QHR Physician Services offerings fall into two categories:  Physician Practice Consulting and Physician Practice Management.

Our Physician Practice Consulting offerings address all aspects of the day-to-day operation of a physician practice, including: strategy, hospital-physician alignment, patient access, clinical throughput, revenue cycle, provider productivity, operating costs, managed care contracting, compliance and coding. Specific offerings include:

Practice Management Leadership Support

QHR’s Practice Management Leadership Support provides a practice administrator to assist/advise with practice operational challenges – including those specific to patient access, clinical throughput, revenue cycle, provider productivity, operating costs, managed care contracting, documentation and coding. The administrator is on-site several times a week or month, as needed.

Practice Financial Monitoring

This service is designed to help ensure that a practice’s operations are performing to expectations. Financial oversight and expertise is provided from QHR’s corporate office using a dashboard tool to identify practice challenges and drive recommendations for change. Monthly reviews include: volume and productivity plan, profit and loss, revenue and dashboards, and a monthly reconciliation guarantee.

Physician Practices Strategic Planning and Implementation

This consulting service includes the development of market assessments that enable a practice group to: ascertain the impact of their strategies and plans on key audiences; determine their strategic goals and objectives; create hospital/physician alignment strategies; develop implementation plans and organizational resources; and create a defined business/strategic planning process with an accompanying work plan.

Physician Strategic/Alignment Services

QHR assists with physician strategic planning; conducts a physician/hospital alignment readiness assessment; facilitates a physician/hospital alignment retreat/workshop; conducts or helps create a physician enterprise organizational review; and provides physician leadership coaching.

Medical Group Governance and Leadership

QHR facilitates the development of joint operating committees and assists in and/or guides them; leads strategic planning retreats with physicians and leadership; and outlines/educates on the legal structural options for employing physicians and developing integrated service delivery (ISD) systems.

Physician Compensation Modeling

QHR’s physician compensation plans are designed to help hospitals meet their organizational objectives, while supporting the overall physician/hospital enterprise. They are presented in understandable terms and with simple, understandable calculations and methodologies. And they are sustainable over time based on the financial capacity of the hospital and the economic demands of the market place. Specifically, they take into account: productivity, specialty, years in practice, and comparison to MGMA, provider metrics and compensation options report, market size and patient satisfaction. They also address: incentivizing and remunerating provider production; advancing cost management and operational efficiencies; delivering quality patient care; and empowering providers with control over their practices and their incomes.

Practice Assessment

The goal of a General Practice Assessment is to identify significant challenges in practice operations. The analytical assessment of performance to benchmarks looks at production, revenue, staffing, physician compensation and other costs. This assessment will be conducted on, with data collection and delivery done electronically prior to arrival.  To include overall practice findings (issues), profit and losses analysis, per physician MGMA report, physician compensation analysis, physician production analysis, CPT coding analysis, recommendations.

Practice Operational and Performance GAP Analysis

This is a “deep dive” analysis that looks at all aspects of practice operations, patient throughput and care delivery. It addresses areas of operational systems, policies, procedures, scheduling, staffing, billing and collections, and includes a more detailed level of analytics for targeted areas such as payer mix, Charge Master, revenue cycle, compensation and production. It looks at performance metrics to benchmark in three primary areas: production, revenue and costs.  The end result is a GAP analysis summary table combining multiple practices to assess “enterprise” performance. (Detailed GAP Reports by clinic location are also available to identify the economic drivers for each specific site.) A operational analysis can be done in conjunction with a practice assessment, or as a result of a practice assessment.

Revenue Cycle Analysis

This is an on-site, in-depth review of all billing and collections processes from scheduling and check-in to claims submission, follow-up and denial management. The deliverable for this assessment is a recommendation for improvements through the billing and collections process.

Acquisition Assistance

This consulting service can benefit any hospital considering the acquisition of a physician practice. It can include: oversight of a third-party practice valuation; physician compensation modeling; a coding and compliance audit; new practice planning; financial modeling and impact analysis; facilities planning and project management; and provider enrollment.

New Practice Start-up

During on-site visits, QHR works with the physician and staff on: provider enrollment; practice start-up project management; initial physician orientation and education; pro forma and budget review; volume or productivity plan review; work plan creation, coordination and oversight; collaboration with hospital management; and review of dashboard metrics.

Federally Qualified Health Centers (FQHC) / Rural Health Clinic Review

This comprehensive review of provider-based FQHC’s or Rural Health Clinic operations is designed to ensure compliance with current regulations, local and federal guidance and best business practices. Billing methodology specific to provider-based (Medicare Part A) requirements is assessed to ensure accurate charge capture and billing of hospital and professional services.

Coding and Compliance Audits and Training

QHR provides coding education for physicians and staff; establishes and documents the coding process from documentation to charge entry; creates a documentation template and encounter form; conducts chart audits and coding distribution; and makes compliance recommendations.

Provider Enrollment

QHR coordinates with the recruiter and the hospital to initiate processes as quickly as possible – gathering provider information and completing, submitting and following up on payer applications until the provider is approved.

Hospital/Physician Managed Care Contract Review

QHR’s experts review the key language and financial payment issues that must be addressed to avoid unforeseen reimbursement issues or operational requirements that the hospital/physician cannot administer. Our reviewers see the same boilerplate proposals from key national payers on a regular basis; they know what can be modified. They’ll use this knowledge to enhance the net revenue of the agreements and minimize future conflict with payers that may occur with less clear contract language and financial terms.