Medical Practices Make Big Staffing Changes

As medical practices face big changes and challenges, from EHRs to declining reimbursement to the ICD-10 transition, medical practice staff members face big changes and challenges as well.  

Here are six staffing changes experts say practices are making due to the changing healthcare industry:

1. Practices are eliminating the role of medical records clerk. As practices acquire EHRs, many are eliminating the role of medical records clerk. Physicians Practice’s annual Staff Salary Survey findings indicate just how prevalent a trend this is becoming. Between 2010 and 2013, the percentage of survey respondents who said they employed a medical records clerk dropped from 31 percent to 19 percent. “Unless you’re of a size where the scanning is so much that you really need a full-time person to be doing that, that old medical records position is going away,” consultant Mary Pat Whaley recently told Physicians Practice.

2. Practices are making the most of medical assistants. While the outlook is bleak for medical records clerks, it’s more positive for medical assistants (MAs). As practices face declining reimbursements, many are attempting to squeeze more patients into each day. Practices see MAs as a great help in accommodating that higher patient volume, consultant Elizabeth Woodcock recently told Physicians Practice. “I definitely see medical assistants ... playing a bigger role because as volume has gone up, physicians just need staff to room patients, there’s just a lot of work to do,” she said.

3. Practices are placing more value on billers and coders. As practices face increasing oversight and the transition to ICD-10, many practices, especially larger practices, are placing more value on billers and coders.  “As things become much more intense with chart audits, with ICD-10 on the horizon, I think practices are thinking, ‘Maybe I really need somebody here that is going to be able to get us through this transfer,’” said Whaley.

In addition, as reimbursement declines, many practices are looking for ways to collect as much of their hard-earned cash as possible. “If they’re big enough, they’re thinking about adding either another biller or a biller with the coding experience,” said Whaley. “Every penny is so important that they’re really digging down into, ‘Why are we writing this off? Why aren’t we getting this money?’ The finances have just become more and more crucial.”

4. Practices are exploring emerging staffing roles. As more practices transition to medical homes, and as more participate in accountable care organizations, many are focusing on adding staffing that will lead to improved care coordination and teamwork. “I definitely see a huge role for patient navigators and health coaches, and that’s a term used interchangeably,” said Woodcock, noting that these individuals typically hold nursing degrees in primary-care practices. “I’m also seeing advanced practice providers, like behavioral health specialists, pharmacists, really come into the outpatient practice environment to really be members of the care team.”

5. Practices are identifying technology alternatives. While practices are likely to experience more patient demand for services in 2014 as patients gain insurance due to the Affordable Care Act, many practices are not yet hiring staff to accommodate that influx of patients, said Whaley. “Practices are more reactive than proactive,” she said. “They want to really see the need for a position before they hire it.”

In addition, Whaley predicted that many practices will look to technology as a way to improve patient access to care. “If they don’t have a patient portal for secure communication ... they may be thinking about that,” she said. “They may be thinking about other ways that they could potentially deal with the onslaught of patients or predicted onslaught of patients without necessarily hiring another clinical person.”

In addition, practices are growing to accept, and see the benefits, of allowing employees to work remotely. “I would not see a big rush to employ full-time on-site people in practice,” said Whaley. “I would see outsourcing technology supported services and remote employees kind of moving up to fill some of those needs.”

6. Practices are considering outsourcing. Due to declining reimbursement and increasing overhead, many practices are forced to operate with fewer staff members. In response, many are looking to   outsource more roles and responsibilities  , said Whaley. “Maybe having somebody just do credentialing for the practice, or maybe having somebody just do something that’s related to billing, I think that’s a big trend.”

What staffing changes have you recently made at your practice?