I own a clinic or practice
Your perspective and interests in healthcare are unique. In order to facilitate easier discovery of topics, we have organized our articles for you here.
They are arranged by the problems others in your position have experienced.
Each underlined word is a link to an article that may help you. Click it to read more.
Why does my net income keep decreasing?
The rates the Center for Medicare and Medicaid Services (CMS) will pay for Medicare services impacts the majority of your contracts. With time, these rates have either stayed constant or decreased. Decreasing rates coupled with inflation will negatively impact your business by 1-3%+ per year.
In order to combat this, you should improve your management/reporting capabilities via the data already captured in your EMR. With clear reporting and improved management processes, your team can begin to improve the profitability of your contracts, physicians, and locations.
Why are insurances paying rates far below my old charges?
How can I change that?
The government is trying to decrease overall spend on healthcare as the baby-boomer generation ages. One way to do that is to pay less per medical encounter. This has resulted in a decrease of rates for your procedures.
As rates decrease, depending on your relationship with payors, you can either negotiate rates up or you'll have to accept the lower rates.
You'll need to develop a long-term strategy to combat these decreasing rates and improve your overall contract management processes.
Why do I need to keep hiring more staff?
1. If you're trying to see more patients a day, you need more staff to help you do that
2. As more companies and regulations emerge in healthcare, the industry increases in complexity and more people are needed to handle that.
Your support staff will continue to increase. You'll need to decide whether that support will come from your own staff or an outside group.
You can only focus on a few things and do them well. As a provider, decide what your long-term focus will be and execute on those before you focus on other, less critical tasks.
How do I increase the success of my business?
Success stems from making good decisions consistently and remaining flexible to capture the upside of unforeseeable change.
Develop both short-term and long-term strategies that will help you succeed with your key stakeholders. Keep in mind your key function as a business and avoid closing your doors due to the risks you will face. Maximizing your value takes time.
In order to make good decisions, it's best to utilize several decision frameworks or mental models. The best investors and business leaders will typically build decision pods/systems to avoid making human errors.
What should I focus on?
You'll want to focus on the items that have the highest return on your investment of time and financial resources.
Every provider group is in a different state but in general, you'll want to:
1. Understand your core function
2. Develop short-term and long-term strategies
3. De-risk your business as much a possible
4. Utilize data to track performance
5. Develop/improve your management processes
Completing these items is a never-ending process but focusing on them will keep your doors open and failing to focus on them will likely result in a significant struggle for you.
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I am a physician in a practice or clinic
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I am looking to provide cost-effective care