In honor of this month's Juneteenth holiday and in recognition of the challenges facing the African American community that we’re seeing highlighted through the Black Lives Matter protests, Fast Layne Solutions CEO Christopher Hughey connected with a hospice administrator and nurse this past week to talk about what it means to be a healthcare leader of color. This blog article is based on that conversation.
Due to the contentious nature of these topics, our interviewee, whom we will call Pam, has asked to remain anonymous. She is a middle-aged African American healthcare leader based in the South.
Pam is many things: nurse, healthcare leader and administrator, mother.
She is also African American.
What went through your mind when I added that last fact and how do you think it impacts those other labels that describe Pam? Many people these days want us to ignore race. They tell us it shouldn’t matter, so we should simply disregard it. For them, that is how we will end racism: just pretend race isn’t even a thing and all will be well! So let’s examine how being Black in America in 2020 changes how Pam has to manage her life and then re-ask that question at the end.
Being a nurse v being a Black nurse:
One day, in her role as a nurse, Pam (a highly qualified medical professional) and her colleague (her White assistant) arrived at a home to visit an ailing, elderly patient in hospice care. The patient’s wife answered the door in a panic as her husband had just lost control of his bowels and the result was a very unpleasant mess. The wife was also quite distressed as she was uncertain how to administer her husband’s anti-anxiety medication and needed a nurse to help her with it. Upon seeing a Black woman and a White woman at her door, she immediately handed towels and a bath basin to Pam and the medication to her White assistant.
Does 'White privilege' mean that that White assistant has never had struggles in her own life? That becoming a nurse's assistant was easy for her? That she faces no personal challenges of her own? No. Of course not. All people face struggles in life. But what White privilege does mean is that her skin color doesn’t add to those struggles. And it means people don’t draw on centuries of stereotypes and oppression and shove cleaning supplies in her hands when she walks in the room based on the automatic assumption that she must be the ‘help’.
Being a healthcare leader and administrator v being a Black healthcare leader and administrator:
Being a healthcare administrator and leading a team of providers and staff are two challenging responsibilities for anyone. But when you add in the African American experience, it can become more than just challenging. At times, it can become next to impossible, especially in an age when we are seeing dog-whistled approval of racist attitudes coming from the highest levels of our country’s leadership. This has impacted Pam’s life directly. She supervises a staff of almost four dozen people in an area of the country already not known for its racial tolerance. Of late, the climate of tension has made her job even more difficult, with some staff openly disrespecting her. And it is impossible to gloss over the impact America’s political toxicity is having on this aspect of her life: she has noticed, for example, that such behavior is measurably worse the day after a televised ‘Make America Great Again’ rally. But as a business leader, she can’t mandate people’s politics or attitudes, and she also faces the constant stress of walking the line between maintaining control of her organization and being cast as the ‘angry Black woman.’
None of these are challenges faced by White healthcare leaders and administrators.
Being a mother v being a Black mother:
One day recently, Pam, a Black mother of biracial adult children, noticed that her son’s car had a malfunctioning taillight as he was pulling out of her driveway. She had a moment of panic and stopped him before he could leave, insisting he take her car instead. When she recounted this story to her White friend, whom she has known for decades and who has an adult son roughly the same age as Pam’s, her friend was puzzled that Pam would be so adamant about her son switching cars. After all, a non-working taillight isn’t such a danger to vehicle safety, and even if he got a ticket for it, it would be a minor offense. Pam had to explain to her friend that none of those everyday considerations was going through her mind when she panicked and made her son change cars. This wasn’t about such mundane factors as vehicle maintenance or insurance costs or ticket court dates. No, when Pam saw that darkened taillight, what she had to picture was her gentle giant of a son being shot to death because a nervous cop approaching a car occupied by a large, dark-skinned male panicked when he saw that man reach for his license. She had to picture herself identifying his body while listening to the police explain how her son’s death was his own fault for acting ‘suspiciously,’ how a wallet can look like a gun in the heat of the moment. She had to imagine White social media explaining to her that none of this would have happened had he simply maintained his car properly (because apparently we have capital punishment for burnt-out bulbs if you’re Black). Her White friend was aghast at all this. It had never occurred to her to fear such outcomes from something so trivial as a broken taillight.
Being a mother is hard for every woman. And being a mom isn’t made easy by being White. But it also isn’t made harder, either. And it doesn’t include the grim task of teaching your children how to behave ‘just so’ to avoid ending up dead after even minor encounters with law enforcement, encounters that would be at most a mild annoyance to the majority of White people.
The purpose of this article isn’t to solve racism. We don’t have those answers for you.
