Laurie Morgan

About Morgan

Learn more about my background at: linkedin.com/in/lauriemorgan

Everyone needs continuing ed — not just clinicians

When I was in business school, the idea of continuing ed for MBAs was occasionally bandied about. It just seemed odd that other professions like law and medicine made ongoing education and improvement a priority while ours didn't. Of course, the most obvious response to this is that the competitive nature of the business world makes mandating continuing ed unnecessary for MBAs and other business professionals. If you're not constantly learning and adapting, your skills can quickly become outdated -- and it's almost impossible to hide that in a typical business setting. That's why companies invest in corporate training and conferences, and why ambitious managers read (or at least skim) all those hot business books and why they network so much more regularly than physicians. In business, everyone takes charge of their own continuing ed -- and if they don't do so, someone else who is more in step with new ideas will come along and, as the saying goes, eat their lunch. In medical practices, though, we sometimes find physicians don't appreciate the need for ongoing business education for their managers. I've personally even encountered physicians who describe their managers as "fully trained." Perhaps it's because continuing education for managers isn't a regulatory requirement that physicians don't understand how important it is. Whatever the reason, if you're a physician who is not encouraging (and funding) ongoing education for your manager(s), you're making a mistake. No field has as much constant change as medicine. Medical practice managers, billing managers, and other practice business leaders need to not only stay on top of normal business evolution (e.g., technology change, marketing and communications change), they have to keep up with medicine-specific changes (e.g., regulation, research, clinical standards, insurance). Investing in continuing education for your managers is frankly cheap in comparison to the risk and costs associated with falling behind. So when your manager asks for budget for a conference, book or online education program, think twice before saying no. And if your manager never asks for these things, think about whether you've unintentionally discouraged a behavior that is essential to your practice's

By Morgan|2022-01-01T22:52:06-08:00October 3rd, 2014|

Reminder: patient collections webinar next week!

If you haven't signed up yet, there's still time to join my upcoming webinar on patient collections on 9/23/14 (9AM/12PM). "Front Desk Collections: the New Linchpin of Practice Profitability" is sponsored by Wellero and hosted by Physicians Practice. It's free! Register here.

By Morgan|2022-01-01T22:52:06-08:00September 19th, 2014|

Send your staff to conferences

Sending a key staff member - whether a biller or a practice manager - to a medical practice management or billing conference can seem like an expensive perk. It can be an especially difficult decision for a small practice. But there's just no substitute for the learning and connections that are possible by spending a few days at a high quality conference. Case in point. I just returned from the HBMA conference, where I presented to about 200 motivated and engaged billing service managers and owners. Attending as a speaker gave me the opportunity to listen in on some of the other speakers, and to hear attendee feedback. Now, the HBMA is a vibrant organization that provides plenty of valuable information throughout the year through its list-serv, payer-focused groups, and other resources. But the conference adds another layer of value -- and it does it very efficiently. For example, I sat in on a presentation about changes in bundled payments and other coding and payment issues -- including the four new modifiers the CMS recently announced. Everyone in the room valued an update on this (so far, still confusing) new information from the CMS. When you're working by yourself in your practice office, juggling all the normal day-to-day tasks and priorities, it can be all-but-impossible to get a clear answer on some of these kinds of issues. Programs like PQRS and PCMH are very difficult to parse through alone; it's hard to feel confident that you're on the right track, and the consequences are expensive. Being taught by an expert at a conference can be a lot cheaper than going it alone and getting it wrong. Of course, not all conferences are created equal. Be picky. Choose events by respected organizations, with well-regarded speakers. Review the agenda to be sure it hits the topics most relevant to your practice. And don't forget to consider the value of the audience: conference networking creates connections that can help your managers get help problem-solving long after the conference ends. So think about who will be there when selecting. It might cost a bit

By Morgan|2022-01-01T22:52:06-08:00September 17th, 2014|

Upcoming (free) webinar on patient collections — 9/23/2014

Front desk collections are more important than ever before. Trends in insurance plan terms mean that patients are more responsible for the cost of their care than at any time in recent memory. Mastering front desk collections is not just a way to be more profitable -- it's essential to maintaining any level of profitability and keeping your practice healthy! And there are important implications for patient relationships, too. This is why my new, free webinar is called "Front Desk Collections: the New Linchpin of Profitability." It's simply essential that front desk staff are empowered to fulfill this critical task. To learn more about the whys and hows of collecting from patients at the time of service, join me on September 23. I'll share some of my observations about how to optimize your front desk collections, plus there will be time for any question you'd like to ask. Join me for "Front Desk Collections: the New Linchpin of Practice Profitability" on 9/23/14 (9AM/12PM) -- sponsored by Wellero and hosted by Physicians Practice. It's free! Register here.

