Understanding Financials in Hospital Systems and Private Practices-Session Recording

Video Transcription

Video Summary

The presentation focuses on educating physiatry residents and physicians about the financial and business aspects of Physical Medicine and Rehabilitation (PM&R) practices amidst a shifting U.S. healthcare landscape. Key topics include CPT coding for billing, complexities of reimbursement tied to procedures and patient encounter documentation, and recent trends indicating overall decreases in reimbursement rates for certain PM&R services despite some increases, such as in electrodiagnostic procedures.<br /><br />Experts stress the importance of adaptability and a clear understanding of diverse practice models—ranging from VA and academic systems to private practice and locum tenens work—and their respective risks and benefits. Dr. Matt McLaughlin highlights the evolving payment models moving from fee-for-service to value-based care, emphasizing the need for physicians to understand Relative Value Units (RVUs), billing complexities, and negotiation tactics within their healthcare systems to maintain sustainable practices.<br /><br />Dr. Michael Lupinacci discusses post-acute care roles for physiatrists across inpatient rehab, skilled nursing facilities, and consultative services, noting the increasing demand driven by aging populations and complex patient needs. He provides insights into managing overhead costs, dealing with regulatory challenges, and navigating Medicare’s Merit Incentive Program (MIPS), which imposes quality reporting requirements with financial implications.<br /><br />The panel underscores the escalating administrative burdens physicians face—including coding, billing, staffing, and legal costs—and emphasizes the value of mentorship, group support, and continuous education in business skills to preserve physician autonomy and well-being. Final advice highlights prioritizing meaningful work and location over salary in early career decisions, negotiating contract terms thoroughly, and maintaining financial prudence to thrive in a complex healthcare environment increasingly dominated by large systems and evolving reimbursement models.

Keywords

physiatry education

financial aspects

business aspects

Physical Medicine and Rehabilitation

PM&R practices

CPT coding

reimbursement complexities

electrodiagnostic procedures

practice models

value-based care

Relative Value Units

post-acute care roles