So we’ll just close by first asking that same question again:
How do you think race impacts Pam’s roles in life?
And we’ll add another on which to end:
After reading about Pam's experiences, do you think America can solve racism by simply ignoring the role of race in our society?
Postscript: Another thing to consider when asking if race matters is this: we were originally going to use Pam's real name and the name of her town. But after reading the draft, she asked that we make her contribution anonymous, and understandably so. If racism is 'over' in America, why does an African American healthcare administrator have to fear for her job (and potentially even her safety) for simply discussing actual events from her life with the CEO of a small company? Again, we don't have the answers. But we do feel it's time for everyone of every race in America to start asking themselves these questions.
Covid-19, the deadly and highly contagious disease caused by the novel coronavirus that was first reported late last year, has already tested our country’s healthcare delivery system, and it is almost certainly not even close to peaking yet as of this writing. Here at Fast Layne Solutions, we are, as always, focused on how to help small- to medium-sized independent medical practices, so this blog post outlines our response, including our advice and the steps we intend to take to help our clients and our country. It will be updated as events unfold and as we add more measures.
Let’s start with social distancing. It is absolutely vital that we minimize human-to-human contact to stem the spread of the virus. For any medical procedure that does not require in-person consultation, we strongly recommend e-visits, aka telehealth. If your office is not already equipped to do telehealth visits, please contact us. For the duration of the Covid-19 pandemic, we are waiving much of the implementation cost for our clients and, for qualifying practices, will amortize the rest over one year. We can get practices set up on telehealth extremely quickly and we have two versions: one is embedded into the patient portal that we provide with our EMRx and Revenue Cycle Management offering (see iClaim below), while the other is a standalone app that is Bluetooth-enabled and vendor/platform-agnostic and can be rolled out in a matter of days. In either case, with just a few clicks, you can be seeing a patient anywhere in a secure, HIPAA-compliant environment. (Because Apple will not sign a BAA, FaceTime, for example, is not compliant. Do not make that risky and potentially expensive mistake. Please see our statement on the HIPAA telehealth enforcement waivers for more information.) In the embedded version, in the same portal where you hold the telehealth session, your patients can make appointments and even pay for their visits, as well as message your office, review their records, and check lab results.
Another way your office can facilitate social distancing is to get rid of the old practice of having patients arrive early to fill out paperwork. Using our portal, patients fill in their paperwork online in advance, and your office staff see it as highlighted entries ready for them to check and confirm before making them permanent entries into the patients’ records. As noted above, that same portal can also minimize face-to-face interactions by facilitating online payments, scheduling, records and results retrievals, and messaging.
Now we need to discuss an unpleasant topic, doctors and practice administrators. The insurance companies have waived certain co-pays related directly to testing, but this will not impact any other costs to patients, including actual treatment. Independent doctors already struggle with denials, claim rejections, and outstanding patient debt even at the best of times. During this crisis, those problems will only grow. So let’s look at how we can use technology to minimize the impact on your practice so that you can continue serving your patients:
Technology has an important role to play in this crisis, and we are ready to help you implement it quickly and efficiently to minimize negative outcomes for both you and your patients. And to help even more, we will be offering all the basic features of our standalone telehealth app free of charge until the pandemic is over or until September 13 2020, whichever comes first.
To further assist doctors and their patients at this difficult time, Fast Layne Solutions is also offering a monthly 5% rebate to any of our clients who are in a position to offer medical care to uninsured patients, in order to help them defray those costs. This offer remains in effect until the pandemic is declared over in the United States.
For the duration of the crisis, we will also be donating 5% of our clients’ monthly invoices to the Center for Disaster Philanthropy’s Covid-19 Response Fund. We will also be earmarking 5% of all 2020 corporate profits for Covid-19 relief.
We want to close by thanking our tireless and brave healthcare workers who will be on the front line in the battle against Covid-19. You are our heroes and America’s best hope.
Last week, we talked about the challenges facing a fictional doctor, Dr. Janelle Smith, a young endocrinologist trying to serve the South Side of Chicago as an independent practitioner. When we left off, she was facing an impossible choice: stay in her private practice but barely scrape by, or join a large hospital and let go of her dream to serve her community. But it's a false choice, because all those problems we described actually have solutions.
