business sense

Cost-cutting: pick your battles wisely

We recently worked with a smart, energetic practice administrator who was very motivated to improve his practice’s bottom line. He’d already found significant savings by switching billing and phone services (even getting better billing results, to boot). Spurred on by those successes, he’d turned his attention to clinic staffing. While the physicians in his practice mostly used conventional medical assistants (MA) for support, a few of the doctors and non-physician providers (NPPs) had opted to use “scribe assistants.” These hybrid staff help clinicians by both scribing during the visit and handling typical MA tasks like test orders and scheduling follow-up care. Because of the extra duties, and because they were hired through an agency, their hourly cost was a bit higher than for the MAs – a 15-20% differential that caught the administrator’s attention. The administrator estimated the hourly cost of hiring a new MA would be about $20, including taxes and benefits. The scribe assistants, meanwhile, cost the practice about $24 per hour. The scribes did some tasks the MAs weren’t trained or expected to do – notably, scribing. But the administrator believed that at least one of the NPPs who was currently using a scribe assistant could do just fine with an MA (she was a recent grad and tech enthusiast). So the administrator decided to suggest gradually switching some of the contracted scribes with employed MAs – and was surprised that his idea met with resistance. (After all, 18% would be a significant cost savings – yet even some of the partners resisted the idea!) As the administrator repeated his idea at a few monthly meetings in a row, the resistance grew into a testier conflict. Was the conflict a sign the administrator was wrong to bring up the idea of saving money on clinical staff? We wouldn’t say “wrong” per se – but we might have not have prioritized this particular cost-saving avenue. It’s natural for clinicians to be wary of any changes to clinic staffing. Clinical support staff is essential to physicians’ productivity. Anything that disrupts clinic flow can make it harder for physicians to

By Morgan|2022-01-01T22:51:45-08:00October 15th, 2018|

The power of managing details

I'm working on an ebook right now about medical practice staffing. More specifically, it's about how the instinct to cut staff, to be as leanly staffed as possible, can backfire*. There are dozens of little details that any practice can explore to improve profitability. These small changes can be made with much less risk than eliminating a job or cutting staff hours. And because they improve the profitability of your processes, they are a gift that keeps on giving, making your bottom line a little bit bigger every day. Here are just a few of the possibilities I explore in the ebook. Are you taking full advantage of these opportunities to improve your bottom line? Reduce no-shows: Take a quantitative look at your no-show rate. Are you tracking both true no-shows and last minute cancelled slots that can't be refilled? Audit your reminder process and results. Is your timing right? Experiment with reminding further ahead or closer to the appointment. Remind people using the technology they prefer. Capture email and cell info: Being able to reach people electronically opens the door to multiple efficiency improvements, including more effective reminders and better collections. And your patients that want to be emailed or texted, not called, will appreciate the option. Win-win! Train patients on portals: Too many practices make portal adoption a low priority, or abandon the effort altogether, because they find it hard to get patients engaged. It is hard! But it's still very worthwhile. As more patients use your portals, you have more ways to reach them for marketing. Portals make other key tasks more profitable, too. Notice I said "portals," plural? If you don't have the ability to collect payments through your EHR portal, investigate the option to set up a payment portal with your PMS vendor. Patients want to help themselves -- and they want to pay without having to write a check or find a stamp. They'll reward you by paying faster and more reliably. If you cut staff before checking out all the possibilities to improve your operations, you may not have the people you need

By Morgan|2022-01-01T22:51:56-08:00May 8th, 2016|

Dashboards: Practice performance at a glance

A medical practice performance dashboard is a great time-saver to help keep your finger on the pulse of practice performance and understand your position in real time. It is similar to the one in your car – a set of indicators provide a simple, practical way to know what’s going on and to let you know when you’re headed for trouble. The dashboard is a metric reporting tool that makes it easy to look at business performance so you know when the practice is doing well and are alerted when something is wrong. Dashboards provide a layered interface that conforms to the way you work. When performance dashboards are aligned with the practice’s operations, productivity, finances and strategic plan, managers and physicians begin to work more efficiently and effectively toward achieving shared objectives. Typical indicators revealed on the dashboard focus on practice productivity and finances. However, the power of the dashboard can be extended to include other data. For example, if a new provider was added recently or you opened a new satellite clinic, monitoring growth and financial progress of this entity can be added to the dashboard. The dashboard can be designed to compare internal performance from the prior year or to look at how you compare to your colleagues across the nation. Medical Group Management Association’s (MGMA) has conveniently packaged a set of dashboard metrics with its Cost Survey on disc. This enables the user to create a dashboard based on six indicators that are benchmarked against other practices in a few short minutes. The spreadsheet used to prepare the dashboard shows your ranking when compared to the MGMA database. If you find yourself on information overload with management and financial reports screaming for attention, think about implementing dashboard technology to monitor your practice's business performance at-a-glance. With web-embedded technology some applications can update information automatically eliminating the need to repopulate the spreadsheets. Charts and tables can be configured to support drill-down capabilities. Keep in mind, though, that dashboards are only as good as the data that supports them. Success is dependent on the quality and flexibility of

