|Editor’s Note: Medical director turnover negatively impacts both payers and providers. Now, even successful CMOs and MDs are being pulled apart with competing priorities. Ease the pressures with physician advisor review services from BHM. Schedule a call with a BHM advisor CLICK HERE to learn more.
Last week, our blog, “Stretching Medical Directors Too Far?” covered the new roles and responsibilities for chief medical officers and medical directors. FULL BLOG. This blog focuses on the financial impact and possible solutions for medical director turnover.
In a cover piece for Managed Care magazine, Frank Diamond writes, “Managed care medical directors provide clinical leadership and expertise related to health insurance programs including — but not limited to — quality improvement, utilization management, network design, policy development, accreditation, credentialing, care delivery, and working in a team/collaborative relationship with other organization leaders…”
The article continues, “Some plans want medical directors to be involved in many extracurricular activities, such as meeting with specialty groups, serving on multiple internal committees, visiting practitioners and hospitals, all the while being responsible for time sensitive turnaround cases without coverage from your peer physicians, which creates a huge amount of stress and job dissatisfaction.”
“all the while being responsible for time sensitive turnaround cases without coverage from your peer physicians, which creates a huge amount of stress and job dissatisfaction.” – Frank Diamond, Managing Editor, in a cover piece for Managed Care magazine
Similar pressures hold true for providers. A November 17, 2016, article by Chris Serres, in Minnesota’s Star Tribune read, “Citing burnout, top medical director of Minnesota’s state-operated hospitals resigns. Psychiatrist, medical director cites burnout from staff shortage.” It goes on to explain, “Dr. Steven Pratt, a veteran psychiatrist who oversaw medical care at Minnesota’s state-operated hospitals, resigned unexpectedly this week, citing ‘burnout’…”. His decision to resign “was triggered by an “intense shortage” of psychiatrists…”
The iconic turn of phrase pops up in music (Supertramp’s 1975 album of the same name), film (1973’s Day of the Jackal), and print (2003’s Crisis? What Crisis?: Britain in the 1970s By Alwyn W. Turner). Can this phrase now attach itself to chief medical officer and medical director turnover?
Many factors contribute to the building crisis of chief medical officer and medical director turnover. These professionals, working in payer and provider environments, face mounting pressures of patient care and business operations management. Both responsibilities require a different, intense, and diverse skill sets. Sometimes, goals pull in opposite directions and push individuals to the breaking point.
Putting the costs in perspective, just recruitment and on-boarding expenses for practicing physicians are estimated between $300,000 and $500,000, not including loss of revenue. The down time and lost revenue from the front line doctors are big hits. The recruitment hard costs are at least similar for chief medical officers and medical directors.
Now image the number of revenue stream represented by the number of cases passing through the hands of the chief medical officers and medical directors.
Outsourcing is not a new word for healthcare. The speed of growth of outsourced services is new. Now administrative services joins the ranks of services under outsourcing consideration. A recent survey indicates providers look to outsourcing complex case and claims review. Almost a 20% growth from 2013 to 2016.
Contracted review services can ease the pressure on current staff; allowing more time for the “many extracurricular activities” described above. When these positions are vacant, contracted review services bridge the downtime until a new staff come on board.
The impact on hospitals was outlined in a 2016 survey by Black Book that stated, releasing in-house staff to focus solely on optimizing traditional claims also improved internal productivity according to 77% of all current hospital outsourcing users surveyed.
- 81% of hospitals state they lack the specialized talent to resolve very difficult claims/cases, including 92% of hospitals under 150 beds.
- 69% of hospital CFOs state the[y] must staff with high cost back office employees to compensate for current patient accounting systems which lack in functionality to manage complex types of claims activity.
- 49% of hospital CFOs acknowledge that outsourcing is becoming a more viable alternative in 2017 for more parts of their organizational claim processing.
A similar survey for payers is needed, though the same benefits likely hold true for payers while the percentages vary. The ROI calculation on outsourcing review services must include the retention and recruitment expenses as well as the lost/delayed revenue. On the positive side, the calculations include the increased productivity and increase in job satisfaction.
Medical director turnover negatively impacts both payers and providers. Now, even successful CMOs and MDs are being pulled apart with competing priorities. Ease the pressures with physician advisor review services from BHM. Schedule a call with a BHM advisor CLICK HERE to learn more.