Let’s take her EHR. Her total annual costs, including maintenance, updates, and training, for her current system exceed $25,000 for the practice. And that’s just what she pays to her provider. What she’s not capturing in that figure is the value of the time wasted by her and her PA due to how complicated and user-unfriendly her system is. So she sits down and runs the numbers: she and her PA are averaging 10 minutes per patient encounter and they see 40 patients a day. To her horror, she realizes that almost an entire headcount is dedicated just to charting. But a tablet-optimized, Cloud-based EHR like NextGen’s EMRx costs a fraction of that, and because it was designed by doctors, it’s intended to get doctors through the charting process as quickly as possible, in an average of just two minutes per encounter. Her first year savings alone are going to be almost $10,000 just for the software, and it leads to productivity gains equating to getting ⅔ of a new headcount for free. She almost has enough to add a second PA and expand her practice. And she’s just getting started.
Now let’s look at her overhead. She has a staff of five, including herself. Of those, three produce no revenue whatsoever and are not involved in providing care to her patients. They spend their days in purely administrative tasks, as noted above. But how much of that work is even necessary? Very little of it. With a full-feature practice and revenue cycle management suite, claims are generated automatically based on the integrated EHR, and reviewed by experts who handle claims for many offices, getting her practice out of the billing and claims business. (Any self-pay bills can be printed with a push of a button.) And because those claims are scrubbed by the advanced iClaim claims management system, the rejection rate is under 2%, and the payments hit Dr. Smith’s account within just a few days, thanks to the separate clearinghouse the system uses.
Patients can now fill out their paperwork in advance through the patient portal. They can also submit their medical records requests there, make appointments, and even pay their bills. And all benefits verifications are now automated and executed with the push of a single button when the patient checks in. And denials? A thing of the past thanks to a rigorous and automated verification system.
So the work of three staff who had been working 45-50 hours a week can now be done by two staff members working 40 hours a week. Now Dr. Smith has a receptionist/admin working no overtime and a far less stressed-out office manager working a normal schedule. Including overhead, salaries, and overtime, she is saving over $50,000 a year. That’s the rest of the money she needs to add that second PA or a nurse practitioner!
She also implements ChoicePay, cutting her credit card transaction fees to 1.79%, saving her money, allowing her to take payments online, and giving her a fully HIPAA-compliant merchant services solution that is seamlessly integrated with her billing system.
Her overall financial situation starts to improve dramatically as her AR days fall and she all but eliminates write-offs and bad patient debt caused by denials. Cash flow is excellent, with payments coming in within days of service provision. She’s no longer worried about making payroll. Her staff of five is now three healthcare providers, all of whom are caring for patients and generating revenue. She’s thriving. She’s able to dedicate more hours to her free clinic. She’s no longer living month to month; on the contrary, she’s making bold plans to expand to a second location.
As you look back through this scenario and consider the impact on the South Side, you can see the obvious benefits in terms of keeping quality care in the area and helping a local practice thrive. But you might have one concern. What about that biller? Yes, the practice still employs five people, but that biller is out of a job, and that isn’t good for the community. That’s why Fast Layne Solutions is proud to announce an initiative to create jobs in the communities we serve by training and equipping claims handlers in those neighborhoods. For example, we are committed to adding one new job for every five providers we serve on the South Side of Chicago. Note we’re saying providers, not clients, here. So a single office with, say, three doctors, one physician’s assistant, and one nurse practitioner would lead to a new job on the South Side. We will provide the training and the equipment, and the claims handlers can not only work from home, but also set their own hours, since we require only that a certain number of claims be processed within a given week. Think about what that means for, say, a single mother. Single mothers in economically vulnerable neighborhoods often struggle to find sustainable employment because working outside the home simply doesn’t pay once you account for childcare. But if you have a job that can be done from anywhere and at any time of day, you have the flexibility to earn a good living while still caring for your children.
The term “win/win” is thrown around a lot, but that’s truly what this is. We are giving practices the tools they need not just to survive but thrive in a challenging environment, while also creating new jobs in the community, jobs that involve highly valued, transferable skills.
Want to learn more? Email us today and let’s set up a free, no-obligation practice analysis. If we can’t prove that we’ll save you more than we will charge you, we just won’t ask for your business. It really is that simple.
Corporate Social Responsibility
CSR, or Corporate Social Responsibility, is undeniably important, and is also largely industry-agnostic. What we mean by that is this: doing good is good for business, any business. We believe this deeply, and as a company that combines a subscription-giving platform, volunteer concierge, and personalized impact reports to serve as a "CSR-in-a-Box" for 50-500 person companies, we are incentivized to believe it. Additionally, though, we have identified that some companies can move beyond the baseline notion above that doing good is simply good for business. What we mean by that is this: Some companies are set up to be better at the "doing good" part, as well as receive higher returns from the "good for business" part. HealthTech companies are one such example.
