Practice Managers Connect in Connecticut
Edition: May 2000 - Vol 8 Number 05
If you have occasion to grab a cup of coffee in a restaurant in northeastern Connecticut, be warned: That group sitting at the long table against the wall just might be talking about you. That's right. If they're throwing out words like ‘wacky pricing’ and ‘group deal,’ they could be members of the Eastern Connecticut Practice Management Association.
This loosely aligned group of 30 to 40 practice managers in rural Connecticut is engaging in that time-honored tradition known as ‘throwing their weight around.’ They're pretty nice about it, although that wasn't always the case.
The association was organized five years ago by physician office lab consultant Rosemary Madych of Madych Associates Inc., Storrs, CT. A medical technologist with a master's degree in health administration, she has worked closely with staff and office managers on POL issues for a number of years.
Shortly after beginning her work with managers in area labs, she noticed a couple of things. First, the managers had very few resources to call on when they needed help understanding regulations. Second, they had very little contact with one other.
‘I would listen to them ask the same questions and voice the same complaints,’ she says. ‘What I thought was most interesting was that some worked virtually across the street from one another, but they didn't talk to each other.’
‘We never exchanged information,’ says Judy Miller, practice administrator, Med-East Medical Walk-In Center, Willimantic, CT. ‘There was always the misconception that if you knew something, you should keep it to yourself.’ When a couple of the managers encouraged Madych to organize a group, she took the plunge and invited several to lunch. Five showed up. Not surprisingly, Madych was the only one who knew everyone at the table.
But the managers embraced the idea of forming a group that would meet regularly to share ideas and get educated on common issues.
Managed Care Concerns
In the early days, the association focused almost exclusively on managed care. ‘Managed care hit us late, which is why in 1995, it was a big concern of our practice managers,’ says Madych.
The issue that really stuck in their craw was the failure of managed care companies to reimburse them accurately and in a timely fashion, says Miller.
‘There was a lot of anger and frustration, but no good mechanism for getting their attention,’ says Madych. That was particularly true in the rural northeastern corner of Connecticut.
‘Any time the insurance companies would hold an informational meeting, it would be miles from here,’ says Miller.
But the managers reasoned that even if they couldn't individually grab the attention of the big HMOs, they might as a group. They were right.
The stage was set for their first meeting with the provider relations representative of a particularly heinous HMO.
‘It was very unpleasant,’ recalls Madych. ‘The managers were excited. The room was very hot. It was a confrontational situation.’ Not surprisingly, the HMO representative got defensive under the barrage of complaints.
Despite the inauspicious beginning, the practice managers were energized by the experience. ‘They realized they had a voice,’ says Madych. So, they called more meetings. In fact, for the first year and a half of the association's existence, most of the monthly meetings involved some type of interaction with insurance/HMO representatives.
‘It set up a dialogue and allowed managers to have a feeling of solidarity,’ she says. ‘They knew they weren't alone.’
But as the managers made the painful transition from indemnity to managed care, they were ready to jump new hurdles. Like purchasing.
What happened was predictable. Once the managers started talking to each other, they discovered an irritating fact about pricing ... it was all over the place. They asked themselves whether they could command better (and uniform) pricing if they worked together.
Some vendors to whom the managers spoke loved the idea, but others weren't so keen. ‘They didn't like the fact that managers were getting together,’ says Madych.
Miller's office supplies vendor was one who embraced the concept. Another was the local PSS rep. With his help, the offices identified their most frequently ordered items. The rep came back with a bid on them.
After two or three groups tried the deal on for size, the rest were invited to join. Today, two-thirds of the practices use the contract. A percentage of the gross purchases are rebated to the group to defray meeting costs as well as Madych's fee.
In addition to med/surg supplies, the association cuts a deal every year for flu vaccines. The first time they did so, the vendor shipped product to Miller, who did a milk run to all the participating groups. Today, the association buys $24,000 worth of vaccine, and the distributor ships to and bills each practice individually.
The association has found that local businesses, such as laundries and uniform shops – are extremely eager to cut a deal with them.
‘More and more, distributors are willing to work with us,’ says Miller. ‘When we started, people didn't think we could actually get something together. But we did.’
Next up is education. The association has sponsored forums on such topics as hiring and firing, time management and electronic medical records. Recently, they signed a deal with Practice Management Institute in Texas, a provider of development programs for practice managers and physicians. Four educational programs are scheduled for this year, including one on coding.
‘We amaze ourselves,’ says Miller. ‘When we started, we figured we would be a few managers getting together at lunchtime. Now look at us.’