By Judy Capko|2022-01-01T22:52:09-08:00January 31st, 2014|

Trade shows – there’s so much to gain
Gallery
Trade shows – there’s so much to gain

Business, business sense, medical practice business, planning ahead, practice management, productivity, technology

Trade shows – there’s so much to gain

There are lots of reasons to spend time in the exhibit hall when attending practice management and other medical conferences. By visiting the exhibit hall you will learn a lot about what’s going on in the industry, how vendors are seeking to meet your future needs and what technology changes have emerged that can make a practice more efficient and profitable, while improving service and outcomes. Yes, there are lots of reasons to get down to the exhibit hall, but it's also important to plan how you can do this without being overwhelmed or wasting your valuable time. Forget about seeing everything – it’s just not possible and can lead to unnecessary frustration. However, with thoughtful planning you can see those things that can make a difference in your very own practice. Get off to a good start. Conference materials at the convention will include a list of all the vendors that are exhibiting. Match these with your interests. Then check-out their location on the exhibit floor. This will allow you the opportunity to plot your course. Visit your selected vendors, by covering one section of the floor at a time. It’s a strategic move that will get you off to a good start. Refer back to your vendor list as you move through the convention. You might want to take photos using your mobile phone or make notes. This will be valuable for follow-up and decision-making when you get back to the office. Pace yourself. Be realistic in evaluating how much time must be spent on the floor of the exhibit hall to achieve your goals and meet with the different vendors you have targeted. Allow an average of 5 minutes for each of the vendors on your list. When you meet with an exhibitor, it’s important to be a good communicator and get right to the point. Let the sales representative know what information you want and why. At the same time, if the sales rep is not a good listener you could be wasting valuable time. Don’t allow him or her to lead the conversation to information

By Judy Capko|2022-01-01T22:52:10-08:00January 21st, 2014|

The cost of poor decision-making

We were recently called into a group practice where the physician owners of Struggles Medical Group were disillusioned with the practice of medicine. Their concerns were typical, shrinking reimbursement, dismal profits and the threat of new competition, as a large urban academic faculty practice was beginning to penetrate this suburban community. Sound familiar? This is happening around the country as a response (or reaction) to healthcare reform, where larger healthcare organizations see new opportunities to get a bigger piece of the revenue pie. Struggles timing was perfect for bringing this consulting team in and here’s why. We performed a detailed practice assessment, examining the implications of past decisions and analyzing the current state of Struggles Medical Group in primary areas of performance including practice structure, finances, human resources, billing, clinic operations and work flow and marketing. One physician owned this practice and the other physicians and providers were employed. We soon discovered the physician owner had a history of making bad decisions. They did not analyze return on investment (ROI) before making investment decisions that would impact the practice operations, finances and possibly patient care. A perfect example of Struggles poor decision-making was buying very costly diagnostic equipment that they were unable to use because payers were contracted with a lab to provide these services. This meant the investment was rendered useless to the practice. Besides this, with new models on the market every six month,s there was no way to attract another buyer for the equipment. There were other equally disastrous investments Struggles made over the past two years. The most recent strategic error was changing the direction of the entire practice. In their quest for new revenue opportunities the practice decided to focus on expanding its service to workers compensation patients. Attracted solely by somewhat higher gross reimbursement rates, they went ahead with this in this in 2013 without thinking of the implications with would have on staff, workflow and profit. This was a costly error. Workers compensation is a practice model that is significantly different from other payers and requires specific expertise in report writing and tremendous