By Morgan|2022-01-01T22:52:06-08:00September 14th, 2014|

Front desk collections and patient-centered service

Would you believe that failure to collect consistently and adequately at the front desk can actually create a negative impression of your practice's patient service? And that skipping financial conversations to keep the focus on patient can actually backfire? Money conversations can be hard for all involved. And, when a practice staff is very focused on patient-centered service, it can seem counter-intuitive to emphasize financial details -- especially when patients are ill or injured. But, ironically, not being clear about financial terms and not collecting appropriately can actually cause your patients to feel worse about your practice than a conversation about money ever could. When you fail to collect adequately at the front desk, your patients will receive a bill -- and, if you are waiting for their insurance to pay its portion first, that bill may not even be mailed until a month or more after their visit. By that time, the patient may have forgotten all about the visit -- and never even considered they would owe a balance, especially if staff never mentioned that they would or provided an estimate. It's likely they've already allocated their monthly budget to other things. And maybe they're confused about the bill -- and now will spend time trying to figure it out, perhaps on hold with their health plan, or feeling they have to call your biller. All of this adds up to aggravation. And if they don't believe (or don't want to believe) they owe the money, they can become quite angry with your practice. Nobody likes unexpected bills. Properly estimating patient costs and alerting patients that they have financial responsibility for all or part of their service is one of the kindest things you can do for them -- and critical to maintaining a positive relationship. Learn more about front desk collections at my upcoming webinar on 9/23/14 (9AMPST/12PMEST) -- sponsored by Wellero and hosted by Physicians Practice. It's free! Register here.

By Morgan|2022-01-01T22:52:06-08:00August 26th, 2014|

Where will your superstar employee grow?
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Where will your superstar employee grow?

medical practice business

Where will your superstar employee grow?

When you have a stellar employee -- say, an amazing MA or RN, or a superstar patient service performer at your front desk -- it's likely that this hard-working, dedicated employee is hoping you're noticing. And it's also likely they're hoping that you're noticing because you're thinking about giving them more responsibility, allowing them to develop more skills, and nurturing their aspirations. Too often, though, physicians and medical practice managers react to notable displays of talent and dedication by doing everything they can to keep that superstar employee in the same job. It's understandable: who wouldn't want to have the world's best MA supporting them at a busy practice? But when that superstar is looking to grow and advance, they'll eventually only resent your efforts to keep them in the same role 'because they're so great at it.' They're going to start to feel punished for their excellent performance. And when that employee realizes that you're never going to allow them to grow because they're 'too good' at their current role, he or she will start looking for a better growth opportunity elsewhere. Even if your practice is small, you can give employees a feeling of growth and development in their jobs. If your practice is so small that it's inevitable that strong performers will feel compelled to leave eventually, manage for this outcome. Help employees to grow and expand their responsibilities and earn recognition while they're with you. You'll enrich their experiences while they are on your team and help keep morale high -- and, you'll be more ready if it unexpectedly becomes necessary to promote someone new to practice manager or team lead. Regardless of the size of your practice, cultivating 'bench strength' is important to protect your business -- and the process of doing it can help your staff members feel more excited about their future prospects (either with you or in their next role). Even when employees end up moving on, if they've had a wonderful experience working with you, there's always the chance you'll be able to hire them back at a higher level when,

By Morgan|2022-01-01T22:52:06-08:00July 7th, 2014|

Google Places, +Local renamed and reorganized again: Google My Business

Google seems to change up the marketing and integration of its business listings offering about twice a year; the newest incarnation, "Google My Business," continues the search giant's efforts to better integrate its various directory, map and social tools for local businesses. Given that the change just happened a few days ago, we're still digging in to see if there is any significant impact on medical practices and their physician listings. So far, it all looks reasonably familiar, but the process for setting up listings is perhaps a bit more streamlined. If you've heard us speak about claiming your Google Places or Google+Local listings and haven't yet gotten started, head to www.google.com/mybusiness to get started -- the process hasn't changed much, and it is still pretty intuitive and easy to complete.

By Morgan|2022-01-01T22:52:07-08:00June 30th, 2014|

Doc’s new doc(umentary) aims to illuminate the challenges of the ER — and the EHR

All Things Considered (NPR) has a great story that I think any doctor or healthcare professional will find worth a listen (~5min). Emergency physician Ryan McGarry talks about the new documentary film he directed called Code Black, which goes behind the scenes at always-busy LA County Hospital's ER. Click here to listen on the NPR site. McGarry speaks passionately about the changes he's seen in his time in the ER -- including the intrusion of regulations and record-keeping into the patient relationship. For more on the movie itself -- include release dates for various cities around the country -- visit the Code Black movie site.

