Goals and Objectives of the Practice Management Curriculum
Goals
- To instruct family practice residents the principles of practice management.
- Residents will know about the changing health care environment and the impact of the business of medicine on the care of the patient, education of physicians and medical research.
- Residents will begin to see how that they will fit into the business of medicine and the changing health care environment
Objectives:
After completing block and longitudinal components of the curriculum the resident will be able to:
- Identify a potential community as a practice location.
- Choose a partner
- Choose practice mode.
- Acquire the skills to plan an office in terms of design and equipment.
- Identify major components of an employment agreement or contract
- Develop a patient appointment schedule.
- Differentiate among various billing systems.
- Generate patient accounting policies
- Differentiate among various health plans
- List at least 5 ways to market a practice
- List staff job descriptions and identify ways of hiring good employees.
- Differentiate among various personal investment and financial options including:
- tax shelters
- estate planning,
- insurance needs
- retirement plans
- Develop a medical record system.
- Distinguish among various available professional liability insurance.
- Define the concept of capitation and health risk contracting
Practice Managment Block
Practice Management half-days are scheduled in the PGY3 Subspecialty rotation. The days during this block are provided for work on your QA project, completion of required readings and completion of at least *one* of the practice management exercises described below.
Practice Management Longitudinal
Readings not completed during the dedicated practice managment block in PGY3 should be completed longitudinally, along with your QA project. Presentation of your QA project results at a practice management meeting is required for successful completion of this portion of the curriculum.
Practice Management Exercises
1. Patient billing exercise:
The point of this exercise is to reinforce the billing cycle as it exists FOR YOUR PATIENTS IN THIS PRACTICE. The exercise requires approximately 20 hours to complete.
- identify two patients you have seen within the prior six months but no more recent than one month ago.
- identify the insurer for the patient at the time of billing - one capitated (medicaid, KHPE, Aetna HMO), one not (Personal Choice, BC/BS, Tricare, CHAMPUS, etc.)
- identify the patient and group ID
- answer the following questions for each patient in writing and submit electronic version of answers to Dr. Neill and Martin by no later than one month after the end of your practice management block.
- How were you (we) paid for the visit that you performed?
- what charges existed on your bill?
- what charges were missed (charge capture error)?
- when were you paid in relation to your visit?
- what exceptions, errors, or omissions were noted on the EOB (if any?)
- who (name of a person) completed the billing transaction? How?
- under whose billing ID did you receive payment?
- how did this provider get credentialled for the health plan you were paid under?
- Who negotiated any allowances that reduced your fee/payment?
- For your captitated patient what is your per member per month payment for this patient?
- Who negotiated the PMPM for this plan?
- Consider using the following tools to guide your data collection and reporting: FPM Charge capture Chart Audit Article, FPM Charge Capture XLS file
2. Human Resource Exercise:
The point of this exercise is to familiarize you with common human resource issues related to the practice of medicine. This exericse is expected to take approximately 20 hours.
- What is the ideal staffing for a two physician family medicine office? Include all paid staff, their responsibilities, their hours worked per week and their hourly or yearly compensation.
- What national, regional, or local benchmarks exist for staffing data? Which if any did you use?
- What are the requirements for licensure for an RN in Pennsylvania? Are they different from licensure requirements for an LPN?
- What is the EEOC? What job interview questions are prohibited?
- What is a cafeteria plan according to the IRS?
- Find your most recent W-2 statement. Where do employers find current tax rates for the local, state and federal withholding taxes? What is *your* current tax rate for each of these. Did UPHS correctly withhold your taxes?
- What employment records are employers required to keep? How long? In what form?
- What written job descriptions exist for employees in our practice? Who writes them?
- Who are the employers of record for the medical assistants in our office? For our residency coordinator? For the faculty? For residents?
- Who is head of HR at PPMC? Who performs these functions in a two person family medicine office?
- What is the national labor relations board? What is their mission?
- Are PFC employees covered by NLRB Jurisdiction?
- Read and be ready to discuss readings below on Managing your Staff.
3. Coding Exercise:
The point of this exercise is to familiarize you with how your documentation influences coding frequency, and how this compares to national benchmarks.
The exercise is expected to take approximately 20 hours.
- Download the Coding Frequency Spreadsheet.
- Using your own Coding Frequency estimates complete the worksheet and review (document this) with your advisor.
- Choose one change to make to your coding over a period of one block.
- Measure your coding frequency for that month.
- Compare your "post" to your "pre" coding frequencies with your advisor.
- Calculate the RVU's generated by your coding during this block.
- Turn in your results to Dr. Neill, Cronholm, Martin or Nicklin for credit.
Required Readings
Coding
Career Planning
Managing Staff
Managing Risk
Leadership
Additional Readings
Additional Resources
Career planning - AAFP Tools for planning your future: http://www.aafp.org/online/en/home/residents/yourfuture.html
Practice and QA tools - http://www.aafp.org/x20091.xml
ABFM certification - Follow ABFM guidelines closely http://www.theabfm.org
USMLE Step 3 Instructions/FSMB - http://www.fsmb.org/m_usmlestep3.html
PA State Board of Medicine License Info - http://www.dos.state.pa.us/bpoa/cwp/view.asp?a=1104&q=432792
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