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You don’t have to be a business whiz to make and keep your practice profitable. Focusing on just a few high-impact areas can make the difference between a flourishing enterprise and financial problems.
Nandkishore Ranadive, MD, loves the professional freedom that comes with running his 15-provider independent practice, Orlando Heart Specialists in Altamonte Springs, Fla. “I have the ability to work when I want to, take time off when I want, and not worry about what my employer will tell me,” he says.
That has fueled his energy for growing it. He started the practice about 17 years ago with three employees. Since then, as president and chief executive officer, he has grown the practice to between 60 and 65 employees. But with the regulatory environment bringing mounting costs to medical practices, keeping it thriving has required Ranadive to give frequent attention to the business side.
“The challenge in today’s world is to remain viable,” Ranadive says. “If one is having difficulty sustaining the overhead of the practice, it becomes easier to join a hospital system or some other large provider and give up those headaches.”
Taking a proactive approach to managing the business side of a practice is essential today, as the Affordable Care Act, International Classification of Diseases-10th revision (ICD-10) and other measures add economic pressure. Fortunately, by concentrating on high-impact areas of the practice-like cash flow and online reputation-it is very possible to build a healthier operation with long-term sustainability and more time to care for patients, experts say.
Here are some strategies for attaining that goal:
With patient satisfaction becoming increasingly important both in terms of reimbursements and in building a strong online reputation, creating a positive first impression when a patient first checks in makes more of a difference than ever to a practice’s success.
“The person at the front desk can make a life-long patient or a one-time patient, based upon how they meet and greet the patients,” says Steven Peltz, CHBC, managing partner of Peltz Practice Management & Consulting Services in Brewster, New York.
Evaluate your staffing
The ideal front-desk employees have both the warmth to make patients feel like family members and the skills to simultaneously handle insurance verification and accept copayments in an organized way, experts say.
“With ICD-10, the front desk is going to have to ask much more of the patient than they are doing now,” says Peltz. “The front-desk person is going to have to determine the reason for the person coming in.”
Invest time in finding personnel who combine soft skills and deftness in multi-tasking.
“The one point I can’t stress enough is hiring the right person, no matter how many interviews you have to go through-and to train that person to succeed,” says Peltz. “If you don’t have good training, the person will not succeed and you will have to start the process over.”
Next: Streamline your intake before patients arrive
Streamline intake before patients arrive
The less time patients spend in your waiting room, the happier they are likely to be with their visit.
To make sure they see their practitioner quickly, ask them to download and complete intake forms or use a secure system where they can submit the information online, recommends Audrey “Christie” McLaughlin, RN, president of PhysiciansPracticeExpert.com, a Dallas-based consulting firm. There’s an added bonus: “It saves staff time,” she says.
Fine-tune scheduling practices
Many practices risk hurting patient satisfaction because they don’t build their schedules properly, according to Valora Gurganious, MBA, senior management consultant at Doctors Management, a medical and healthcare consulting firm in Knoxville, Tennessee. Her firm helps medical practices introduce new processes and systems to keep physicians on schedule. One strategy that has been successful is clustering time-consuming visits at certain points in the week and arranging new-patient visits at the optimal time.
“Never schedule a new-patient visit after 2 p.m.,” she advises. “It will make you go way past 5 p.m.” Smart scheduling also makes life easier for doctors. “They are not walking into a train wreck,” Peltz says.
Put strong financial controls in place
Reconcile the copayments you are accepting with what gets deposited in the bank regularly so you don’t lose track, says Drew Stevens, PhD, a practice management consultant at Stevens Consulting Group, based in the St. Louis, Missouri area and author of the book Practice Acceleration!
“At one of the doctors I’ve worked for, the front desk had been stealing $40,000 in cash,” says Stevens. “It took them almost a year to find out that kind of money was missing.”
Even if you have no time to tweet your latest medical insights, it’s important to pay attention to what patients are saying about you on review sites like Healthgrades, Yelp and Yodle. RealSelf.com, a plastic surgery review site, has found that physicians typically get one referral from every two patient inquiries.
“The relationship with the patient doesn’t end with the procedure or with checkout,” says Tom Seery, chief executive officer of RealSelf.com, based in Seattle, Washington. “A lot of doctors think of reviews as a judgment of them. What consumers are trying to understand are: What can I expect when I attend this practice? How do they treat their patients and people? It’s less about the doctor and more about the experience.”
Here is how to make the most of patient reviews:
Designate a point person
Medical practitioners need to build a “brand” that is known in the community, says Stevens. You can achieve this goal in a variety of ways, from blogging to doing radio and TV interviews, but it won’t happen by accident if you’re busy caring for patients.
“If you can’t do it yourself, find someone to assist you,” advises Stevens. That may be someone on your staff or an outside agency.
Ask for reviews
Many doctors feel awkward asking patients to post a review on a social site. Framing the value proposition carefully can make it easier. A physician might say, “What you experienced is really important for others to learn from,” says Seery.
To facilitate the process, many medical practices print cards to have their team hand out to patients. They might invite their patients to “share in an unbiased fashion your experience,” says Seery.
Don’t worry if you don’t get a perfect, five-star review, says Seery. In fact, perfection may raise questions, since prospective patients will realize there must have been occasions where a patient got annoyed by being kept waiting or other issues.
“If consumers just see a cleaned up version, they are going to think something is going on,” says Seery.
Next: Fine-tune your operations
Tackling just one or two key projects to improve the bottom line at your practice this year can mean the difference between thriving and teetering on the brink of joining a hospital staff.
“If we can maintain overhead within a reasonable level and maintain revenue, that is the key to survival and staying independent,” says Ranadive. A practice’s revenue must consistently exceed expenses or it will struggle.
Re-negotiate contracts with insurance companies
A 3% improvement in reimbursement annually can make a difference, says Ranadive. “Many physicians don’t ask for increases,” he notes.
Re-connect with dormant patients
Do a mailing to remind patients you haven’t seen in a while to come in for a checkup.
“A lot of doctors fail to keep in touch and communicate with patients,” says Stevens. “That’s where their future revenue lies.”
Prioritize your accounts receivable
Many medical practitioners delegate handling this job to staffers, consultants or other help.
Make sure they are doing their job well. For example, Stevens worked with a chiropractor who was surprised to learn she was owed $278,000 over a 155-day period.
“She had a family member handling it for her who never went after the insurance company reimbursement,” says Stevens. “This happens on a repeated basis.”
Re-evaluate recurring costs
Billing, invoicing and customer relationship management software can be pricey, so make sure you are getting enough bang for the buck.
“I had one client who was paying $1,500 a month just in software charges,” says Stevens. The medical software company took a percentage of gross receipts, as well, he says.
Delegate someone on your staff pay attention to the latest cloud-based technologies, so you can find the most cost effective one.
Motivate better performance
Raising your team’s productivity can reduce the need to hire additional staff. “If you have 10 physician’s assistants, give them a scorecard,” Ranadive says.
You will quickly know which team members are rolling up their sleeves. “Work with the ones who are lagging behind,” he advises. “If they don’t improve, you may have to replace them.”