By Morgan|2022-01-01T22:52:07-08:00June 22nd, 2014|

Didn’t win a complimentary copy of Laurie’s ebook? There’s another way to get one.

If you weren't one of the 100 lucky winners of my medical billing service ebook, Get the Best From Your Medical Billing Service (Management Rx), you might be able to borrow it for free. If you're an Amazon Prime member, you can borrow the ebook for free for up to a month. (If you're not yet a member but are thinking about it, click here for Amazon Prime Free 30-Day Trial-- once you sign up, you'll be able to borrow my ebook and loads of other interesting stuff (one at a time) as well.)

By Morgan|2014-06-18T13:54:50-08:00June 18th, 2014|

It’s a great time to be a medical billing professional

During our webinar with Kareo (@gokareo, #kareowebinar) today on choosing and managing a third-party medical billing service, one of our attendees commented that it seemed like we were predicting that billing professionals were going to lose their jobs in droves, thanks to the trend toward outsourcing medical billing. Nothing could be further from our view! If you're a medical biller currently working inside a practice, and you're wondering if the outsourcing trend is a negative for your career, our take at C&M is that the trend towards outsourcing medical billing (which itself is driven by two other key trends: increasing billing complexity and improvements in billing and EHR software) should mean more opportunity for you in the future. But you might need to expand your vision for how your career will unfold. As billing services proliferate -- and cloud-based tech companies like Kareo, eClinicalWorks, Athenahealth and others up the ante by creating their own services to take advantage of their integrated practice management and EHR platforms -- demand for experienced and knowledgeable billers will only increase. The key difference is that new jobs for billers are being created more quickly in billing services than in practices. While jobs inside practices may gradually become harder to come by, the growing market for outsourced medical billing services will not only maintain or even expand the total number of billing jobs available, there will be much more variety in the types of jobs, too. Billers will have the chance to work in organizations with other like-minded professionals, perhaps even specializing on a medical specialty or other billing niche if they are so inclined. And cloud-based tech platforms like Kareo's allow motivated and entrepreneurial billers to set up their own services much more quickly and easily than ever before -- and allow billers to offer great technology to their practice clients as well. We foresee a great future for medical billers -- with more options, whether as employees or business owners, and more career growth and flexibility in the future. It's a great time to be a medical billing professional!

By Morgan|2022-01-01T22:52:07-08:00June 18th, 2014|

Reminder: Tips for choosing and managing a medical billing service (free webinar)

Reminder: I'm presenting a free webinar this Wednesday, June 18 (10AM Pacific, 1PM Eastern) with Kareo, offering tips to maximize the benefit of outsourcing your medical billing . Whether you're already using a third party billing service or just considering switching to one, this webinar will provide you with ideas, insights and pitfalls gathered from Capko & Morgan's years of experience working with practices that have chosen the outsourcing route. PLUS, best of all, 100 lucky attendees will get a free copy of my ebook on the subject, Get the Best From Your Medical Billing Service (Management Rx). Woohoo! Hope you will join me next week! Click here for the sign-up page on Kareo.com.

By Morgan|2022-01-01T22:52:07-08:00June 16th, 2014|

The minimum wage conversation and your medical practice
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The minimum wage conversation and your medical practice

medical practice business

The minimum wage conversation and your medical practice

A few months ago, when the idea of raising the federal minimum wage over $10/hour first became a hot topic in the news (with some federal workers even getting a minimum wage bump), we worked with an internal medicine practice in a rural area that had many employees earning around that proposed new figure (or even a little less). Although the news really had no effect whatsoever on the practice's compensation structure or even the local economy (where $10/hour was still well above market rate), it still caught the attention of employees, and had started to eat at their morale. "So now I could be paid just the same if I worked at McDonald's?" said one front desk employee, whose hourly rate was right around $10, during our confidential interview. "I might as well work there. I'd never have to stay late," she lamented. She was not the only employee thinking this way. Many team members were deeply affected by the idea that their compensation level -- which in every case was at least 20% higher than the actual prevailing minimum wage in their area -- was what some people now considered the minimum standard for people with no experience and no credentials. Even though no change to the minimum wage had taken place, these employees already felt like they'd been demoted! This particular practice really prides itself (justifiably) on its attention to employee satisfaction and to paying employees a living wage -- and the minimum wage discussion in the news, and its unexpected impact on employee attitudes, really threw them a curve ball. Employees who had previously felt appreciated and well-compensated versus their alternatives in their little rural town were suddenly wondering if they were underpaid -- or worse, under-valued. Medical practices are (unfortunately) accustomed to the unexpected impact of government actions on their business. But in this case, the impact happened before any action has even happened. Some markets may not be affected at all by new minimum wage rules, which seem to be much more likely (at least for now) to be driven by local market conditions

By Morgan|2022-01-01T22:52:07-08:00June 14th, 2014|

Working with — or considering — a medical billing service? Here’s what you need to know.
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Working with — or considering — a medical billing service? Here’s what you need to know.

billing services, medical practice business, reimbursement, revenue, revenue cycle, revenue, billing and collections

Working with — or considering — a medical billing service? Here’s what you need to know.