We initially identified this super-CSR mutation from a few of our early, successful clients in Visibly & Candid Co. We then looked across the HealthTech industry to confirm if it was widespread, and confirm we did. Here's why all companies prioritize CSR, and why HealthTech companies carry super-CSR mutations:
Why all companies prioritize CSR programs:
Why HealthTech companies carry super-CSR mutations:
So, to the thousands (ok, hundreds) of HealthTech companies who've read this far, how are you going to do better by doing good?
Welcome to the new Fast Layne Solutions blog! Tune in here for regular updates on a variety of topics, from updates about the company and valuable promotions to topics of interest to professionals in the field of healthcare. We'll also be welcoming some wonderful guest bloggers, so stay tuned! To make sure you don’t miss any updates, please sign up for our newsletter and also follow us on Twitter. (We use safe unsubscribe, so you can unsubscribe from our newsletter at any time.)
To kick off our blog, we’d like to tell you about Fast Layne’s missions and history. Fast Layne Solutions started as an idea in our CEO’s head back in 2016: bring together all the best industry solutions under one roof to create an affordable, one-stop shopping experience for small- to medium-sized, independent physicians’ practices who need cutting-edge tools and services to maintain their independence, stay profitable, and compete with the large corporate providers and hospital systems. And we accomplished that mission! From the industry’s best revenue cycle management solution (iClaim) to a user-friendly, MD-designed EMR (EMRx) to affordable merchant services that enable online payments (ChoicePay) to a patient debt management system (QuickCollect) to HIPAA and coding compliance services to practice marketing to credentialing assistance, we have all your needs covered! And best of all, it’s all 100% à la carte: we customize our solutions specifically to your needs.
But we have more than just a business mission here at Fast Layne. We also have a mission to give back to the communities we serve. That started with a commitment to earmark 5% of our net, post-tax profits to St. Jude Children’s Hospital for pediatric oncology research. We also work with local non-profits to help create new revenue streams by tying successful referrals to ongoing revenue-sharing with them. We’re even kicking off a project to create great jobs in economically distressed areas. (If you run or do fundraising for a non-profit, email us at firstname.lastname@example.org for more information and to see if we can work with you to help your organization.)
We also work with individuals in the healthcare sector to identify doctors’ practices that need our services, and in exchange we pay referral fees up to $3000. So if you know a doctor with any of these issues (see below), send an email to email@example.com, and if we sign that doctor’s office, we will pay you a referral fee! Ask for the details and “fine print” when you provide the referral and we will give you all the terms and conditions in our response. (Don’t worry! We keep the fine print to a minimum!)
Problems we solve:
-High insurance claim rejection rates. If over 2% of a practice’s claims are being initially rejected by commercial insurers (e.g. Blue Cross/Blue Shield, UnitedHealthcare, Aetna, Anthem, Cigna, etc.), Medicaid, and/or Medicare, we can help transform their bottom line! Even if those claims are eventually getting paid after resubmissions, it’s hurting the practice: consider that each reworked claim adds an average of $25 in cost to the practice.
-Slow reimbursements. Do you know a practice that is taking weeks or even months on average to get paid by the insurance companies? We can help! We get our doctors paid in days, not months.
-Clunky, user-unfriendly, slow, overpriced EMR/EHR systems. Do you know a doctor who spends too many nights and weekends catching up on charting? Or who is just paying way too much for such a system? (Many systems average tens of thousands of dollars PER DOCTOR PER YEAR!) Then talk to us! Our MD-designed, cloud-based, tablet-optimized subscription EMR is so efficient that doctors spend an average of only two minutes per patient encounter to finish charting. And it’s actually affordable!
-High merchant services costs. Many doctors pay well over 3% on credit card transactions and can’t even take online payments. We change all that! By leveraging the buying power of thousands of doctors, we get rates as low as 1.79% on merchant services for Visa, Mastercard, American Express, and Discover. And we can help doctors accept payments online and even offer a free, full-service patient portal!
-Scheduling nightmares? We offer a system that not only allows for online scheduling, but even helps doctors optimize their patients’ waiting room experience and reduces patient dissatisfaction by minimizing waiting room times.
-Struggling with HIPAA and coding compliance? We can help doctors get and stay HIPAA compliant and we also do coding audits to ensure they aren’t overcoding (dangerous!) or undercoding (costly!).
-Trouble with patient outreach? We offer AutoCard, a mailer marketing service to help doctors stay in touch with their patient base and even market to prospective patients. In an age when it seems that most emails are ignored and/or go to the spam folder, physical mailers are the new email!
So if you know a doctor who is struggling with any of these issues, drop us a line!
Thanks for tuning in to our first blog. Come back and visit us often and follow us on our mission to help independent doctors stay independent and to help them be doctors again, paper-pushers.