Resurgens Orthopaedics, based in Atlanta, was formed when six small groups of orthopedic surgeons merged together in 1999. The original group of 40 physicians has grown steadily over the past decade to include 94 physicians today. Despite a healthcare environment in flux, Resurgens has been able to continue thriving and has a plan for success in the future.
Here, Steven B. Wertheim, MD, co-President of Resurgens, discusses how his practice was able to meet and exceed the challenges of today's healthcare market.
1. Meet new government regulations proactively. Ever since the Patient Protection and Affordable Care Act passed in March 2010, new regulations have begun to reshape healthcare delivery and provider management systems. These regulations include changes to HIPAA, meaningful use and corporate compliance. While some practices have chosen to wait until the Supreme Court ruling decides the constitutionality of PPACA in June 2012, Resurgens has taken a proactive approach to meeting the new standards. However, there have been some frustrations.
"We recently spent about four weeks trying to correct our processes to comply with some new 5010 changes related to date of onset of illness, and when everything was in place we were told that requirement would be waived on the 5010 form, so we had to go back and change everything we did," says Dr. Wertheim. "This is a daily occurrence. We are spending our time, effort and money to comply with these regulations that aren't always well thought out."
For the 5010 billing changes, government regulations stipulated the conversion of billing requirements was set for Jan. 1, 2012. However, despite the government's efforts to prepare insurance companies for the change, many were not ready in time. Some providers, such as Resurgens, were ready for the changes but their updated claims were rejected because insurance companies weren't ready for them.
"It's amazing how many companies weren't prepared and it affected the physicians greatly," says Dr. Wertheim. "We got the rejections and that was a huge issue because we had to go back and try to recreate why they were rejected. It is an amazingly frustrating process and a waste of resources when our time and money should be going toward taking care of patients."
Regardless of the bumps in the road, Resurgens' proactive approach means the practice will be prepared for these changes and ready to meet additional requirements in the future.
2. Maintain physician ownership and management. While some groups have become more dependent on non-medical business professionals to operate their practice, Dr. Wertheim maintains that Resurgens has overcome management challenges because of physician leadership. "The the co-presidents and board members are physicians, so any new decisions really affect us like the rest of the partners," says Dr. Wertheim. "When you have practicing physician owners running the practice, you can figure out what will work and won't much more quickly."
Practice leaders are constantly making decisions about practice management systems, changes in workflow and electronic medical record systems.
3. Build a strong group ethic among surgeons. It's important in any working environment for colleagues and employees to focus on achievement of the same core goals. When the six original groups merged, they all had the same primary focus on patient care, which is one of the reasons the merger has been so successful. Any new groups wishing to join Resurgens now must adopt the same group ethic.
The practice issues patient satisfaction surveys, which includes a physician report card. Patients can easily give feedback to the physicians and the practice can ensure a high level of patient satisfaction. "We believe that by looking at patient satisfaction in a measured way, it's easy to get all the surgeons headed in the same direction," says Dr. Wertheim.
Another factor that brings together the surgeons is equal treatment. "We believe every physician owner should have the same contract," says Dr. Wertheim. "The deal is the same and people are treated equally from the compensation standpoint as well."
4. Look ahead for partnerships that will be beneficial in the future. The healthcare industry and government regulators now promote a more integrated care delivery model, which means partnering with other organizations could be beneficial for orthopedic groups. Resurgens is in conversation with local hospitals, health systems and payors about various ways to approach today's new healthcare market.
"We believe that delivering good patient care in a cost effective manner — no matter the partnership or payor model — will allow us to survive in any market," says Dr. Wertheim. "We haven't formally done anything yet, but we are in talks with a number of different entities."
Over the next few years, Dr. Wertheim expects these conversations to grow into formal relationships with hospitals, insurance companies or other healthcare delivery groups. "Regardless of whether the Affordable Care Act is ruled constitutional or not, we believe patients will have a choice of where they receive care in the future, and if you can provide a good patient experience, you will always have patients to take care of," he says.