If you're considering working with an outside medical billing service -- or are working with one now -- my free webinar next week with Kareo can help you get the very most from outsourcing. Using a third party medical billing service can be a great way to improve cash flow and collections, and minimize hassles for your practice -- provided you know how to choose wisely and manage the relationship. Perhaps the biggest mistake practices can make when deciding to outsource to a medical billing service is to lose focus and interest in the billing process -- making sure your practice gets paid is still ultimately your responsibility, even when you've got an outsourced team helping you make it happen. The key is knowing what questions to ask and to establish a relationship of communication and teamwork with your billing service partner. To explore these ideas -- and many more ways to maximize the benefit of outsourcing your medical billing -- please join us next Wednesday, June 18, for a free, lively and informative webinar that will help your practice work with an external medical billing service to improve profitability -- and your peace of mind! PLUS, best of all, 100 lucky attendees will get a free copy of my ebook on the subject, Get the Best From Your Medical Billing Service (Management Rx). Woohoo! Hope you will join me next week! Click here for the sign-up page on Kareo.com.

By Morgan|2022-01-01T22:52:07-08:00June 12th, 2014|

Could an incentive ‘nudge’ improve your medical practice patient flow?

The idea of 'nudging' in behavioral economics gets a lot of play in healthcare. But most of the attention is on the public health/patient side -- i.e., how to persuade patients to do what public health administrators believe is best for them. These ideas often focus on negatives and can be controversial -- prompting cries of 'nannying' and 'coercion.' But some fascinating recent research by Balaji Prabhakar of Stanford shows that positive, incentive-based nudging can help reduce traffic and even help people have a little fun at the same time -- and it got me to thinking, should we take a look at this type of positive nudge as a way to improve medical practice workflow? If you have a minute, take a look at this brief article on the Stanford Business School site -- it explains how Prabhakar was inspired to try to help address the insane traffic problem he observed when visiting Bangalore on business. A commute of 9 miles to his client's office in one of the busier areas of the city took employees an average of 71 minutes! Prabhakar thought a scheme of incentives might help persuade employees to commute at off-peak times. His goal was to apply a key insight from his work as a computer scientist: that reducing peak load by just 10% would dramatically improve other metrics like wait times. Could this insight also help your practice? Prabhakar used an interesting incentive to encourage off-peak commuting: lottery entries. Each early arrival earned an entry into a weekly lottery -- so more early arrivals meant more chances to win. This was a positive approach (unlike some nudges that are perceived as punishments), and it helped make the program fun and created weekly excitement. So what if your practice wanted to reduce congestion -- say, due to late-arriving patients? What about rewarding patients who arrive on time with a thank you and a scratch ticket or other small gift? And are there times of day that are harder to book at your practice? Perhaps a little reward for patients that can come in at those less

By Morgan|2022-01-01T22:52:07-08:00April 30th, 2014|

Payer, hospital directories get in on the ratings act
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Payer, hospital directories get in on the ratings act

medical practice business

Payer, hospital directories get in on the ratings act

There have been some interesting developments in the world of physician directories and ratings sites. First, payers have started opening up their directories, allowing prospective patients to see which doctors are participating before deciding on a plan. This is useful for practices, too, since it makes it much easier for you to see if your listing information is incorrect (without, for example, needing to contact your rep or access the data through a physician portal). A second interesting trend is that payer sites -- perhaps inspired by the success of commercial physician review/rating directories -- have started adding reviews and ratings to their directories. While some of you may be groaning as you read this, I think that this is mainly a good thing, provided that patients need to log in as plan members before rating (as seems to be the case where I've seen ratings on payer sites). This validation of membership helps ensure that the people doing the rating are actually patients -- and not, as sometimes seen on generic reviews sites, people who don't seem to be patients, but instead are just friends with opinions or even disgruntled employees attempting to pose as patients. Hospital directories have also joined the bandwagon -- providing more data about doctors with privileges and affiliations, and even adding ratings in some cases. Which relates to another trend -- it's becoming more common to see a whole bunch of directories at the top of the results for virtually any physician category in many local markets. With hospital directories, payer directories, physician reviews and ratings sites, generic reviews sites like Yelp and Angie's List, and even Google's own Places/+ directory listings all competing for the top spots, it is becoming much rarer for any practice's own site to make it onto the first page of search results (much less the top half). Which means it's more important than ever to take the initiative and manage your practice's (and individual physician) online image and reputation. My upcoming ebook will feature practical and quick tips on how to do it -- to be alerted when

