With physician practices threatened by declines in reimbursement and increased regulation, it is critical for office staff to streamline work flow and optimize revenue performance, says Teri Gatchel, MBA, CPC, Southwest regional director for AAPC Physician Services in Salt Lake City.

As Medicare reimbursements decrease and many smaller group practices struggle to maintain their margins, more than a few physicians have begun to seek the financial shelter afforded them by hospital employment. Not all physician practices, however, are interested in giving up their independence to join their local hospital or health system, and in some rural settings physicians aren't interested in a long-term commitment to the area. Clinical comanagement agreements offer physicians and hospitals an opportunity to thrive, but their structure may vary, especially as accountable care organizations (ACO) take seed.

A study published in the May 2011 online issue of Archives of Internal Medicine has created a field-tested "top five" list of potentially unnecessary cost drivers for primary care that-if reined in-could improve cost and efficiency.

Being a medical director is nice work if you can get it. A physician medical director can add several thousand or even hundreds of thousands of dollars to his or her ­compensation package for duties that can range from recruitment, ­attending meetings, conducting clinical peer reviews, and strategic development.

If you want to be on your best footing for contract negotiations, understanding your practice and your needs is not enough. You also need to understand the overall healthcare market and how current conditions will affect your negotiations, says Kyle Kobb, a principal at Equation, a healthcare consulting firm based in Salt Lake City.

Physicians, nurses, and midwives might have to toss their neckties, jewelry, and lab coats thanks to an infection prevention effort making its way through the New York state legislature.

It's long been assumed that the more primary care physicians (PCP) serve a geographic population, the fewer avoidable hospitalizations and the lower rate of death for Medicare patients. But a Dartmouth report published this past May 2011 in the Journal of the American Medical Association says that mortality and hospitalizations are significantly lower in areas where there are more PCPs who work full time taking care of patients in ambulatory care office or clinic settings.