By Judy Capko|2022-01-01T22:52:10-08:00January 10th, 2014|

A taste of MBA training for doctors — without the hassle and cost

If you follow this space, you may already know that I'm dubious about the value to physicians of stopping out for an MBA. As an MBA-holder myself, I think the coursework can be overkill for independent physicians who just want to run their practices better (this is less the case for those that intend on corporate careers, of course). So much of modern MBA training focuses on things that aren't generally relevant to the small/medium business owner (and, therefore, the typical private practice physician partner). Even worse, some of the business basics that doctors need most usually aren't well covered by MBA programs -- managing people; the minutia of local, state and federal regulations; the marketing of a small, local business; real estate finance; negotiations, etc. The other issue facing physicians (and sometimes practice managers, too) is the opportunity cost -- and actual cost. The opportunity cost is the income lost by taking time off from practicing/working to attend an MBA program, and the actual cost is the (often very high) tuition at business schools. For many, perhaps most, private practice owners and managers, it just may not 'pencil out' to take the time and invest the money*. One solution that can work well as a substitute is taking local classes (e.g., nights and weekends) that focus just on what you really need and want to learn. This can be a reasonable approach -- and even a trial to see if further investment in MBA education is of interest. But, there is also the issue of having to attend class at set times -- not always convenient ones. Now, though, there is a better alternative: MOOCs, massively open online courses. Incredibly, some of the most prestigious business programs in the country, including Stanford, Wharton and Columbia, are making some of their most valuable content available through the free platforms like Coursera and EdX. And it's not only self-directed -- i.e., you take the classes at your convenience -- it's FREE! (Yes, unbelievable.) Lest you think this is just throw-away content, Business Insider has kindly assembled a list of some of

By Morgan|2022-01-01T22:52:14-08:00October 16th, 2013|

Lessons and reminders from the Yahoo! work-at-home flap

Practice managers and physician owners might look at the media attention focused on Yahoo! CEO Marissa Mayer's decision to end work-from-home at her company and think, well, that doesn't apply to me. And it's true, with only a few exceptions (say, billing), medical practice staff members are unlikely to be able to do their work from home -- not just because they need to be where the patients are, but also because of the privacy risks of bringing documents out of the office. That doesn't mean, though, that the controversy and discussion that Mayer's decision engendered (and now Best Buy CEO Hubert Joly's as well) are completely irrelevant to physician practices. Because even though working at home is an option that won't often make sense for medical office staff, the media frenzy about one company's HR decision does illustrate how challenging it can be to make management changes without unintended consequences, even when the need for the change seems obvious. Change sparks fear One of the theories that immediately emerged about the Yahoo! telecommuting ban was that Mayer was simply implementing "backdoor layoffs" -- i.e., that she'd determined that forcing everyone into the office would be an easy way to encourage telecommuters to quit to achieve needed cost reductions. Naturally, this theory provokes fear in all staff -- what if there aren't enough quitters to bring costs down, and my job ends up on the chopping block? There are mixed reports of how the end of telecommuting is actually playing with Yahoo! employees -- despite the ongoing outrage of bloggers, there are also reports that many current Yahoos understand the need for and actually support the change. But, certainly the situation is a good reminder about how important it is to communicate effectively with employees, to help prevent unnecessary fears from taking hold -- otherwise, you risk losing your most valued employees, who will begin job hunting in earnest when they sense trouble. (I have seen changes as small as eliminating free coffee to save a few bucks lead to swirling rumors that bankruptcy is imminent! When communication is missing,

By Morgan|2022-01-01T22:52:33-08:00March 9th, 2013|

“Always say yes to networking”

The Harvard Business Review has a great tip today, entitled "Always Say Yes to Networking." I love this tip because it emphasizes how important it is to maintain personal connections with the friends and associates in your network -- and to think of networking as the process of keeping in touch and maintaining relationships, not just meeting up for the purpose of job-hunting or other goals. Most of the physicians and medical office managers and staff we work with do little or no networking at all. This is such a missed opportunity. Staying in contact with your network is great for your morale and your perspective -- not just your job prospects. It's harder, perhaps, for medical professionals to break away for coffee or lunch with a friend or colleague. But, social networking can help -- I'm personally so grateful for the friendships I've rekindled using Facebook. Find whatever ways work for you to keep in touch with the people you've met along your journey. Read the HBR tip here.

By Morgan|2022-01-01T22:52:34-08:00February 12th, 2013|

13 for 2013 Tip #13: Make haste slowly (have a plan!)