By Morgan|2022-01-01T22:52:08-08:00April 26th, 2014|

Special Judy Capko webinar event: The Secret to Strategic Planning – Making the Most of Your Practice’s Future (May 8, 2014)

Join Judy Capko, author of Secrets of the Best-Run Practices, for a special, 90-minute webinar for physicians on strategic planning. A strategic plan will provide your practice with a strategy to respond to key regulation like the Affordable Care Act and secure your future in times of rapid change. A strategic plan will help you clarify where you are, help you understand your needs and determine what strategies will help you achieve your goals. By participating in this webinar you will learn how to: Overcome challenges and obstacles that hinder performance; Understand the essential requirements in preparing a strategic plan; Take concrete steps that capitalize on your strengths; and Develop a plan that positions your practice for success. Regardless of practice size or specialty, a strategic plan is essential in guiding a practice to achieve its objectives, stay competitive, and be profitable without compromising the quality of care and service you provide. This course covers the key elements required in developing and structuring a strategic plan – and how to get everyone on board – so you can guide your organization in this time of unexpected change. To learn more about this webinar and enroll, visit this link: https://www.greenbranch.com/store/index.cfm/product/1405_20/secrets-to-strategic-planning-making-the-most-of-your-practices-future.cfm

By Morgan|2022-01-01T22:52:08-08:00April 14th, 2014|

Thinking portals and Meaningful Use Stage 2? Join my free webinar

Does Meaningful Use Stage 2 have you thinking (perhaps worrying) about offering a patient portal to your EMR? Or do you have a portal, but wonder if it's getting the use that it should -- and whether it's really helping to engage your patients? Next Wednesday, 4/16/14, I present a free webinar on successfully implementing your portal as part of Kareo's webinar program. I'll take a look at: Why patient engagement matters -- and how portals fit in Keys for a successful portal roll-out Tips for promoting your portal to patients How portals satisfy Meaningful Use -- and why it's not just about Meaningful Use! Please join me on 4/16 to explore this important and exciting topic. Click to sign up for the free webinar on Patient Engagement, Patient Portals and Meaningful Use

By Morgan|2016-03-04T11:54:55-08:00April 10th, 2014|

“We are not a bank” — Lessons from CNBC’s “The Profit”

I just got around to watching the episode of The Profit focused on A.Stein Meats. Now, you may be wondering why on earth I'd be posting about a meat business here -- what could that have to do with medical practice management? Well, The Profit deals with a variety of small businesses, and there are often take-aways that apply to almost any business, but the A.Stein Meats episode really hit some notes that are so important for managing the business side of a physician practice -- especially the under-appreciated perils of poor management of accounts receivable. When Marcus Lemonis arrives at A.Stein Meats, he learns that the 75-year-old company is losing $400,000 per year -- despite $50MM in annual revenue. He's initially confused about how the company's expenses could be exceeding their revenues. But he soon figures out that the biggest missing piece lies in the back office: accounts receivable. The office manager -- who nominated the business for the show -- reveals that the receivables are more than $4MM. And Lemonis quickly notes, many are so old, they'll likely never be collected. The owners, meanwhile, seem almost unaware of why they should be concerned about accumulating A/R -- after all, they're just trying to "work with" customers, many of whom are "friends." But, as the old saying goes, with friends like that, who needs enemies? The business's inattention to collecting the money they're owed was putting their solvency at risk; revenue is almost irrelevant if it isn't realized as cash coming into the business promptly. Moreover, the business was essentially financing its customers -- without getting paid to do so. Lemonis stated clearly, "we are not a bank" -- the same message we give our medical practice clients when they're too quick to say, "sure, we'll bill you" instead of asking patients for a credit card at the time of service, or a credit card on-file for procedures that need to be paid for over time. Medical practices are perhaps a bit luckier than a business like A.Stein Meats in that insurance payments still usually provide the biggest portion

By Morgan|2022-01-01T22:52:08-08:00March 31st, 2014|

Small practices: PCMH is not out of reach

The Patient-Centered Medical Home is so much more than just a payment innovation -- it's an idea that appeals for clinical reasons to so many physicians and practice managers, who were already aiming to provide the higher level of care-coordination and patient engagement that is the foundation of the PCMH. But many small practices we work with have been nervous about the hurdles for certification -- is it too much for a solo or two-physician practice to take on? A recent AAFP blog post offers a wonderful idea for smaller practices daunted by the prospect of tackling the PCHM checklist on their own: form an informal network with other, like-minded practices in your area, and divvy up the research and learning. What a great solution -- and a great way to expand your connections with other professionals in your community. Read about it here.

