How to provide outstanding patient care while remaining a financially sustainable practice

As we head into the new year, it’s important that we look ahead and put strategies in place to set ourselves up for a successful 2023.

With the bulk of the COVID-19 pandemic behind us, 2023 will see a significant shift in what practices focus on. We are finding that practices are excited to get back to the fundamentals of providing excellent patient care while simultaneously finding opportunities to ensure that they are running a financially sustainable practice.

The following article dives into how data can aid in providing excellent patient care and ensuring that you’re on track to meeting your financial goals.

Data, data, data

If you know me or anyone from the Cubiko team, you’ll know we are big advocates for looking to your practice data. Data is one of the most valuable tools you could be using in your practice daily and opens your practice up to a world of opportunities.

Utilising your practice data provides many benefits for your practice and can help you

  1. Better understand how your practice is performing
  2. Find opportunities to become more financially sustainable
  3. Identify opportunities to provide proactive care
  4. Improve patient outcomes and satisfaction

There are a few key areas I recommend tracking in your practice when diving into your practice’s financials, and the potential improvements you can make. These areas include looking at your:

  • Unbooked appointments and hours
  • Potential DNA billings
  • Missed billings and incentive opportunities
  • Overdue recalls and reminders
  • Future unbooked appointments

Unbooked appointments and hours

For any practice to run successfully and continue generating revenue it’s important that they have a steady flow of patients coming through the door. The first step in ensuring your practice’s financial sustainability is to look back at how your practice has historically performed and identify any areas for improvement.

I recommend diving into your historical appointment data, particularly your unbooked appointment and hours. These insights can help shed some light on how much availability you have had across your practice (for the selected period) that you haven’t effectively been utilising.

Dive deeper by looking into which of your practitioners have the highest proportion of unbooked appointments and hours, and why this may be. Work with your practitioners to see how you can further support them and what strategies you can put in place to help improve their utilisation.

gp unbooked hours and appointments cubiko

Potential Did Not Attend (DNA) billings

Patients who do not attend appointments can have a massive impact on the practice overall both from a patient care and financial perspective.

From a patient care perspective, there are two key impacts from DNA appointments:

  1. The patient who DNA’d the appointment did not receive the care or test results they may have desperately needed; and
  2. Other patients who may have desperately needed an appointment were unable to book an appointment that they otherwise would have attended.

There is also a financial impact on the practice when patient’s DNA. No patient attending = no revenue generated during this appointment slot. I know stating the obvious here, Chris! But do you know the true financial impact that DNA’s have had on your practice? No? Then I strongly encourage you to take a deeper look at the historical trend of DNA’s in your practice to help identify the potential billings your practice could have earned from these appointments. Surprisingly for some, this figure is substantial.

If DNA’s are an issue in your practice, I recommend checking out our recent blog post on the steps you can take to reduce DNA’s in your practice. Click here >

Missed billing and incentive opportunities

We know that running a practice isn’t always easy, especially with the increased cost of doing business. It is, therefore, more important than ever for practices to ensure that they’re financially sustainable.

To have a real impact on your bottom line, look to your practice data to identify any missed billing or incentive opportunities. This includes looking at any:

  • Unbilled Appointments: Use this metric to increase your practice income by finding any appointments that may have fallen through the cracks and weren’t billed.
  • Uncompleted patient appointments: This metric helps you easily see the number of appointments in your appointment book that are not marked as complete. These appointments may be indicative of missed billing opportunities. I suggest getting your admin team to follow up on these weekly to maximise the billings generated in your practice.
  • Potential 10997 opportunities: Use your practice data to find appointments with your nurses were a 10997 may have been performed but not billed. You can download a list of these patients to check if a 10997 was performed on that date so that you can bill Medicare.
  • Possible Item 93666: In December 2021, Medicare introduced item 93666 as a temporary incentive payment for the COVID-19 booster vaccination. This item could be billed in conjunction with the COVID-19 Vaccination Suitability Assessment Service MBS Items (93644, 93645, 93646, 93647, 93653, 93654, 93655 and 93656) when a patient received a third dose or booster dose of the COVID-19 vaccine.

    You can use this metric to easily identify any patients who were billed a Vaccination Suitability Assessment during their COVID-19 booster appointment but were not billed the COVID-19 Vaccine Booster Incentive item.

