The healthcare industry is known for its diversity, especially when it comes to the various sizes of its organizations. Hence, over the span of a decade, we have come across facilities and organizations varying drastically in size. However, such variations may not always result in variations of management style. This means that policy management for a healthcare facility may be easier when collaborated with other similar organizations to make it easier for such facilities to manage and organize their policy and procedure manuals. In our day and age of globalization and the rapid progress in the technology realm, it is becoming more and more common for entities to collaborate and share the information they collect. At PolicyMedical, we strive to develop solutions that make collaboration and sharing of policies as easy as possible so that our clients can painlessly create, organize, and share policies and procedure documents amongst each other. However, despite our best effort, we realize that we may not be able to cater every healthcare organization’s needs and that there may be another vendor that can. Regardless, this article is addressed in a generic manner so you can gain as much knowledge on the subject as you can, no matter which solution you choose to employ.
More healthcare providers than ever are coming together to take advantage of the benefits of forming group practices. As the healthcare industry continues to shift at a rapid pace, many practices are joining forces to consolidate administrative and management functions, share risks, and provide a broader range of quality care to patients. In this new environment, more stringent control over policies and procedures is needed to establish shared goals, collective knowledge, and mutual understanding. Policy management is crucial for a practice of any size, however, for large-group practices, effective policy management is an essential part of the organization’s success.
A large group practice is a comprised of healthcare providers that come together and take a collective approach to delivering care. The Center for Medicare and Medicaid Services (CMS) defines a group practice as 25 or more eligible professionals in the same practice. The specifics of the group can vary. In some practices, all providers have the same specialty; in others, they have varying, complementary specialties. Group practices often provide services in multiple office locations. The number of group practices in the United States is steadily increasing, and today, nearly half of the physicians are part of a group practice.
The consolidation of providers into groups, addresses two of the Affordable Care Act’s goals: improving healthcare quality and reducing healthcare costs. As a team of providers, group practices can offer a set of services to consumers that individual physicians struggle to compete with. For example, an individual provider may not be able to afford an expensive MRI machine, so they have to refer patients out for the procedure. However, a group of providers can share the cost, making it more affordable to providers and accessible to patients. Providers who are part of a group also have access to regular and frequent peer consultation, both formal and informal, ensuring that patients are receiving the best possible care.
Becoming part of a group practice also benefits the providers by combining administrative and management costs, thus, lowering overhead for each group member. By reducing time spent on tedious tasks, such as, billing and filing, providers can spend more time and resources on direct patient care. Larger group practices also have greater negotiating leverage with health insurance plans, and have the advantage of pooling capital and lowering risk. Acting as a unit allows group practices to be more efficient in many areas, avoiding duplication, improving communication, fostering teamwork, and adopting innovation.
How Policy Management Can Support Large Group Practices
Policies are an integral part of any healthcare organization. They communicate the mission and vision of an organization, impart a respectful environment for workers, and influence their behavior and decisions. They are necessary to ensure that healthcare organizations operate within legal standards, while establishing expectations and repercussions for non-compliance.
Policy management is the process of creating, communicating, and maintaining policies and procedures. Efficient policy management provides employees with easily accessible policies and procedures that are up to date in compliance with regulatory bodies. Having solid, well-managed, policies protects the organization from various safety and litigation risks. With the implementation of new regulations such as, the Affordable Care Act and HIPPA Omnibus Rule, policy management has become more of a concern for hospitals, private providers, as well as, group practices.
Healthcare organizations routinely have several hundred policies and procedures, and in a large group practice this number can be in the thousands. Therefore, there must be a comprehensive approach to managing policies and procedures across providers and office locations. Having a centralized authoring, review and approval workflow, controlled distribution, and ready access to the policy management system is critical to the success of the practice. In large group practices, communication and collaboration are key.
Michael Rasmussen, policy management guru, defines compliance as adhering to stated requirements, while establishing the values, ethics, commitments, and social responsibility of the organization. Compliance should be a major goal of large group practices, as they deal with countless requirements and standards, from local, state, and national regulatory bodies. An electronic policy management system can aid a hospital in creating and maintaining policies that keep them up to date with these requirements and standards. A successful compliance program in a group practice requires many providers working together to keep operations flowing constantly.
Collaboration requires shared responsibility, consensus-building, group goal-setting, and decision-sharing. Collaboration in a group practice should be a well-oiled machine, encompassing each provider’s individual needs and preventing potential accidents and legal mishaps. Rich technology integration can help facilitate this. For example, an electronic policy management system allows employees from any location to sync up and work on shared documents simultaneously, while receiving critical updates in real-time. It is important, however, to create an effective strategy and shared vision before incorporating technology. There should also be appropriate informal collaboration spaces and regular process review, reporting, and feedback.