By Morgan|2022-01-01T22:52:08-08:00March 24th, 2014|

Patient use of physician ratings sites increasing — not waning

If you've been among the practice managers and physicians ignoring the 'fad' of physician ratings sites, hoping they'll just fade away eventually, there's bad news for you in last month's JAMA: more people than ever are aware of the existence of physician ratings sites. And more people than ever are using them. As has long been the trend, though, patients aren't flooding sites with rants of disgruntlement; positive views continue to heavily outweigh negative ones. The most important take-away from this new research? If you haven't started taking control of your listings on ratings sites, the time to act is now. Hiding won't help ... and taking charge is easy, once you learn a few key steps. Interested in learning more about online reputation management? I will be publishing a new Management Rx ebook on this subject in the next few weeks. To be notified (and take advantage of free review copies if you're interested), sign up here: Subscribe to the Management Rx interest list by Email

By Morgan|2014-03-24T16:37:12-08:00March 24th, 2014|

Bullying can be a problem at medical practices

Yahoo! reports that a recent study by the Workplace Bullying Institute showed that bullying -- defined as "abusive conduct that is threatening, intimidating, humiliating, work sabotage, or verbal abuse" -- is a problem at nearly half of all US workplaces. They also found that 27% of all adult Americans have directly experienced it, 21% have witnessed it and 56% of perpetrators are bosses. More discouraging, the study found that employers are doing little to combat bullying. Among employers who had received complaints about bullying, only 12% established policies to combat bullying, and only 6% reported a zero-tolerance approach to eliminating it. And, the researchers also found that all this bullying has a high cost in employee turnover: 61% of employees who were victims of bullying either quit, were fired or were forced to quit. Medical practices exist to help patients, and usually most of the employees in a practice were attracted to the field for that reason -- so you wouldn't think that bullying could be a problem in the practice workplace. But bullying is something we often uncover in working with practices, especially when we're brought in because of high turnover or operating problems that the physician owners are having trouble solving. Despite being rooted in a caring profession, medical practices often have characteristics that make it possible -- even easy -- for bullying to take hold. These include: Physician owners are most often with patients and have little time to observe ordinary interactions between staff Physicians often dislike the management side of their practices and become too trusting of and over-reliant on one or a few key managers -- who then have too much power Managers spot the opportunity to seek excess power from uninvolved physicians -- becoming expert at managing upward and hiding the true nature of their relationships with staff* Physicians may have experienced very demanding, bullying (or quasi-bullying) environments throughout their medical training -- and may adopt the same management style almost automatically, without appreciating the costs When our analysis of a practice suggests that a manager, supervisor or physician colleague may be creating a threatening

By Morgan|2023-05-23T17:23:30-08:00March 17th, 2014|

Windows XP: a potential HIPAA risk — and an opportunity to boost productivity

Microsoft recently announced it will end support for the Windows XP operating system on April 8, 2014 -- and this may have HIPAA implications for your practice. What could 'support' have to do with your HIPAA compliance? The biggest implication is that hackers could discover new ways to breach XP security -- and no support means Microsoft will no longer issue patches to plug the holes. That means you'll potentially expose protected health information to hackers if you continue using the unsupported operating system. Even if you're using cloud-based EMR and other systems, your office PCs may still contain protected information -- for example, if documents are scanned and saved to their drives. The good news is, PC prices are lower than ever, and upgrading can make your team more productive. (In virtually every practice we visit, we find at least a couple of computers that are so slow that they are adding to patient wait times at check in, check out and while scheduling on the phone -- and cutting into staff productivity. Inevitably, the practices believe they're saving money by not upgrading, but at today's prices, faster computers would likely pay for themselves very quickly.) If you act fast, you might even be able to get Windows 7 machines -- you'll miss out on the pizzazz of the new Windows 8 interface, but also skip the longer learning curve when transitioning from XP.