5. Expand services to capture additional services and revenue. Now more than ever, it's crucial for orthopedic groups to capture as many ancillary services as possible. Bringing these services under one roof not only gives the patients more integrated care (and a better experience at the practice) but also allows your group to take in additional revenue. Resurgens made ancillary services a top priority from its formation in 1999, and now includes MRIs, X-rays, physical therapy and outpatient surgery centers.
"We believe that by having these ancillary services, we are able to control the quality of care patients are able to receive," says Dr. Wertheim. "When patients have to go off-site for ancillary services, they have to fill out forms at each place, take time out of work for additional appointments and spend money to get there. Having an integrated approach to our practice allows patients to have better quality of care and saves them time in the long run. We believe this is the model of the future."
6. Stick to core business investments. Resurgens has always been financially conservative, focusing on core business investments that directly correlate with delivering orthopedic care. "We don't really deal with outside real estate investments or things like that," says Dr. Wertheim. "A lot of groups have been hurt by investing in real estate or other projects that weren't related to orthopedics. Anything our partners want to invest in that doesn't directly relate to orthopedic care must be done outside of our practice."
Another goal of the physician partners is to keep debt very low, which has allowed the group to survive the ups and downs in the turbulent healthcare market. As a sign of their success, the practice hasn't had to lay-off any employees due to the recent economic downturn.
"We haven't had to sacrifice patient care because of increased costs or decreased reimbursement," says Dr. Wertheim. "The key is to really focus on your core business. Sticking to what you do well — and not venturing out into other areas — is crucial for financial success."
7. Gather patient referrals by building a positive reputation. Like many thriving orthopedic groups around the country, Resurgens drives patient volume primarily through word-of-mouth. The physicians have built a positive reputation in their community by delivering quality care, which means their former patients are willing to return or recommend the practice to their friends.
"One of our main referral sources is still word of mouth from other patients so we focus a lot on delivering a good patient experience," says Dr. Wertheim. "We do patient satisfaction surveys to find out the areas we are lacking in and work with a customer service and patient flow group to improve efficiency."
The practice also has a marketing team that reaches out to primary care physicians, referring specialists and workers compensation groups to increase the number of referrals from each source.
Related Articles on Orthopedic Practices:
10 Ways to Differentiate Sports Medicine Practices in a Competitive Market
10 Tips for Online Orthopedic Practice Marketing
11 Statistics on Orthopedic Surgeon Practice Setting
Here, Steven B. Wertheim, MD, co-President of Resurgens, discusses how his practice was able to meet and exceed the challenges of today's healthcare market.
1. Meet new government regulations proactively. Ever since the Patient Protection and Affordable Care Act passed in March 2010, new regulations have begun to reshape healthcare delivery and provider management systems. These regulations include changes to HIPAA, meaningful use and corporate compliance. While some practices have chosen to wait until the Supreme Court ruling decides the constitutionality of PPACA in June 2012, Resurgens has taken a proactive approach to meeting the new standards. However, there have been some frustrations.
"We recently spent about four weeks trying to correct our processes to comply with some new 5010 changes related to date of onset of illness, and when everything was in place we were told that requirement would be waived on the 5010 form, so we had to go back and change everything we did," says Dr. Wertheim. "This is a daily occurrence. We are spending our time, effort and money to comply with these regulations that aren't always well thought out."
For the 5010 billing changes, government regulations stipulated the conversion of billing requirements was set for Jan. 1, 2012. However, despite the government's efforts to prepare insurance companies for the change, many were not ready in time. Some providers, such as Resurgens, were ready for the changes but their updated claims were rejected because insurance companies weren't ready for them.
"It's amazing how many companies weren't prepared and it affected the physicians greatly," says Dr. Wertheim. "We got the rejections and that was a huge issue because we had to go back and try to recreate why they were rejected. It is an amazingly frustrating process and a waste of resources when our time and money should be going toward taking care of patients."
Regardless of the bumps in the road, Resurgens' proactive approach means the practice will be prepared for these changes and ready to meet additional requirements in the future.
2. Maintain physician ownership and management. While some groups have become more dependent on non-medical business professionals to operate their practice, Dr. Wertheim maintains that Resurgens has overcome management challenges because of physician leadership. "The the co-presidents and board members are physicians, so any new decisions really affect us like the rest of the partners," says Dr. Wertheim. "When you have practicing physician owners running the practice, you can figure out what will work and won't much more quickly."