Do you find yourself and your medical practice in a state of emergency when changes in the market arise? Do you have long-term personal, professional or financial goals that are in your head, but no plan to make them real? Are you relying on gut -- rather than metrics -- to know if your practice is on track or in decline? Too many private practices are winging it -- leading to bad decision-making and unnecessary panic in response to market events, and under-performance and delayed goals because there was no road map to achieving them. Don't let this be your practice. Make 2013 the year you take control of your practice by developing a strategic plan. It's easier than you think, and operating from clear planning will not only help your practice become more stable and more profitable, it will improve the morale of everyone on your team. Get started with an honest, data-driven assessment of your practice. Tools and activities that can help: SWOT (strengths, weaknesses, opportunities, threats) analysis Benchmarking Modeling (i.e., scenario testing) Mission and goal-setting -- for one year, five years, ten years If you've got team members that are experienced and currently underutilized, these activities can be a great way to improve your practice. On the other hand, if you're barely keeping up with your day-to-day activities, but understand the value of strategic activities - including how it can free up your time - Capko & Company can help. Furthermore, while our tailored consultations improve financial performance, they're also fun for physicians and staff - resulting in an improved work environment and better morale. We look forward to hearing from you.

By Morgan|2022-01-01T22:52:34-08:00February 5th, 2013|

13 for 2013 Tip #10: Engage staff

Most practices have an underutilized resource - namely, their employees' ability to identify and solve problems. As practices deal with the day-to-day business, it's all too easy to fall into a routine-inspired complacency. To establish some positive momentum, make a point to ask each of your staff to identify problems and possible improvements - and give everyone an opportunity to contribute their ideas during your regularly scheduled staff meetings. We think you'll be surprised at the sources and quality of ideas that emerge. Be generous with your appreciation and praise and you'll see a staff that is happier and more motivated than ever.

By Joe Capko|2022-01-01T22:52:35-08:00February 4th, 2013|

Will 2013 be better than 2012? It’s up to you!

A new year has already begun! If you are hoping for significant year-over-year improvement you need to act – and sooner rather than later. Here’s how great practices help ensure that each year is better than the last. Examine past performance. Consider what data points are important to review. As a guide, great practices will compare their performance against at least these benchmarks every year: Total revenue per full time equivalent (FTE) physician Total operating expense as a percentage of total medical revenue Total visits/procedures per FTE physician Percentage of total A/R aged 120 days more Bad debt due to fee for service activity per FTE physician Determine what the numbers mean to you. Compare your performance between 2012 and 2011 to evaluate your year-over-year performance. Are you clearly performing better or worse? Then assess why there is a difference. If you did better was it because you were more assertive? Dit you have clearer established goals to guide you? Perhaps changes in performance can be traced to changes in staff or actions taken to improve contract reimbursement? Did you implement a marketing plan or are differences between years merely chance variation? If there was no change in 2012 or you did worse, you will want to take decisive action to make 2013 a better year. Plan for 2013. Of course, given the challenging business environment, leaders of improving practices make planning a priority. I recommend a strategic planning session be scheduled well in advance. Scheduling an off site meeting in early February can minimize interruptions. If you have a skilled communication facilitator on your staff, and your practice isn't facing especially serious challenges, your practice might conduct your meeting without an outside consultant. On the other hand, a consultant can increase the value of strategic planning sessions by facilitating communications on difficult topics, providing an objective overview of your practice’s performance, helping you understand your position in the marketplace, and assisting leadership in determining goals for the upcoming year. Practice leaders it is not too early to think about the steps you can take to protect and guide the practice’s

By Judy Capko|2022-01-01T22:52:36-08:00January 16th, 2013|

13 for 2013 Tip #3: Cash management quick-check

Do you accept cash payments at your practice? The start of a new year is a great time to review how your practice handles cash -- to determine if your internal controls could use some tightening up. With cash, the biggest temptation is to handle these "small" amounts more casually than other payments. When cash payments are rare -- a $30 co-pay here, a $25 co-pay there -- it can seem that they're less important to the bottom line. But, over the course of a year, even a single $30 cash payment per day amounts to close to $8,000! Keeping tabs on those "unimportant" cash payments is actually very important, indeed. The biggest pitfall: mixing cash receipts with petty cash. This all but ensures these amounts won't be deposited and may not be properly tracked. Petty cash should never be more than about $50 or so -- just enough to handle small payment amounts for the office that cannot be handled by credit card or check. Allowing petty cash to grow creates a temptation for misuse -- or worse, theft. Cash should be deposited regularly -- ideally, every day -- for security and for effective tracking for practice evaluation and tax reporting. Receipt stock should be monitored, and the cash received should be reconciled against the day's postings by some at the practice who doesn't collect it and post it to the billing system (in smaller practices, this might need to be the physician/owner).

