Key Points: Leadership, robust analytics and data-based business decisions are the fundamentals to position your practice for the future.
For many practice leaders, the mid-year practice financial and operation review delivered a somber reality. The unending and complex challenges of leading a profitable medical practice continues in full force. The perfect storm:
- Multi-year stagnant or declining reimbursements
- Growing government and payer demands for physician accountability for the cost and quality of care delivery
- Rising overhead expense.
Add increasing payer driven positive and negative financial incentives targeting performance and increasing demographic driven demand and the complexities just increased. The reality: Changing the physician reimbursement system without aligning incentives and effective rebuilding the infrastructure is problematic. Simply, increasing practice net income, for many practices, is a complex task.
Successfully navigating the reimbursement environment for 2019-2020 demands the practice rethink their financial and clinical operations model. Creating the right infrastructure requires a long-term strategy designed to position the practice to capitalize on evolving opportunities. For optimum benefits, focus on generating actionable data and tangible insight and not just standard practice management reports. The analytics must align with targeted measures and metrics to facilitate leveraging data for effective business decisions. Knowing where you are is important, having an action plan for the future is critical.
Quick Action Plan Summary:
Step 1. Define where the practice is today and where you need to be downstream is key.
Step 2. Harness core practice data and robust analytics.
Step 3: With actionable data, retune the practice for future profitability.
Step 4. Secure team buy-in.
Step 5: Reengineer the practice to meet targeted goals.
Step 6: Develop effective top-down communications to support team buy-in. This is arguably the most difficult – successful communication is more art than science.
Sept 7: Monitor and adjust to environmental changes and opportunities. Keep moving forward.
The PRS team partners with group practices, physicians and hospital multi-specialty groups of all sizes and geographic locations. This unique relationship provides us a clear view of the growing impact on practice profitability and organization cohesiveness. We understand medical practice dynamics and complexities. We understand this is not an easy environment. We understand that having the right partner on board with hands on experience is essential.
Case Study
I will briefly share how our team tackled a critical concern for a mid-size group practice faced with declining revenue and increased partner dissatisfaction. The practice was confronting numerous problems and had no clear understanding of what was driving the lost revenues. The practice physicians contacted the PRS Team requesting a situational review. After initial conference calls and our preliminary review of practice management reports we recommended a Top Down practice revenue cycle assessment. Clearly, the practice was facing a serious revenue shortage and partner crisis. This quickly evolved into a PRS multi-team approach. Our team implemented a multi-faceted game plan with clear actionable goals and solutions. This practice restructuring required on-site support, conference calls, webinars and short-term executive management support.
Situation Overview: Eight urologists’ and three nurse practitioners supporting two metro central office locations. Our evaluation of the practice revenue cycle highlighted ongoing poor business practices, little management oversight and no actionable game plan.
Results: The PRS consulting team partnered with the practice to provide get well improvement actions including:
1) an acceptable and enforceable financial policy
2) protocols and processes for check in
3) monitoring process and feedback loop for reimbursement and coding
4) Clinical staff documentation review and process change
5) staff education and training
To ensure long term success, we provided a 120-day executive management oversight and practice manager recruitment. We are still working in concert with the urology practice on ongoing practice management issues and stage 2 planning targets.
Summary: Leading a successful practice requires an integrated team aligning both clinical and business models. The challenges will continue. The solution for most practices is fundamental: Implement solutions that deliver value and drive profitable revenues. Keep it simple. Demonstrate success and solve one issue and then another. Building a winning infrastructure and nurturing success requires leadership now more than ever.
For more information or to discuss your practice please contact me at lkemp@prsdata.com.