We all wish we had a crystal ball to look into the future, but in independent medical practice today, we can only take it a year at a time. For those who want to know what trends we'll see in 2014, I've put together a slide deck of ten predictions for the year. What predictions would you add to this list?

1. Ten Predictions for
Medical Practices in 2014
By Mary Pat Whaley, FACMPE,
CPC

2. PREDICTION #1 MORE CASH PRACTICES
More practices will add a cash component
to their practice.
It may be cash for additional services, cash for
telemedicine, email or texting, a Direct Primary
Care (DPC) model where cash augments or
replaces the insurance payment or an all-cash
practice that bypasses insurance payment
altogether.

3. PREDICTION #2 –
GROUP VISITS MAKE $EN$E
Medical practices will adopt group visit
models.
The group visit will become more popular as
physicians realize that seeing 12 – 15 patients in
a group for 90 minutes makes more sense than
seeing 10 patients each for 15 minutes. Most
patients really enjoy a visit that includes time
with other patients that share the same
problems – widely used for diabetes, COPD and
heart failure patients.

4. PREDICTION #3 –
INDEPENDENCE WILL NOT DIE
Physicians will hold on to their
independence via a variety of practice
models.
The models that will allow physicians to continue
to practice independently are lean solo
practices, Independent Physician Organizations
(IPAs), Physician Service Agreements (PSAs),
Accountable Care Organizations (ACOs) and
Single Tax Identification Number Organizations
(S-TINs.)

5. PREDICTION #4 –
TOS PAYMENTS ARE CRITICAL
Practices that master time of service
payments will be able to pay their physicians.
The “shock absorber” in private practice is the
physician’s take-home pay. Only those practices
that have substantial cash (elective) services or
that build strong time of service collections will be
able to sustain the physician’s desired salary.
Even surgeons will struggle with the balance of
insurance payments vs. patient payments.

6. PREDICTION #5 –
OUTSOURCING BRINGS SAVINGS
Forget what you thought you knew about
what you can outsource.
Practices can outsource appointment scheduling,
billing and even nurse triage. Virtual assistants,
home workers, apps and software-as-a-service
(SaaS) can be the answer. If physicians can
adjust to the idea that their employees aren’t
physically in the office, they can take advantage
of what technology has to offer in savings.

7. PREDICTION #6 –
THE HEALTHCARE CLOUD IS HERE
The cloud has gone mainstream.
Small practices cannot justify the investment in
hardware and mid-to-large practices are looking
for the flexibility and mobile advantages the cloud
has to offer. Traditional On-site, client-server HIT
is now the exception, not the rule. Groups are
looking for a basket of services – EMR, PM, email
and calendar, marketing etc. - that can work
together, as well as with their legacy systems.

8. PREDICTION #7 –
THE VALUE PARADIGM
Everyone has heard that healthcare is moving
from volume to value.
Whether practices are part of an ACO or
negotiating independently, they will be expected
to demonstrate value to patients and payers. That
means population management, no duplication of
tests, outpatient care vs. inpatient care, care
protocols, and a focus on prevention and
wellness.

9. PREDICTION #8 – THE YEAR OF THE
GOVERNMENT MANDATE
It is a tsunami year for government mandates
and it will push some practices over the edge
and into opting out of Medicare.
If a practice wants to maximize their paltry
Medicare payments, they will have to comply with
and act on Meaningful Use (MU), the Physician
Quality Reporting System (PQRS), the Health
Insurance Portability and Accountability Act
(HIPAA) and the International Statistical
Classification of Disease, 10th Edition (ICD-10).

10. PREDICTION #9 –
SOCIAL MEDIA MAKES SENSE
Engaging with current and potential patients
on social media platforms does three things
for your practice.
First, it communicates medical, nutritional, and
specialty health information to your patients in a
place they are looking for it. Second, it creates an
Internet presence that is widely picked up by
search engines – again, where your patients look.
Third, it produces value as a marketing tool.

11. PREDICTION #10 – PHYSICIANS
LEAVING HOSPITAL EMPLOYMENT
Some physicians will leave willingly and
others will be released from employment.
Hospitals are finding (again) that managing
physician practices is not intuitive, and they will
start to weed out physicians who are not toeing
the line. Some physicians who have put their time
in at hospitals, finding that they can return to
private practice for as little $20K, will start over
again in a new world.

12. Mary Pat Whaley, FACMPE, CPC
President, Manage My Practice
(919) 370.0504
marypat@managemypractice.com