By Joe Capko|2022-01-01T22:52:36-08:00January 10th, 2013|

Beware of opportunity costs

Recently, we worked with an OB/GYN practice that had taken some big steps to reduce staff costs. In particular, the practice was concerned about their long-standing process of providing new maternity cases a lengthy consultation with an RN -- covering all the information a newly pregnant woman would need, and offering her a relaxed opportunity to ask questions. Because the RNs were paid at $22-$25/hour, the practice manager and managing physician partner felt that these consults were an extremely wasteful expense. They reasoned that the consults could be easily incorporated into the initial physician visit -- adding 15 or 20 minutes to the visit, instead of paying for 30-45 minutes of RN time for the consult. The maternity visit with an OB would be included in the patient's global payment -- no additional revenue would be generated by adding 15-20 minutes of physician time to the visit. But, the practice reasoned, they would no longer be incurring the RN costs of $15-20 per consult -- and, since the revenue was the same either way, the impact would be bottom-line positive, right? Wrong. What the practice failed to consider was the opportunity cost of tacking 15-20 uncompensated minutes onto the physician visit. While the practice no longer had to pay an RN $15 to discuss pre-natal vitamins and exercise with maternity patients, the practice was giving up 15-20 minutes of provider appointment time -- time which could potentially be billed out at much more than $15 if it were used for an additional patient visit. Provider time is a practice's most precious resource -- it's the only means the practice has to generate revenue. Using providers to do tasks that can be done by an RN or MA almost never makes economic sense for a practice. Plus, taking higher level tasks away from your RNs and MAs deprives them of the satisfaction they get from those activities. Keep everyone -- especially your providers -- utilized at their highest potential, and you'll keep everyone more satisfied with their roles and your practice more profitable.

By Morgan|2022-01-01T22:52:38-08:00November 13th, 2012|

Hotel Hôpital

What if hotel billing were like medical billing? A funny-but-sad video by Costs of Care in partnership with Harvard Medical School and the University of Chicago explores the possibility in a tongue-in-cheek way (click "continue reading" to view the video). "Surprise" medical costs do more than just frustrate patients -- they hurt practices, too. By helping patients understand the costs of their care, practices can help patients make more informed decisions, plan better, and maintain a positive relationship with the practice. And, patients who are better informed and understand what they'll be charged are more likely to pay their bills.

By Morgan|2022-01-01T22:52:40-08:00March 25th, 2012|

Inspiration from small businesses

I recently completed a series of articles for Kareo's Getting Paid blog about how small business management issues relate to practice management. While medical practices have an important mission that reaches beyond business, they can't achieve that mission without succeeding on business terms. And, in many fundamental ways, medical practices are not so different from other kinds of small businesses. There's a lot to be learned from examining the success factors that apply to seemingly-unrelated businesses. Plus, it's kind of interesting and fun to think about other businesses in the 'real world' and how they deal with their challenges -- almost like looking at your own organization through a different lens. If you're interested in checking out the Small Business Lessons for Physician Practices series, here are the links: Small Business Lessons for Practices: Human Resources Getting Started with Marketing Financial Basics Operations Management for Physician Practices

By Morgan|2022-01-01T22:52:40-08:00January 9th, 2012|

How to get what you want for the practice in 2012

Almost everyone wants to be more successful and achieve more each year than they did the year before. Here are a few straightforward things you can do to guarantee your success in 2012. First, ignite your passion for the practice. Recognize all the capabilities you have and how you can use those to grow the practice in the direction you want to take it. Your passion can energize everyone in the practice and give them the confidence and desire to help you achieve amazing things. Second, set goals that push your further, but are achievable. This is accomplished by reviewing benchmarks on key performance indicators and how they have trended over the past few years and raising the bar for 2012. Then set goals that stretch performance, but are achievable. This is accomplished by taking a historical look at practice performance trends and setting the bar a bit higher. Know what you want and then you can plan to achieve it. For example, do you want to do more of a particular procedure, do you want 10% more new patients, increase utilization of lucrative ancillary services or promogr a new procedure? You may even want to establish goals related to healthcare reforms push for monitoring quality and improving outcomes. Whatever you want to do, establish goals that are concrete and measurable. Next, develop a well-crafted written strategic plan. This is the beginning of a true commitment and using professional resources is worth the investment. An experience healthcare consultant can guide the process to ensure you develop a powerful plan that yields amazing results and positions the practice longterm success. So what are you waiting for? Contact Capko & Company, www.capko.com, and make 2012 your best year ever.

