Authors: Nancy Timmons, MSHA, CMPE
“Patients will not have access to life-saving neurosurgical care if their local neurosurgeons cannot afford to maintain a viable practice, as it truly is ‘No margin, no mission.’ And just as we physicians need to go to our scientific meetings to keep up with advances in medicine and provide the best patient care possible, it is just as vital that our neurosurgery practice managers and administrators be a part of NERVES and attend their meetings. With the ability to network and learn from other neurosurgery practice managers and administrators, they can help us maintain the ‘margin’ needed so we can continue to do what we do best, provide the best possible neurosurgical care to our patients in need.”
Joseph S. Cheng, MD, MS
Associate Professor of Neurological Surgery
Director, Neurosurgery Spine Program
Vanderbilt University Medical Center
NERVES (Neurosurgery Executives’ Resource Value and Education Society) is the only national neurosurgery administrator society in the United States. The organization is the result of an initiative by the CSNS to help neurosurgery administrators to network, combine their resources to gather information, and learn from their colleagues about how to run a successful neurosurgical practice.
As a neurosurgeon you may be asking yourself, “Why would I support my practice administrator’s participation in the NERVES organization? Is this just an added cost to my overhead that will not really benefit my practice?” The leadership of NERVES and your esteemed colleagues would tell you that it is imperative that neurosurgeons support their practice administrator’s membership and participation in the NERVES organization.
The NERVES organization brings a wealth of resources for individual practice administrators, beginning with the ability to participate on the NERVES listserv. This resource provides real-time access to members across the country to ask pertinent questions about any subject and receive responses from multiple colleagues quickly. Many responses include offers of help via phone calls or documents that could assist your administrator with the issue at hand. Recently there have been many questions concerning the CMS 2015 PQRS program and how small neurosurgical practices are having a difficult time complying with the new requirements. Suggestions of measures and measure groups, implementation of data collection and reporting, and reputable registry companies have been offered by NERVES members. Any question that comes up in the daily running of a practice can be asked on the private listserv, and responses from experienced administrators, who have been in similar situations, can be obtained quickly without having to enlist the aid of your professional attorney or accounting firm, saving your practice many dollars.
NERVES also provides development and oversight of the NERVES Socio-Economic Survey, a key resource primarily used to benchmark your practice in comparison to your colleagues’ practices across the country. The survey is administered confidentially by the independent accounting firm of Katz, Sapper & Miller. The data includes provider production, compensation, operating costs, malpractice costs, and other overhead expenses specific to neurosurgery, related specialties, and midlevel providers utilized within the neurosurgery practice. Now in its tenth year of publication, this tool is recognized as one of the most essential planning and development tools within the practice of neurosurgery. It may be used to educate your hospital or health system, utilizing national data for trauma call reimbursement, compensation, compensation methodology (i.e., use of RBRVS metrics to pay neurosurgeons), operating costs per FTE physician, and staff ratios per physician. The survey is updated on an annual basis to request responses on current issues in the practice of neurosurgery. The survey is a tool for practice administrators to benchmark their practice performance against other practices, which can provide information needed to improve on target areas that are not in the range compared to other practices. The listserv can be utilized to ask specific questions on how to obtain a target.
The NERVES Annual Meeting is conducted prior to the AANS Scientific Meeting each spring. This meeting presents an opportunity for NERVES members to network in person with other administrators as well as with outside vendors who can provide resources in many areas of management. The meeting features great speakers and breakout sessions on current issues in neurosurgery and practice management. Members build relationships with colleagues who have successfully completed projects in many arenas, such as the development of imaging centers, ambulatory surgery centers, EHR, meaningful use, PQRS, ICD-10 readiness, and many other programs that increase neurosurgeons’ ability to be successful and thrive in the changing health care environment. Practice administrators receive the latest updates on coding and reimbursement, regulatory changes specific to neurosurgery, advances in business management strategies and tools, and successful practice structures and models.
In addition to what NERVES can do for your practice administrator, participation in NERVES as an officer or volunteer can be very rewarding and increase the expertise of your practice administrator by providing leadership opportunities and the ability to acquire advanced skills and knowledge base. Long-time NERVES members are happy to be mentors to new practice administrators and are always open to providing insight and expertise to new NERVES members.
Membership in NERVES enables practice administrators to seek answers to difficult problems, share knowledge, and find collegiality and support in the stressful healthcare environment. Its dedication to neurological surgery and affiliated service providers makes it the ideal choice for your practice administrator. The NERVES organization is committed to providing organized neurosurgery the resources and expertise to enhance the practice of neurosurgery in these challenging times.
“The NERVES association has been an invaluable asset to neurosurgery in many different ways. Facilitating open communication and collaboration among our practice managers is in and of itself tremendously valuable in improving the administration of our practices. However, obtaining and publishing accurate and statistically valid benchmarking data is of even greater significance. Given that the data collected by NERVES comes from our practice managers, it is likely far more accurate and complete than what could be obtained from surveying practicing physicians. Furthermore, the number of practices it represents, the level of detailed information collected, and the independent auditing make it an unprecedented and a compelling source of reliable benchmarking data. Given the overall quality of the data collected, it is easy to argue its acceptance over other less valid available neurosurgery benchmarking data.” - John A. Wilson, MD, FACS, Professor and Vice Chair, Department of Neurological Surgery Wake Forest University School of Medicine