    You can download a list of services for possible item 93666 where a Vaccine Suitability Assessment Service during their COVID-19 booster appointment was billed but the COVID-19 Vaccine Booster Incentive was not for your team to action.
  • MT83 – MT89: The DVA introduced Veterans Access Payment (VAP) items that can be billed with telehealth and telephone consultations billed to DVA. As these items are manually added, they’re often missed. I suggest looking at your practice data to download a list of possible historical opportunities that you may have missed and give this list to your practice team to action. I recommend checking list weekly to ensure that these incentive payments don’t fall through the cracks.
missed incentive opportunities 10997 cubiko
recalls cubiko

Overdue recalls and reminders

Overdue recalls, and reminders are two key metrics practices that should regularly be tracking. Not only to reduce any medico-legal risks for the practice but also to ensure that you continue providing the best care possible to your patients.

You can do this by downloading lists of patients with overdue reminders or urgent and non-urgent recalls that are not marked as contacted. Give these lists to your admin team to contact and book in for appointments, ensuring that these patients are adequately followed up and cared for.

You can also utilise these lists during traditionally slower periods in your practice by booking these patients in for appointments, ensuring that there is a steady flow of patients and income coming through your practice’s doors.

Future unbooked appointments

Earlier we had a historical look at your practice’s unbooked appointments, and the opportunities to improve your practice’s utilisation. While taking a historical look is great for learning and identifying areas for improvement, practices must take what they’ve learnt and put it into action.

Looking at your future unbooked appointments is a great metric to track in your practice regularly. Helping you see how many appointments or hours you still have available to be booked with your practitioners. In conjunction with your item eligibility lists, you can use this metric to recall patients and book them in to help fill these appointment slots. This enables you to provide proactive patient care and helps ensure that you have a steady flow of income for these appointment slots.

Bulk Billing vs Mixed Billings

With stagnant Medicare rebates and a sharp increase to wage and consumable costs, many practices made the decision to transition to a mixed or private billing model. According to a recent survey conducted by HealthEd 22% of GPs have made changes to their billing model to keep up with the rising wage and consumable costs.

More and more practices are making the move from bulk billing to mixed or private billing models to help ensure they are running a financially sustainable practice, while continuing to provide high-quality medical services to their patients. 

Making changes to your billing model isn’t always an easy transition. It requires your patients understanding why this change is occurring, and a shift in the billing behaviour of your practitioners.

To set your practice up for success I’d recommend slowly transitioning into your practices new billing model and putting the following strategies in place:

  1. Notifying your patients in advance about the upcoming changes to your practice’s billings
  2. Work with your practitioners to get them in the mindset and habit of billing your patients as per your practice’s new billing model
  3. Utilise your practice data to investigate which services will have the biggest impact on your practices bottom line when transitioning to a mixed billing model
eligible 10997

How can I use my data to find opportunities to provide excellent and more proactive patient care?

Running a Chronic Disease Management programs is an excellent way to ensure that you’re providing great proactive care to your patients, while still finding opportunities to increase billings in your practice. However, without the appropriate tools and technologies, identifying patients who may be eligible for a Care Plan or a Health Assessment can be a time-consuming process. From downloading reports from your Practice Management System (PMS) to writing custom queries to find those eligible patients.

Cubiko’s Item Optimisation cabinet contains a suite of metrics that can help you quickly identify patients who may be eligible for a Health Assessment, Care Plan or CDM related item numbers. You can break down these lists to find which of these potentially eligible patients have an upcoming appointment booked and those who do not have a future appointment booked.

We recommend downloading a list of potentially eligible patients who do not have an upcoming appointment and getting your reception or nursing team to book these patients in for appointments. If you’re a Cubiko user, you can provide your nursing team access to our Item Optimisation Cabinet. Giving them the opportunity to be proactive in the care they’re providing by opportunistically booking these patients into their appointment book. We always recommend creating a specific appointment type for your nursing team so that you can easily see and track these appointments.

Ready to start improving clinical and financial outcomes?

We understand that running a thriving a General Practice can have it’s challenges. With General Practice being short staffed, and many feeling as through there aren’t enough hours in the day to get everything done.

Why not relieve some of the pressure and help set yourself up for a successful 2023 by booking a demo with our fantastic team. When they’ll show you how Cubiko can help you focus on providing proactive and quality patient care while increasing your billings to improve your Practice’s overall financial viability.

Trusted, reliable, loved by practices

Hear what your colleagues in the industry have to say