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Practice Management

Turning Around a Failing (or Non-Optimized) Medical Practice Using G.R.O.W. Steps

It is no secret that 2024 was a rough year for many small businesses throughout America, and medical practices were not excluded from the macro-economic challenges of inflation and economic uncertainty. When inflation rises quickly like it occurred in 2023 and 2024, it is hard to keep up and adjust quickly enough to offset the impact. According to AHA.org, inflation grew at 12.4% from 2021-2023, but Medicare reimbursement only adjusted by 5.2% during this same period.

Having growing expenses without adjusting revenue leads to decreased financial stability. Since medical practices are highly dependent on third-party payors, it is nearly impossible to adjust their revenue, even if they have the time and foresight to do so since their reimbursement rates are fixed. In these times, it is important to focus on the Key Performance Indicators (KPIs) to help and guide the discussions on operational efficiencies and adjustments of operational overhead.

Physicians who own medical practices are focused on providing care for their patients and often lose sight of the details around cash flow forecasting and budgeting. More importantly, the difference between the revenue coming in and the costs going out are gradual changes, and it often takes someone to “step back” and see the big picture before they notice the changes—this is often during tax time when their profits are lower than expected. The Change Healthcare cybersecurity attack was one of those eye-opening events that occurred in 2024 and had an immediate negative effect on cash flow that still has residual challenges today.

Based on my 14 years of business consulting and running businesses, there are key steps to start the process of turning around your business to meet both short-term and long-term goals. If you are struggling to make payroll, or if you are just looking to optimize profits, these steps will allow you to take a strategic step forward in turning around the trajectory of your business in 2025!

Follow these steps to GROW:

G: Gather the Information and Conduct a Thorough Assessment of the Current Practice

Gather 12-24 months of data: You want to see the trends, so gather productivity reports for the past 24 months to understand the trends. Are patient volumes going down? Are costs going up? Are write-offs a problem?
Evaluate financial health: Review your financial statements to understand your revenue, expenses, and profitability. Identify areas where costs can be reduced, or revenue can be increased. Look at monthly and yearly costs and identify the top 10-20 costs that you are currently spending. Hint: Payroll should make this list of top 2-3 costs.
Patient feedback: Collect feedback from your patients through surveys or direct conversations to understand their needs and areas for improvement. This is important for all cases, but if patient volume is going down, then gathering this information will take action to fix the problem.
Staff performance: Assess the performance of your staff and identify any training or support they might need. During busy months, it is easy to “add” employees instead of training them on new procedures. Understanding staffing ratios will be important when making overhead decisions.

R: Review the Data and Prioritize Your Easy Wins

Assess the damage: Now that you have the data, identify the areas that don't line up with benchmark data. This may be billing by rendering provider or collections per provider or MAs to provider ratio. Analyzing the data and looking for trends will allow you to make a list of all potential ways to increase profit in 2025.
Set clear goals: Define specific, measurable, achievable, relevant, and time-bound (SMART) goals for your practice. This could include improving patient satisfaction, increasing patient volume, or enhancing operational efficiency. These should address both short-term needs (like improving cash flow by $10K per month) and long-term needs (like adding a new mid-level provider in Q3).
Create an action plan: Develop a detailed plan, outlining the steps needed to achieve your goals. Assign responsibilities and set timelines to ensure accountability.

O: Optimize the Practice and Implement Changes

Optimize operations: Streamline your practice operations by adopting enhancements to your existing electronic health records (EHR) systems, such as AI, schedule reminders, or other features. Look at the schedule and determine if you can add more patients by adjusting time slots or set-aside slots.
Identify the areas of the practice that are profitable vs losses: In many cases, you can adjust the operations to enhance the profitability of certain components of the practice, but you may need to stop providing a service if you are currently losing money. Remember that this is a business decision, and you can always add it back later in a more profitable situation.
Enhance patient experience: Focus on improving patient engagement and satisfaction by enhancing communication, reducing wait times, and providing personalized care.
Financial management: Address financial issues by renegotiating contracts, reducing unnecessary expenses, and improving revenue cycle management.
Ask your staff for assistance: Maintain open lines of communication with your staff. Hold regular meetings to discuss updates, gather feedback, and address concerns. They may have the needed insights to make some cost-saving changes in your practice, so listen up and ask for feedback.

W: Watch KPIs and Actively Adjust the Practice Until You See the Results You Are Looking For in Terms of Practice Growth

Track progress: On a weekly/monthly basis, monitor key performance indicators (KPIs) to assess the effectiveness of the changes you've implemented. This could include patient volume, revenue, receipts, and adjustments, but it may also include patient satisfaction scores, appointment wait times, and overall financial performance.
Adjust KPIs: Be prepared to adjust based on feedback and performance data. Continuous improvement is essential for maintaining progress.