By Judy Capko|2022-01-01T22:52:41-08:00December 22nd, 2011|

Leadership: It’s about treating people well

Joe Capko did a webinar with Medical Practice Management Web Advisor earlier this week on how effective leadership translates to more productivity from your staff -- and vice versa. One of his themes was establishing trust by listening and treating people fairly, and letting them know they are valued. People give more to their jobs when they know you care! Aptly, today's email tip from Harvard Business Review was called "Engage Your People," and featured some of the same ideas Joe offered. Basically, less top down, more listening, more working together. To read the HBR tip, click here.

By Morgan|2022-01-01T22:52:41-08:00October 27th, 2011|

Hire slow, fire fast

The old Silicon Valley adage "hire slow, fire fast" is actually apt for any type of small business, including medical practices. The smaller the team, the more powerful this idea is, because as team size shrinks, each member's contribution becomes more critical to success. Moreover, a single poor performer or "bad apple" can disrupt a smaller team much more effectively than a larger one. Medical offices are generally small operations where everyone knows a lot about each other, and sometimes it can feel like a family. And firing a member of your family ... now that's hard! You want to be that nice person who supports someone who's having a tough time. That crabbypuss who comes in late every day, "forgets" to do the insurance checks that are her primary responsibility and never seems to notice when charts are lying around waiting to be re-filed has a family to support after all. Oh, gosh, do we really have the heart to fire her? Well, the problem with that "nice" thinking is that while you're being very, very "nice" to the poor performer, you're being decidedly NOT nice to everyone else on the team. They're all picking up after her, correcting her mistakes, putting up with her lousy attitude and starting their full work-day on time -- without Ms. Crabby, who's late again. Left unaddressed, this situation kills the morale of the good performers -- who may start performing poorly themselves or just leave for a job where they feel good work is recognized. Here's a nice essay on the subject from the CEO of Gilt in Inc magazine -- Gilt is an internet shopping site, seemingly with little in common with medical practices, but Kevin Ryan's observations are instructive for any sort of business. Firing the Wrong People Is Just as Important as Hiring the Right Ones

By Morgan|2022-01-01T22:52:41-08:00October 27th, 2011|

Could your team be great? Aim for real.

Harvard Business Review posted a great tip today about "real teams." The pointed out that "real" teams -- i.e., groups that really work together as one -- all share three important characteristics: Shared sense of purpose Flexible skills Mutual accountability There's a great lesson here for medical practices. Physicians set the tone of purpose and accountability. Good training policies and skilled practice management ensure cross-training keeps everyone fresh and the practice able to withstand absences and staffing changes. Hiring people who can fit with the ethos of the team keeps everything humming along. Read more at Harvard Business Review.

By Morgan|2022-01-01T22:52:54-08:00August 23rd, 2011|

Get a clear picture of practice performance: Part 2

Our last post talked about some of the key performance indicators a practice can examine to understand how well it is performing. Now we will dig a little deeper and look at other indicators that identify if a practice is above the norm and meeting the expectations the team has set. Managing referrals and the revenue cycle It is important to monitor and compare these additional performance indicators between each physician in the practice from year to year: Top ten CPT codes by utilization: Determines the high demand services and variables between physicians. This report can also be used to track payer reimbursement trends for these top revenue sources. Number of new patient and established patient visits: Monitors practice growth or decline. Referral trends: Tells you who are referring, who is not and how this is changing over time. This is also a good way to evaluate referral management and marketing efforts. Accounts receivable and days in A/R, DAR reveals how well you are doing at bringing in the money. Aged accounts receivable 90 days or more: An important indicator for monitoring internal billing and collection performance. Ideally ,this will be less that 15% of the total A/R. Outstanding claims: If there are variants between physicians there could be contracting issues or differences in physician coding (CPT and ICD) and reporting patterns. The old saying “you cannot manage what you fail to measure” is true. When armed with this data the practice will be able to better understand its position and know what corrective actions and changes need to be made. If this post brings a question to your mind that remains unanswered, contact us by following this link: www.capko.com. We are on your side!