Benefits for Large Group Practices
Establishing, communicating, and maintaining multiple policies and procedures for a large number of employees in a group practice is no simple task. However, implementing an electronic policy management solution can reduce the burden. Some of the most notable advantages of implementing an electronic policy management system in a large group practice are the following:
All policies are conveniently located in one place. Organizations save a tremendous amount of time and money by avoiding the cost of printing, copying, and circulating updated policies and procedures, especially if the group practice has multiple locations. Staff members can access policies 24 hours per day, from any location with an established Internet connection. In many cases, policies are accessible, not only on a computer, but also on tablets, or mobile phones.
Electronic policy management systems make collaboration easier than ever by allowing employees to work on shared documents simultaneously. This is especially important in large group practices when providers are working from disparate locations. Providers and policy administrators can receive critical updates in real time, and the policy creation, review, and approval process is seamless. Gone are the days of back and forth emails and multiple drafts of policies clogging up inboxes. During which, it was not unusual for the newest version to get lost.
When policies are easily accessed in a centralized location, all policy creation, review, and approval can be tracked in addition to policy distribution, receipt, and training. An electronic system can create audit trails to monitor who is responsible for each policy, who made certain changes, and when those changes were made. It can also monitor which staff members have read new and updated policies, and when. This adds a layer of accountability that is critical to risk management, especially, in a group practice with many employees.
As regulations change, an electronic policy management solution ensures that policies and procedures stay current, greatly decreasing the risk of litigation. One feature that supports this is a regulation resource library, which allows users to access regulations, legislation, and accreditation requirements, for all relevant regulatory bodies. Users can use a standard linkage feature to link each policy with specific pieces of regulations to ensure compliance. The system can notify administrators when any of these regulations change, keeping the organization accreditation ready.
An electronic policy management system allows you to achieve a consistent look and feel for your policies, with a corporate logo, an appropriate legal disclaimer, and the inclusion of all key policy sections. Templates help to standardize policy and procedure formats across providers and locations. Having a universal format enables policy authors to focus on content instead of structure and font styles.
Inefficient policy management is time consuming and expensive. Valuable time is spent emailing policies from one person to another during the policy creation and review process, searching for the most up-to-date versions of policies and procedures, and disseminating them to employees. Using an electronic policy management system saves valuable time and resources, nearly every step of the way.
As with any innovative new product, electronic policy management systems have limitations and potential challenges. It is important to understand all the implications of this technology to make sure it is a good fit.
When considering the size and scope of larger group practices, implementing an electronic policy management system is no small undertaking. It is likely that before forming the group, each provider had their own unique system of policy management that they are hesitant to move away from. It is true that implementing a new policy management system will be a great deal of work on the front end. It requires standardizing policies and procedures, creating and uploading electronic versions, organizing your policy library, and training all staff on how to use it.
Fortunately, there are resources available that simplify the process, and reputable vendors that will be with you every step of the way. Here, at PolicyMedical, we do on-site training, have regular refresher webinars, and have resources available on everything from hiring a policy administrator, to writing effective policies. The investment of time up front will certainly pay off in the long run.
Some group practices are uncertain about adapting to a cloud-network for fear of cyber-attacks. This is a misconception and many software companies, including PolicyMedical, already use cloud-based networks because of the wealth of benefits. Established, reliable, cloud computing vendors have highly sophisticated data security systems, as they recognize the great importance of data security. It has been shown that switching to the cloud can actually improve security for many organizations.
The Bottom Line
The development of large group practices will require a great deal of collaboration and dependency among various groups of healthcare providers. Today’s healthcare environment not only reflects an explosion in technology, but also on the more legal and regulatory demands, larger, more complex healthcare institutions, greater consumer involvement, and an increase in employee litigations. Providers in any size practice must adapt to these changes, however, this is especially true for large group practices. As the number of group practices in the United States continues to increase, the need for electronic policy management systems will increase as well. This will be a major factor in helping group practices meet the provisions of the ACA through collaboration to achieve their overarching goals.
We, at PolicyMedical, continue to develop and improve contract and policy management solutions so that healthcare organizations can easily create, organize, and share contract and policy manuals amongst each other. Our cloud-based solutions make collaboration as much painless task as everything is easily shared virtually. However, we not only take pride in having a cloud-based system that eases the collaboration process, but also that it is fully secured. With that said, we realize that we may not always be able to cater every organization’s needs and that another vendor may provide a better suited solution. Regardless, we are more than happy to help you come to a solution even if it means another vendor is the right option for your organization. Please, do not hesitate to contact us, should you need any assistance. Alternatively, you may book a demo to witness our solutions in action.