By Morgan|2022-01-01T22:52:09-08:00March 10th, 2014|

Using benchmarks wisely: staff, staff expense per provider

Our work with medical practices often involves analyzing a practice's data against benchmarks from sources like MGMA, NSCHBC, specialty society surveys, etc. But, it's not enough just to compare against the averages and percentiles; you have to know whether meeting or beating a benchmark is a good thing. Believe it or not, this is not always obvious. Among the benchmarks most subject to misinterpretation are staff per provider and staffing expense per provider. Most physicians and practice managers we work with are very focused on keeping headcount and staffing expense low -- and so they're pleased to learn they're in the lower tiers for headcount and staff expense ratios. The pleasure shifts to confusion, though, when we explain that squeezing staffing down to the lowest possible expense is not usually a path to higher profitability -- and can often be associated with lowering profitability! There are several reasons for this. The most important is that well-trained, well-paid, motivated staff -- and enough of them -- free up providers to focus all their attention on the tasks only they can do. Coincidentally, the tasks that only providers can do are almost always also the only tasks that generate revenue for the practice. Increase provider time spent on revenue generating activities (and not on unpaid tasks that don't require their training), and you're on the way to more profitability. Consider that an additional medical assistant might cost a practice about $100-$150 per day. If that additional assistant allows a practice to see as few as 1-2 more patients per day, that's a profitable addition. Often, one additional assistant can help more than one provider -- and help the practice quickly generate more revenue than is needed to make the addition a profitable one. When a practice is focused primarily on expense control and minimizing headcount, sometimes that results in providers doing too many tasks that could be handled less expensively by staff -- an opportunity cost for the practice and a direct hit to revenue potential. What's more, when a practice is too reluctant to add headcount, existing staff can quickly become

By Morgan|2022-01-01T22:52:09-08:00March 3rd, 2014|

Position your practice for growth: free webinar tomorrow

There's still time to register for my webinar tomorrow with Kareo and Physicians Practice. "Position Your Practice for Growth" will explore tactics to ready your practice to handle more patients without sacrificing patient service. Whether you're hoping for or expecting growth from the ACA, whether you're aiming for it with increased marketing, or whether you just want to learn some ideas for increasing efficiency and profitability, there's something in this webinar for you! To join us at 9AM Pacific/12Noon Eastern tomorrow (Feb 6), register at the following link: Free webinar: Position Your Practice for Growth

By Morgan|2022-01-01T22:52:09-08:00February 5th, 2014|

Managing includes developing practice staff

Sometimes, the business of medical practice management is a fuzzy science. Managers have to keep the patients, and their bills, moving through the practice. Most often, physicians are satisfied if their managers accomplish that much. But managing optimally includes softer skills, like bringing out the best in staff. Recently, we've worked with several practices with managers who do a great job of managing upward -- reinforcing the confidence their physicians feel for them -- but who don't have much insight into really managing their own teams effectively. Keeping an eye on the team, and making sure everyone's doing what they're supposed to do, is a huge chunk of a manager's role. But it's not the entire role of a truly effective manager. A truly effective manager helps each member of the team develop his/her skills, understanding each person's strengths and weaknesses, and figuring out how each direct report can contribute more and be challenged and grow. This is not just key to helping the practice improve its short-term results, it is critical to retaining the best staff and successfully completing growth initiatives. Turnover alone can be so costly to practices. Hiring and replacing employees is a time-and-money sink. And while critical jobs stay unfilled, mistakes can happen -- and patient service can suffer. This recent Harvard Business Review article delves into this issue -- and makes the important point that a poor relationship with their direct manager is a primary reason (if not THE primary reason) employees quit. We see it every day! Medical practices often pay a great deal of attention to provider education -- partly by necessity. And managers can often attend conferences and find other paths to learning and development. But staff are often left out of the equation. And if managers aren't finding out what staff career goals are -- and how they can help them learn, grow and achieve them -- then the practice will suffer as a result. Make sure you're evaluating your managers on this important skill!

By Morgan|2022-01-01T22:52:10-08:00January 28th, 2014|

Will the ACA bring a wave of new patients? Prepare for the best
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Will the ACA bring a wave of new patients? Prepare for the best

Affordable Care Act - Obamacare, medical practice business

Will the ACA bring a wave of new patients? Prepare for the best

Will the ACA bring a big increase in patients to your practice? For most of the practices we've been working with, the ACA's impact on patient volume is still pretty unclear. Since we're less than a month into the new coverage year for ACA exchange plans, and the open enrollment period continues through March 31, we're still at the very early stages; the actual impact is hard to gauge at this point. Moreover, the impact may vary widely based on local demographics, practice type, and state participation in the Medicaid expansion. But we're still advising practices to take steps to prepare for more volume -- whether it comes from the ACA or their own marketing. Readying your practice for growth is good business. Better processes not only allow you to handle more volume, they help you serve all of your patients more effectively. Preparing your practice to handle more patients is the subject of my upcoming webinar sponsored by Kareo and hosted by Physicians Practice. Join me on Feb 6 for this free presentation entitled "Position Your Practice for Growth: Responding to the Dynamic Healthcare Market." I plan to share some ideas that can help almost any practice prepare from and profitably realize more growth -- whether from the ACA or their own internal marketing efforts. Plus time for your questions!