Source: Matt Kolinski, DO

Matt Koliniski, DO, is an Associate Management Consultant at DoctorsManagement.

DoctorsManagement simplifies the business of medicine so that healthcare professionals can focus on caring for patients and controlling the future of their business.

https://www.doctorsmanagement.com/

Practice Management

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Practice Management

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Practice Management

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Practice Management

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Practice Management

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Practice Management

Financing Solutions for a Healthier System: Aligning Patient Financial Health With Healthcare Stability:The financial viability of U.S. health systems is under significant strain due to the increasing volume of uncompensated care. In 2023, U.S. hospitals collectively faced billions of dollars in uncollected revenue, severely constraining their ability to invest in critical infrastructure and advancements in patient care.

Practice Management

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Practice Management

Monthly Spotlight on Fraud, Waste, and Abuse:University of Colorado Health, known as UCHealth and headquartered in Aurora, Colorado, has agreed to pay $23 million to resolve allegations that it violated the False Claims Act in seeking and receiving payment from federal health care programs for visits to its emergency departments, by falsely coding certain Evaluation & Management (E&M) claims submitted to the Medicare and TRICARE programs.

Practice Management

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Practice Management

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Practice Management

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Practice Management

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Practice Management

Trends in Denial Management: Strategies to Reduce Revenue Loss:Denials slow down healthcare revenue cycles and increase operational costs; having the right strategies in place can protect cash flow and productivity.

Practice Management
Monthly Spotlight on Fraud, Waste, and Abuse:The following cases highlight fraud, waste, and abuse (FWA) and serve as a reminder to uphold high ethical standards when providing patient care and services.

Practice Management
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Practice Management
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Practice Management
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Practice Management
Medical Practice Valuation: How to Estimate Your Selling Value:If you have built or led a medical practice for years, putting a price tag on it may seem daunting. But if you're transitioning and want to sell, calculating an accurate selling value is essential to ensure you attract serious buyers and get a fair deal.

Practice Management
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Practice Management
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Practice Management
Navigating the Storm: Key Strategies for Effective Denials Management in Healthcare:In the intricate landscape of healthcare financing, denials management emerges as a formidable hurdle, especially amidst the surge in clinical and technical denials. These denials not only lead to payment delays but also set off a chain reaction of adverse financial ramifications, including increased labor or vendor expenses for appeal processes and heightened write-offs.

Practice Management
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Practice Management
CrowdStrike Update: Faulty Sensor Software Update Causes Widespread Windows Crashes:Earlier this week, CrowdStrike released details on the malfunction of its Falcon sensor software, which led to crashes affecting approximately 8.5 million Windows computers. The issue originated with a defect in the Rapid Response Content used for behavioral pattern-matching operations on the sensor. This content, delivered through template instances, introduces new functionalities that enhance telemetry and detection capabilities.

Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
Overcoming Prior Authorization Challenges With Technology:The latest survey from the American Medical Association (AMA) reveals the significant challenges posed by prior authorization in healthcare. Prior authorization, a process insurers use to manage healthcare utilization and control costs, often disrupts patient care, burdens physicians with administrative tasks, and wastes healthcare resources.

Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
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Practice Management
The Significance of Not Obtaining Patient/Consumer Consent Before Poaching Data:Now, in 2023, the FTC announced two consent orders related to the prohibited poaching and use of PHI by known third parties and the DOJ announced another settlement under its Civil Cyber-Fraud Initiative.

Practice Management
Seven Measures Developed by the HHS Office of Inspector General (OIG) to Identify Potential Telehealth Fraud:n September of 2022, the Office of Inspector General (OIG) released a report, "Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks," in which they identified that approximately two in five Medicare beneficiaries used telehealth services within the first year of the pandemic to receive healthcare services from a Medicare provider. This is approximately 88 times more often than beneficiaries engaged through telehealth services prior to the pandemic.

Practice Management
The Crucial Role of Negotiating Payer Contracts Every 18 Months for Physician Offices:The healthcare landscape is constantly evolving, with changes in technology, patient care, and the business of medicine all occurring at a rapid pace. One area that is often overlooked but is equally critical to the success and sustainability of a medical practice is the negotiation of payer contracts.

Practice Management
Revenue Cycle Challenges: The Financial Savior:As consumers, we all face challenging inflationary pressures in our lives, with everything presenting challenges to our budgets. Essential groceries and other items are up significantly, posing tremendous financial obstacles for all consumers. The Consumer Price Index (CPI), a closely watched gauge of inflation, recently showed that price increases continue to slow.