Practice leaders are constantly making decisions about practice management systems, changes in workflow and electronic medical record systems.
3. Build a strong group ethic among surgeons. It's important in any working environment for colleagues and employees to focus on achievement of the same core goals. When the six original groups merged, they all had the same primary focus on patient care, which is one of the reasons the merger has been so successful. Any new groups wishing to join Resurgens now must adopt the same group ethic.
The practice issues patient satisfaction surveys, which includes a physician report card. Patients can easily give feedback to the physicians and the practice can ensure a high level of patient satisfaction. "We believe that by looking at patient satisfaction in a measured way, it's easy to get all the surgeons headed in the same direction," says Dr. Wertheim.
Another factor that brings together the surgeons is equal treatment. "We believe every physician owner should have the same contract," says Dr. Wertheim. "The deal is the same and people are treated equally from the compensation standpoint as well."
4. Look ahead for partnerships that will be beneficial in the future. The healthcare industry and government regulators now promote a more integrated care delivery model, which means partnering with other organizations could be beneficial for orthopedic groups. Resurgens is in conversation with local hospitals, health systems and payors about various ways to approach today's new healthcare market.
"We believe that delivering good patient care in a cost effective manner — no matter the partnership or payor model — will allow us to survive in any market," says Dr. Wertheim. "We haven't formally done anything yet, but we are in talks with a number of different entities."
Over the next few years, Dr. Wertheim expects these conversations to grow into formal relationships with hospitals, insurance companies or other healthcare delivery groups. "Regardless of whether the Affordable Care Act is ruled constitutional or not, we believe patients will have a choice of where they receive care in the future, and if you can provide a good patient experience, you will always have patients to take care of," he says.
5. Expand services to capture additional services and revenue. Now more than ever, it's crucial for orthopedic groups to capture as many ancillary services as possible. Bringing these services under one roof not only gives the patients more integrated care (and a better experience at the practice) but also allows your group to take in additional revenue. Resurgens made ancillary services a top priority from its formation in 1999, and now includes MRIs, X-rays, physical therapy and outpatient surgery centers.
"We believe that by having these ancillary services, we are able to control the quality of care patients are able to receive," says Dr. Wertheim. "When patients have to go off-site for ancillary services, they have to fill out forms at each place, take time out of work for additional appointments and spend money to get there. Having an integrated approach to our practice allows patients to have better quality of care and saves them time in the long run. We believe this is the model of the future."
6. Stick to core business investments. Resurgens has always been financially conservative, focusing on core business investments that directly correlate with delivering orthopedic care. "We don't really deal with outside real estate investments or things like that," says Dr. Wertheim. "A lot of groups have been hurt by investing in real estate or other projects that weren't related to orthopedics. Anything our partners want to invest in that doesn't directly relate to orthopedic care must be done outside of our practice."
Another goal of the physician partners is to keep debt very low, which has allowed the group to survive the ups and downs in the turbulent healthcare market. As a sign of their success, the practice hasn't had to lay-off any employees due to the recent economic downturn.
"We haven't had to sacrifice patient care because of increased costs or decreased reimbursement," says Dr. Wertheim. "The key is to really focus on your core business. Sticking to what you do well — and not venturing out into other areas — is crucial for financial success."
7. Gather patient referrals by building a positive reputation. Like many thriving orthopedic groups around the country, Resurgens drives patient volume primarily through word-of-mouth. The physicians have built a positive reputation in their community by delivering quality care, which means their former patients are willing to return or recommend the practice to their friends.
"One of our main referral sources is still word of mouth from other patients so we focus a lot on delivering a good patient experience," says Dr. Wertheim. "We do patient satisfaction surveys to find out the areas we are lacking in and work with a customer service and patient flow group to improve efficiency."
The practice also has a marketing team that reaches out to primary care physicians, referring specialists and workers compensation groups to increase the number of referrals from each source.
Related Articles on Orthopedic Practices:
10 Ways to Differentiate Sports Medicine Practices in a Competitive Market
10 Tips for Online Orthopedic Practice Marketing
11 Statistics on Orthopedic Surgeon Practice Setting