There are many opinions on what a small physician practice should do to survive as a business. Obviously, in these times, it is more important than ever to “keep your eye on the ball” in order to ensure a profitable practice and your livelihood.I recently conducted a webinar for DecisionHealth on the 7 Habits of Highly Profitable Medical Practices which are tried and true examples of what high performing practices do to stay ahead of the game and viable practices.
In a recent session at the American College of Physicians’ (ACP) annual meeting, John H. O’Neill, Jr., DO, FACP, Vice Chairman of the ACP, learned that many physicians would rather stay in private practice. Physicians who prefer working in solo or small-practice arrangements appreciate the increased autonomy and control over the work environment that they have, as well as close doctor-patient relationships, compared with those in larger groups
In this session, O’Neill provided attendees his opinion of what factors were most important for a small practice to stay viable. O’Neill offered the following advice:
- Analyze your top 10 charges/reimbursements by payer, including immunizations, then approach and negotiate with payers for better reimbursement. “As internists, our bread and butter is really evaluation/management codes,” he says. Physicians can use their payer program participation as leverage, he says.
- Identify and micromanage your overhead using accounting software. “If you’re going to manage your overhead, you have to know what it is,” O’Neill adds. Track expenses and determine which reports to generate and read.
- Pinpoint the procedures that best fit your practice, then track and optimize their use.
- Implement an electronic health record/practice management system to help you improve the care you provide and to optimize your billing and reporting. He recommends using the same vendor for both systems to ensure compatibility.
- Consider developing or becoming part of a Patient-Centered Medical Home (PCMH). “That’s where we’re heading,” O’Neill says. One major difference between current practices and PCMHs is that the latter includes one or more care coordinators who follow the patient inside and outside the practice.
- Think about using midlevel providers in your practice; they can generate additional revenue.
I will agree with some of his points, but there are issues with others that, in my opinion, you need to be mindful of. Implementing an electronic health/practice management system is the right way to go for the future, but you really have to have a well planned implementation plan and all physicians need to really need to immerse themselves into learning it and setting up templates far in advance of going live. This is the only way it will help you improve your care and optimize your billing and reporting, otherwise it will just hinder, and possibly be the downfall of the entire practice.
I am not completely convinced that the PCMH is the way to go. This is very similar to the old “gatekeeper” system that we had back in the 90′s. If done correctly, it can definitely improve patient care, but the jury is still out on how reimbursement will turn out and how practices will survive within this structure. The other points O’Neill communicated make sense and practices of ANY size should pay attention and heed his advice. Remember, this is your business and livelihood, run the business like a business and if you need an expert to help you along the way, make the investment, but conduct and discuss the return on your investment (ROI) first to ensure that the money you spend will bring forth the results you intend. Of course, this goes for any investment you make in your practice.
