Medical practice management consulting

We elevate medical practice businesses with practical advice and expert analysis

Physicians, administrators, and managers trust us to help them with their thorniest business problems — and with their loftiest aspirations. We’ll help you become a top-performing practice without compromising your practice philosophy. We provide objective, data-driven direction and get everyone in the practice working toward the same goals. Patients will receive the best in service, staff will be proud of where they work, and physicians will feel an incredible sense of accomplishment (not to mention a healthier bottom line). And we do it all with a positive spirit — our goal is to engage your team and give everyone a boost, while providing the objective, data-driven analysis that can help you optimize your practice.

Physician-owners who work with us will tell you that we focus on the specific needs of your practice, are meticulous about the quality of our work, and deliver valuable recommendations you can act on to improve your business immediately.

What's on your mind?

Whether you have a specific concern or question, or just want an assessment to understand how to keep your practice profitable, we can help. Every service we provide is customized — if you’re not sure what you need, just ask us.

Ready to Become a Best-Run Practice?

Concerned that your practice isn’t running at peak performance, but not sure what’s wrong — or what to do about it? Or are you simply wanting to fine-tune your practice to be among the best? A detailed practice assessment — our most requested service — will give you the answers you need. It’s a head-to-toe evaluation of your practice’s business operations: billing, scheduling, workflow, financial management, human resources. We look at competitive positioning, threats, opportunities, and leadership.

Our detailed, customized reports focus on the areas you tell us are most important to you. And they’re filled with practical, prioritized recommendations for how to correct problems and take your practice to greater efficiency and profitability.

Technology Secrets Your Practice Needs to Thrive

The front office technology landscape has changed dramatically in the past few years. But innovations that can help your practice collect more and improve service are easily overlooked. And determining what works within your current EHR and PMS set-up can be daunting.

Let us help. Our front office tech review is a very fast, very affordable way for any practice to understand how well it’s using technology, and to learn what new tools might help quickly improve bottom-line results — and how they fit in your workflow. We’ll take the legwork and complexity off your plate, and give you a plan to use technology to start collecting more and improve productivity immediately.

Are You Leaving Money on the Table?

Health plans continue to get more complex. Reimbursements are flat. And patients are on the hook for more of the cost of care. Are you navigating these changes effectively? Our focused billing review is a fast and affordable analysis of the life blood of your practice business: your billing and collections. It can usually be completed remotely, with detailed results and recommendations in less than a week. And if patient receivables are your primary concern, let us help you find the source of the leaks and give you a patient collections action plan.

Optimize Your Team for Optimal Productivity

Overstaffed? Understaffed? Right jobs, wrong people? Too much overtime? Having the right staff and the right staff structure makes or breaks practice productivity. The C&M team has deep experience managing teams of all sizes, and we’ve worked with practices of virtually every specialty. A staffing review can help you understand how your team roster could be enhanced to improve productivity. And if you need to recruit new talent, we can help with that, too.

A Data-Driven Temperature Check -- No Travel Required

As systems continue to improve, we’re able to offer services that focus on analysis of data from your current systems. Whether it’s a review of your compensation structure, physician productivity, or mix of procedures, we can usually complete these projects within 1-2 weeks, without traveling to your office. It’s peace of mind and answers to the business questions that keep you up at night, at a very affordable price. And you get the ROI-boosting answers you need fast, without disrupting your daily practice workflow.

Coaching and Interim Management

New for 2016

Help Adapting After Acquisition

When the transaction that brings practices under a hospital’s wing ends, some of the most important challenges begin. Capko & Morgan has experience evaluating the performance of newly acquired practices, to help practices and hospital systems alike benefit from their new relationship and work together more effectively.

Ready to Set Up Shop?

When you’re ready to set up your own shop, Capko & Morgan can help you.

Take us for a spin for $100!

Get a little taste of what we can do. A 20-minute consultation, focused on a question of your choice, is just $100. What have you got to lose?

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Physicians and managers are asking...

Someone asked:

on June 11, 2019 11:16 am

A nurse practitioner in my 2 physician/3 NP practice resigned. Should I replace her? My administrator says no, arguing “it’s a break-even proposition at best.” But I am not sure this is the right decision.
- Laurie Morgan replied:
  
  on June 11, 2019 11:23 am
  
  First, it’s laudable that your administrator is attempting to answer the question as objectively as possible. Data-driven, quantitative analysis is essential to making good business decisions. But a single financial snapshot is unlikely to tell the whole story, so I’m not surprised you have doubts. Digging into a few additional questions might help you determine the best answer for your practice.
  
  You haven’t mentioned your specialty, and that may make a difference in how an NP or PA’s contributions affect profitability. How non-physician providers fit into your practice is also important to know. For example, if they’re seeing their own patients and billing under their own NPI numbers, it may be easier to get a clear picture of the revenue they bring in. If they’re working primarily as “extenders” and you’re billing incident-to, be sure the data in your system accurately reflects what revenue should be credited to your NPs.
  
