. 93-222) and prepaid group practice plans.

Passage of the 1973 Health Maintenance Organization Act (P.L. 93-222) represents a significant effort by the Federal government to experiment with organizational change in the structure of the health care delivery system. The history of the bill is briefly reviewed. The most important sections of the bill are analyzed from the perspective of an existing prepaid group practice plan. The author concludes that the bill contains sufficiently stringent requirements that it will not result in a major increase in the number of Health Maintenance Organizations unless similar requirements are imposed on other private insurance carriers. Furthermore, significant allowance for "phasing in" will be required for the existing prepaid group practice prototype plans to qualify for Federal certification.

Costs and Cost Analysis↗
PubMedDate not supplied

Knowledge of patient's method of payment by physicians in a group practice.

Physicians generally know how patients pay for their medical care. At the Marshfield Clinic, however, a group practice in Marshfield, Wis., physicians did not know the source of payment for the vast majority of their patients (79.3 percent). Also, even for the approximately one-fifth of the patients whose payment status they reported knowing, the information was incorrect for a small proportion. The patient's age and sex, length of time the physician had provided care, patient's place of employment, reason for patient's visit, and whether the physician was in the medical or surgical department apparently affected the physician's knowledge of the patient's payment status. Twenty-five of the 49 physicians studied reported they knew the payment status of none of their patients about whom they were asked; 24 knew the status of at least one patient. Only one physician in seven, however, reported having this knowledge about all the patients about whom he was asked. Physicians in medicine were more likely than those in surgical sub-specialties to know the patient's payment status. About one physician in five said such knowledge would be helpful for at least one patient; about one in seven said it would be helpful for all patients about whom they were asked. The Marshfield Clinic physicians, who receive salaries, emphasize comprehensive care and increased access to care, rather than maximization of income. The clinic offers medical care to patients in a prepayment health plan while continuing to serve other patients on a fee-for-service basis. Arrangements like this may help ease the transition to repayment if health-maintenance organizations become predominant in the delivery of health services in the United States.

Adolescent↗