By Judy Capko|2022-01-01T22:52:55-08:00June 13th, 2011|

Get a clear picture of practice performance: Part 1

To begin your quest to understand how well the practice is performing is to compare last year’s financial performance to the prior year, examine shifting trends and identify the reasons these shifts are occurring. For example, are you doing less of a particular procedure and, if so, is there a reasonable explanation – or if one physician’s production took a dip was it due to more scheduled time out of the office or is it an abnormality that needs to be addressed. Perhaps one urologist’s aged receivable has spiked because of a payer contracting issue. Identifying these types of issues is a good start to managing finances better. It is also important to compare performance to your peers by obtaining the Medical Group Management Associations Cost Survey (if it includes your specialty), www.mgma.com and The annual Joint Statistics Report from the Society of Healthcare Business Consultants, www.nschbc.com. In a group practice it is important to look at the group as a whole, as well as the some specific numbers and benchmarks for each physician. Examine group performance based on the per physician averages to evaluate and manage income and expense trends and staff levels. For example, how does the practice compares to the average practice in your specialty around the country? • Number of full-time equivalent staff • Gross charges • Percentage of contract adjustments • Gross revenue, expenses and net profit • Operating expenses as a percentage of gross revenue If you simply want to know # of FTE (full time equivalent staff) and percentage of operating expenses against revenue let me know: Go to www.capko.com Capko & Company your source for practice improvement

By Judy Capko|2011-06-08T13:22:21-08:00June 8th, 2011|

Be a Lean Machine

Solving work flow problems is among the biggest challenges medical offices face on a daily basis. Work flow issues can be caused by a lack of defined work processes and individual responsibilities or poor training. It may seem like an oxymoron but too little or too much staff can also be a contributor to poor work flow. Regardless, it will result in unhappy patients and diminished profits. It's time to get serious about creating a lean operating machine. Here's some tips to help you get started: Take a critical look at workflow bottlenecks. Map work flow: Examine processes throughout the office to identify and eliminate those that don't provide added value to the customer or the practice. Involve staff in seeking solutions to problem areas of work flow. Everyone needs to give a valid reason for the various steps they go through to complete a task as a first step to eliminate processes that are redundant or duplicated. Examine errors or tasks that are completed to find the cause and develop the right solution. Develop a written plan to implement the best solution, including target dates for incremental progress. Communicate throughout the entire change process. There will be times when you will want to refocus and perhaps change directions. Celebrate your success along the way!

By Judy Capko|2022-01-01T22:52:55-08:00June 6th, 2011|

Profit with a Clear View of Your Practice’s Competitive Landscape

Whether you're contemplating expanding your practice, starting a new practice, or simply wondering what your practice's profit potential might be, your profits depend on your understanding of local patient demographics. With a host of free online services available, it's easier and less expensive than ever to understand your area's demographics and how they might represent threats or opportunities. You need to know how well your area is being served by your practice-type! One very useful website is www.city-data.com that supplies wide-ranging demographic information on thousands of communities. Among the most telling information is the population and growth trends of your service area -- where your patients come from or nearby areas new patients could come from. Often service areas are defined by geographical barriers, valleys, rivers, etc.. When we work with medical practices, we find that compiling data from the various communities in their service area (and other areas of interest) in a spreadsheet is invaluable. First, we take note of these population demographics: total population, population growth, income and, naturally, any demographic segment particular to your type of practice, such as women, children or the elderly. Next, combine the separate community data so that you can have a single figure for "service area" for each demographic segment. Now that you've compiled data to define the demographics of your service area, you can compare how your service area compares to nearby or similar-sized areas anywhere in the country. Is there a relatively high, low or average number of your practice-type in your service area when compared to similar other regions? You'll need to employ your first-hand knowledge to help you define the "service areas" that compare to yours. Be mindful of population density, income and geography and you should be able to identify at least two competing service areas. You can plug these data from their respective communities into your spreadsheet to calculate the same measures you have for your service area. Now that you've become somewhat of an expert on the population, it's time to gather information on the physicians. You'll goal is to find the number of physicians (FTEs)