  I’m also interested in why “a break-even proposition at best” was interpreted as “not worth replacing.” This raises more questions, like how were overhead costs allocated? The decision not to replace sounds like it assumes doing so would be at best a wash financially, but I’d want to be sure that’s true. Will the remaining two physicians and two NPs be able to bring in the same amount of revenue as five clinicians are now? If not, be sure the calculation you’re relying on accounts for spreading practice overhead across four revenue streams instead of five.
  
  Here are a few additional questions to consider:
  
  • Has the NP who’s leaving reached full productivity? Or might you expect more return on an NP who stays with your practice longer? Today’s “break-even proposition” might be a more clearly profitable contributor with more experience.
  • Will not filling this role put your practice at risk of a more severe crunch if another NP or a physician leaves? Having a little extra capacity in your clinician ranks can protect your practice from disaster if someone unexpectedly departs or needs a leave of absence. With only four total clinicians, this may be a serious risk for your practice.
  • Does having this extra NP allow your physicians to spend time on more complex and highly compensated cases? If your physicians will now earn less per hour for your practice on average (if they have to pick up simpler visits and services the NP would have handled), their profitability will decline. Has the administrator’s analysis accounted for this in the “break-even” calculation?
  • How taxed are your NPs and physicians right now? Is it reasonable to expect them to pick up the slack of the exiting NP? Overburdening your remaining clinicians is another factor I’d take into account.
  • Regarding this last point, you didn’t mention why the NP left, but if she’s moving to another practice in your area, does this signal a morale issue in the NP ranks? And will increasing the other NPs’ workloads make it worse?
Someone asked:

on January 26, 2019 8:56 am

Our practice has the opportunity to hire an experienced clinician in a tight market, but there's a catch: she's the wife of one of our physicians, who wants to return to work after several years off to raise a family. What do you think about hiring family members of other employees?
- Laurie Morgan replied:
  
  on January 26, 2019 11:02 am
  As a general rule, we would recommend avoiding hiring relatives or close friends of practice employees or partners.
  Medical practice workplaces can be very busy and somewhat stressful. Maintaining policies that don't add to stress and drama is always advisable, and that starts with policies that give employees confidence they'll be treated fairly. A policy against nepotism helps in this way.
  
  On the other hand, when a practice (or any independent business, really) decides to go the other way (say, because the owners concluded that they can trust a relative more easily), there is a risk of many problems that tie back to the employees' relationship outside of work. For example:
  
  Regardless of how hard the employees try to be neutral and fair, even if they're objectively quite successful at keeping their personal relationship out of the workplace, the rest of the team will be wary and could even perceive unfairness that isn't there. Convincing employees that there isn't favoritism can consume a lot of time and energy that could better directed elsewhere.
  
  Regardless of how hard the two employees try to be fair and neutral and keep their relationship out of the workplace, they will probably not succeed, and that will cause legitimate concerns on the part of the other employees.
  
  You will likely face a very thorny management problem if you hire a relative and that person doesn't perform as expected. Even criticizing an employee in that situation may cause tension in your relationship with their relative -- and if you have to fire the new employee, the one you originally hired (and liked well enough to hire their relative) may leave or start to underperform, compounding your problems.
  
  The relationship between the two employees may sour, and that external drama will likely affect your workplace.
  
  The employee or partner may think they know more about the skills or work personality of the spouse or sibling or cousin they want you to hire than they actually do.
  
  There are other reasons to avoid hiring relatives, especially into key roles, that vary depend on your individual practice situation. But the list above is a good starting point for thinking about whether your partner's suggestion that your practice hire her spouse is a lucky find or a potential trap.
  
  Final thought: there may be some exceptions that are less problematic -- for example, hiring a spouse to do a short-term, temporary project. But as a general rule, we recommend you have a policy that guards against nepotism, and that you uphold it consistently.
Someone asked:

on December 28, 2018 1:23 pm

Is it better to outsource billing or keep it in-house?
- Laurie Morgan replied:
  
  on December 28, 2018 1:32 pm
  
  To give you a detailed answer, we'd need to know more about your practice. The specifics of your practice's situation would be crucial to this important decision. But a few things you might want to think about are:
  
  Do you have enough volume to keep a full or half-time biller busy? Have you defined the job in detail?
  
  Are qualified people available in your area? If someone on your staff is interested, are you willing to invest in training?
  
  Are you satisfied with your software set-up, and is it flexible -- and, if so, how does that affect your hire/outsource options?
  
  If you're considering outsourcing, have you thought through your requirements and do you know what you need to know to screen your options?
  
  Also, regardless of whether you outsource your billing to a service, it's critical to stay involved -- now more than ever. Capturing every dollar for your practice is a team effort, not just the responsibility of your biller or billing service.
  
  If you would like more specific feedback on your situation, or are interested in a comprehensive review of your billing set-up and performance to help you decide, please contact us.