Cardiology Coding Alert

Hint: You may have overwhelmed physicians.

During the 2021 RISKCON session “Provider Engagement and Education,” instructor Sherrie L. Anderson, MS, CPC, CPC-I, CRC, CPPM, shared the importance of physician engagement. She identified common challenges you may encounter while practicing physician engagement, as well as strategies you can employ to overcome these challenges.

Follow these three tips to master physician engagement in your practice.

Tip 1: See Why Physician Engagement Matters

Physician engagement is the process of the physicians having input regarding how their work gets completed, making suggestions for improvements and processes, setting goals, overall planning, and being aware of their own performance, Anderson said.

“It makes a world of difference when physicians feel engaged with both the administration and the health system,” Anderson added. “When engagement happens successfully, this results in the physicians feeling proud, loyal, and committed to the organization’s mission, vision, and values.”

Anderson also discussed the importance of physician engagement. “Healthcare administrators, auditors, coders, and billers, all who are key within the revenue cycle, cannot manage without the assistance of physicians,” Anderson said. “Seventy-five to eighty-five percent of all quality and cost decisions are driven by physicians. Therefore, that impact is huge.”

Health systems or health plans that involve and engage providers show improved clinical outcomes, member retention, and overall great efficiency, Anderson added. “Achieving and being successful with provider engagement requires us to strategically align quality and economic goals within the provider practice.”

Anderson identified providers as the “backbone” of the healthcare system.

“Their [providers’] decisions impact both quality and cost of care. Some of the things providers have control of include specialist referrals, prescriptions that are needed, and the need and quality of care,” Anderson said. “It’s necessary to engage providers by involving them in goal setting processes because the future of the healthcare system and providers’ futures are linked to their goals and their successes.”

Engaged physicians perform higher at a greater care of their patients, reducing or controlling medical costs and are more efficient than their unengaged counterparts, Anderson added.

Tip 2: Identify Common Challenges of Physician Engagement

Anderson identified some common challenges you may encounter while trying to engage your physicians. These challenges include the following:

Challenge 1: Overwhelmed physicians — “Not all physicians understand how they directly impact or contribute to improving both efficiency and cost. Most do, but some do not,” according to Anderson. Because of this, the physicians who are unaware will not know how to handle the ever-changing environment of healthcare, whether that is patient care or billing. So, it will become overwhelming and be a stress factor.

Other physicians will struggle to embrace engagement because it is not something that is well understood.

“As administrators, we should have a plan in place to help support these physicians and to be able to adapt to new initiatives,” Anderson said.

Healthcare is data, and data in general for some is overwhelming, Anderson added. If you think of healthcare in this way, as data, then you can make a plan to explain what’s behind the data, so physicians become more comfortable with it.

Challenge 2: A poor understanding of new healthcare models — A lack of understanding can create and fuel a physicians’ confusion, Anderson explained. “Consider a physician whose priority is taking the best care of their patient. Now we have added in documentation criteria, which is much more stringent, and the ICD-10-CM world.”

When a physician is faced with documentation, coding, new record systems, and payers, they can become completely overwhelmed and have a poor understanding, Anderson said. It’s challenging for physicians caring for patients all day every day, rotating in-patient shifts, making hospital calls for consults, etc. And, on top of that, they must remember all the ins and outs of the documentation policies.

Challenge 3: A narrow focus — “As management, we sometimes immediately consider adding more individuals to the team before truly thinking about a long-term outcome. Adding physicians to secure alignment or a vision or a plan may seem at first like it could be a good idea,” according to Anderson. “However, adding to the chaos or the confusion may actually have a negative implication rather than a positive one in the long run.”

Adding additional bodies does not make a physician engaged, Anderson said. However, when you add new physicians, you should have a well-organized and strategic plan to do so.

Your strategy should include asking yourself some of the following questions, per Anderson:

• Think about the existing physicians and the new physicians coming in. What are their clinical and personal workspaces? If their workspace and clinical setting are already cramped, will adding additional individuals to the space truly help?
• What’s the onboarding process? How much time and effort goes into onboarding within your practice? What does the training experience include? Does the training cover billing, rules, policies, electronic medical records (EMRs)?
• Consider who the new physicians’ colleagues are going to be. Are you adding new physicians with disengaged or unsatisfied physicians? How can you merge both types?

Tip 3: Use These Strategies for Physician Engagement

Anderson shared some handy strategies you can use in your practice to make sure you are engaging your physicians.

Strategy 1: Have a united purpose: You can help shift the way providers think and become united in your goals and mission, Anderson said.

“It’s all about gaining trust,” Anderson added. “Trust can make or break how well we work with our physicians. Explaining, expressing, and shifting to a united purpose will help gain that engagement.”

Strategy 2: Appoint leaders: Identify your physician leaders, Anderson said. They will quickly adapt and adhere to the organization’s vision and mission. They will communicate that vision and mission by not only words, but by their actions.

Strategy 3: Create partnerships: Recruit physicians who are willing to assist and implement improvements in planning, Anderson said. Partner with them and be cohesive.

Strategy 4: Engage physicians on their terms: Engage physicians by emphasizing improvements versus seeking perfection, Anderson added. Learn quickly from mistakes and help physicians take strides toward immediate improvement.

Strategy 5: Set the example: Administrators should communicate and be transparent on data, results, and update providers on their suggestions, Anderson said. You should share the outcomes of the providers’ plans, thoughts, requests, and questions. You should let them know if their suggestions have been implemented. If they have not, then explain why.

“It’s true that we do not always have the answers, but research and keep your physicians updated on that research,” Anderson added.

Editor’s note: Want more great coding info like this? You can register for the upcoming educational events here: https://www.aapc.com/resources/events.aspx.