By Joe Capko|2022-01-01T22:52:56-08:00March 8th, 2011|

Marketing Your Practice with a Code Update Event

By Joe Capko, Capko & Company Every year, changes to the CPT codes take medical practices by surprise -- even though everyone knows the updates are coming. Whether it's because doctors and administrators assume that coding changes won't likely apply to their specialty, because it's hard to find time to go through the materials, or just due to old-fashioned procrastination, most of the practices we work with wind up ignoring the new codes until they start finding out the hard way that the codes they've been using are no longer valid -- i.e., once claims start to be rejected. Naturally, this is a costly problem for all practices, as these rejected codes can mean payment delays of six months or more. Here's the good news. Since most (if not all) of the other practices you work with as referring partners are facing the same pain-in-the-neck, why not turn this hassle into a marketing opportunity? You can do it by hosting a Code Update Seminar -- call it a "code party" if you want to be less formal about it -- and invite the practice managers and administrators from the other practices you work with to learn about the changes. You arrange for a coding consultant to present an overview of the changes, along with a meal or some snacks -- depending on the size of the group you're inviting, you may need to rent out a large conference or event space at a nearby hotel or business center. Depending on your preferences (and those of your colleagues), you could schedule an early morning breakfast event, a lunch event, or an evening or weekend seminar. If this seems like too much effort or expense, you can try the "lite" version: a smaller, more intimate, group hosted in the office reception area during non-clinic hours. Helping to solve a problem that your colleagues all share while also giving your administrative staff the chance to network with their counterparts at your key referring partners is a wonderful way to promote your own practice without "selling." Be sure to have some tchotckes (pens, post-it

By Joe Capko|2011-01-17T19:03:22-08:00January 17th, 2011|

For better or for worse

The economy remains unpredictable. The outcome of health care reform is unknown and health care leaders keep on wondering what the future holds. Young physicians entering the market will proceed with caution when making a decision about their future. Employed physicians may sit on the sideline and watch the ball game, but if you are in private practice and entrenched in the community chances are you'll stick it out - for better or for worse. Take heart, there are steps you can take to make things better. Know your position. Examine practice finances; how well money is being managed in terms of improving revenue, controlling expenses and managing accounts receivable. Are you better off than you were this time last year? If not take strides to make a difference by setting financial goals and establishing methods to attain those goals. Embrace the future. Look at what's happening around you and the changes that are coming down the pike. Read, listen and explore the impact of these changes. Use this information to develop a strategic plan that positions you for the future. Identify what resources you need to accomplish this and turn to experts to help you out It's all about being prepared and responding sensibly. Act, don't react and you'll make better decisions for your future! Capko & Company, a leader in healthcare management and marketing consulting.

By Judy Capko|2022-01-01T22:52:57-08:00December 29th, 2010|

Doctors: Dig for the gold

Doctors can increase revenue by as much as $100,000 by all but eliminating the missed appointments. Here's how....First, look at the historical scheduling patterns for the past 30 days to get the average number of no shows and double-booked appointments. If it's more than 2 a day your scheduling is out of control and you are losing money. It's time to look at scheduling parameters; the amount of time allocated on the schedule for different patient types.Second, abandon the typical "everybody gets 15 minutes" because it isn't realistic and it isn't happening. All things aren't equal so schedule based on patient types and consider shifting to 10 minute increments to allow more flexibility. I call it the "Go-Ten" scheduling system and it works! Scheduling 10 minutes for follow-ups, 20 minutes for chronic or more complicated patients, 30 minutes for new patients and pre-ops, and 40 minutes for annual physicals is a perfect example - but you decide what works for your practice based on your patients.3rd, honor the schedule - start on time and stay on time! And if you don't want patients to make last minute cancellations you must do the same. Once you get this wired down you can start training everyone to value the appointment.4th, script out language for staff to tell the patients how important the appointment is. "Doctor is dedicating this time just for you" or "We expect you to be here on time." These are strong messages that get the patient's attention.Finally, set up an automated appointment reminder system that confirms appointments 48 hours in advance. It's a great return on investment.Enjoy the results; more compliant patients, getting out of the office on time and a bump in practice revenue!Contact Judy Capko, one of America's best known practice management consultants: www.capko.com

By Judy Capko|2011-03-13T12:21:33-08:00November 26th, 2008|