By Morgan|2022-01-01T22:52:10-08:00January 20th, 2014|

Resolve to give better feedback to staff in 2014

Turnover and hiring are costly. Staff are so important to your practice's patient service, financial performance and overall functioning. Given these things, one of the best investments you can make in your own leadership abilities as a physician owner or practice manager is to develop the skill of delivering effective feedback to employees. The importance of giving effective feedback to staff really can't be overstated. Your ability to nurture better performance and address inadequate performance impacts everything from employee skill development, to team morale, to legal risk. Every aspect practice performance depends on getting the best from your staff, and that depends on giving the right feedback at the right time(s) and in the right way. Giving employee feedback is not easy, and getting really good at it requires effort and focus. But your efforts will be rewarded many times over. One of the best recent summaries I've seen lately on delivering effective feedback comes from the Stanford Graduate School of Business -- a summary of a lecture by Carole Robin. It's a short list of seven pithy tips, and you can act on it now! Highly recommended reading. (A couple of previews: "Do it now" and "Stay on your side of the net." Read the piece for quick explanations of these ideas -- and five more.)

By Morgan|2013-12-24T10:06:33-08:00December 28th, 2013|

ACA out-of-pocket costs: Vindication isn’t always sweet

The New York Times reported today that "On Health Exchanges, Premiums Maybe Be Low, But Other Costs Can Be High." This is something we've been talking about for a couple of months now -- often getting skeptical looks here in our super-blue home-town. But it's not about partisanship. The ACA is simply accelerating the trend of payers pushing more responsibility onto patients -- a trend that has been gathering momentum for many years. It's not unexpected if you've been watching how health plans have been evolving. Still, it is discouraging if you had hoped the exchange plans would offer better patient protection against big out-of-pocket costs -- and it also means that the burden that practices face to collect more of their revenue from patients keeps growing. The AMA's 2013 National Health Insurer Report Card (NHIRC), published earlier this year, revealed that health plans across the country were placing about 25% financial responsibility for cost of care onto patients: Aetna Anthem Cigna UHC Medicare 20.40% 23.10% 25.90% 23.40% 24.60% The target 2014 patient responsibility proportions that were set for all ACA plans skew even higher than this -- even the "silver" level, where subsidies are targeted, pegs patient responsibility at 30%: ACA Bronze ACA Silver ACA Gold ACA Platinum 40% 30% 20% 10% These "actuarial values" were fairly widely reported prior to the exchanges even opening (here's one link from MSN), so it's a bit of a mystery why the Times is reporting this as news at this point. It's critical that consumers understand what they're getting into when they sign up for coverage, and the media should have been on top of this key information. (Especially if you've not purchased coverage before, the terminology behind patient responsibility payments -- co-insurance, deductibles, copayments, out of pocket -- can be very confusing. Many new patients are likely to be confused and possibly quite disappointed.) We expect that this means practices will need to be even more careful and sensitive in dealing with privately insured patients, especially in January, when deductibles re-set. Some patients will be more confused than ever --

By Morgan|2022-01-01T22:52:11-08:00December 9th, 2013|

An embezzling story to learn from
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An embezzling story to learn from

embezzlement, finances, internal controls, medical practice business

An embezzling story to learn from

A marketing director for Castle & Cooke, a mortgage firm, is believed to have stolen almost $200K from her employer in less than a year of employment -- until she was caught and charged with fraud. While the case does not involve a medical practice or healthcare organization, it does offer some reminders about protecting a small office from internal theft. The employee allegedly ran up large false expense reimbursements and forged company checks -- both possible in any small business with inadequate controls, including medical practices. Practices can learn from this incident. Check stock should be protected, and managed by a physician owner. No one should be allowed to sign checks except a physician owner -- no signature stamps! And owners should reconcile the bank statement monthly, so that any unauthorized checks could be spotted. Unauthorized expense reimbursements or charges are common routes to embezzlement in medical practices. Be cautious about allowing employees -- even a manager -- unsupervised control of a credit card or an expense account with a vendor. Review purchases "for the office" carefully -- make sure that everything on the Costco or Amazon bill can be accounted for in the office. Remember, not allowing temptation is the best way to prevent embezzlement -- and the best way to maintain a relaxed, family like atmosphere in your office, because you have less need to be suspicious of anyone. Internal controls are a gift to your practice -- they protect against profitability loss while also helping to support trust and morale.

By Morgan|2022-01-01T22:52:12-08:00December 3rd, 2013|

50% off Judy’s books: Secrets; Patient-Centered Payoff

Judy's publisher, Greenbranch, is offering a special holiday discount of 50% on all books through midnight (EST) on Monday, 12/2/13. If you were considering buying Judy's best-seller, Secrets of the Best-Run Practices, or her new book, The Patient-Centered Payoff, now is your chance to get them both at half off! (The links go to the print edition, but ebooks are available, too.) Click here to shop at the Greenbranch site -- and use the code "Green" when you check out.

By Morgan|2022-01-01T22:52:12-08:00December 1st, 2013|

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