Practice Management
Is the Violation Right of Access or Information Blocking? Do You Know the Difference?:The right of access and information blocking are both related to the access and exchange of health information, but they are different in several key ways. HIPAA Privacy/Security and Compliance Officers and Health Information Management professionals need to know the difference. It is important to differentiate between Right of Access and Information Blocking to ensure your organization is compliant with both rules, as well as any applicable state privacy regulations.

Practice Management
Healthcare Compliance: A Unique Opportunity to Impact the Business Side of Medicine:I have been privileged to make my entrance into the world of healthcare, in medical coding, specifically after my first career as an art historian dissolved way back in 2008 due to the recession. Mind you, I have taken all my research skills, writing, communication, and critical thinking strengths along for the ride.

Practice Management
Overcoming Self-Pay Challenges in Revenue Cycle Management:Amid the headlines of labor shortages and hospital closures, many Americans may have missed some positive recent healthcare-industry news: The U.S. reached a new, all-time low in the rate of Americans without health insurance.

Practice Management
FY24 IPPS Proposed Rule Boosts Hospital Payment Rates by 2.8%:CMS proposed a new rule for the fiscal year 2024 Inpatient Prospective Payment System (IPPS), increasing hospital payment rates up to 2.8%. Also, the newly proposed IPPS rule adopts policies that are aimed at advancing health equity.

Practice Management
Empowering Your Front Desk Staff to Improve your Revenue Cycle Management :The front desk is the first point of contact for patients visiting a healthcare facility, and it plays a crucial role in revenue cycle management. The front desk staff is responsible for managing patient registration, insurance verification, appointment scheduling, and collecting payments. Empowering your front desk staff can significantly improve your revenue cycle management and boost your bottom line.

Practice Management
Spotlight on Fraud, Waste, and Abuse - March 2023:The following cases highlight fraud, waste, and abuse (FWA) and serve as a reminder to uphold high ethical standards when providing patient care and services.

Practice Management
12 Tips to Grow Your Medical Practice in 2023:Do you want to expand your medical practice without collapsing? Here are 12 realistic tips to safely and effectively grow your practice in 2020.

Practice Management
The Importance of Selecting the Right EMR and PMS Software:As a healthcare organization, choosing the right electronic medical record (EMR) and practice management system (PMS) software is critical for the success and efficiency of your operations. The right software can streamline patient care, improve data accuracy and security, and reduce administrative burdens, among other benefits.

Practice Management
Recent False Claims Act Cases Shed Light Upon Compliance Scrutiny:As touted by the U.S. Department of Justice (DOJ) and Members of Congress alike, including Senator Chuck Grassley (R-IA), the False Claims Act, 31 U.S.C. §§ 3729, et seq. (FCA) is the federal government's primary tool to root out fraud and put money back into the federal fisc.

Practice Management
Consensus Cloud Solutions to Showcase Healthcare Technologies that Enhance Interoperability at ViVE 2023:Consensus Cloud Solutions, Inc. (NASDAQ: CCSI), the world's largest provider of digital cloud fax technology, will be exhibiting their suite of interoperability solutions at the ViVE 2023 conference in Nashville, Tennessee, March 26-29th. Booth #1020

Practice Management
Five Steps for Provider Credentialing:When your facility hires a new provider, they need to be credentialed. This process allows you to verify their qualifications and skills while getting them approved to work with insurance companies. Medical credentialing is a time-consuming and expensive process that requires complete concentration by a professional. This can use a lot of your facility's resources.

Practice Management
5 Ways in Which Healthcare Data Visualization is Transforming Healthcare:
Healthcare providers can make use of data visualization to assess past and present medical history and improve patient care and outcome.

Practice Management
The End of the PHE: Medicaid, The Omnibus Act, and What Hasn't Been Addressed:An announcement on January 30th, by the OMB (Office of Management and Budget) and the White House, stated that they plan to end the COVID-19 national emergency and public health emergency on May 11th.

Practice Management
Three Ways Medical Groups Can Leverage Digital Self-Service to Drive Growth:That medical groups and health systems share a commitment to delivering convenient, high-quality care in their respective settings isn't surprising. What is eye-opening, however, is that despite their differences in size and structure, they face many of the same business challenges, such as fending off market competitors, acquiring and retaining patients to ensure profitability, and working to alleviate staff burnout.

Practice Management
How to Establish a Business Plan for Your Holistic Practice:Opening a holistic healthcare practice is an exciting and challenging endeavor that requires careful planning and preparation. A business plan is a critical tool that can help you to organize your thoughts, set goals, and create a roadmap for your practice's success. In this article, we discuss steps on how to establish a business plan for your holistic practice and provide some tips for creating a successful strategy.

Practice Management
CMS Announces Increase in 2023 in Organizations and Beneficiaries Benefiting from Coordinated Care in Accountable Care Relationships:Recently, the Centers for Medicare & Medicaid Services (CMS) announced that three innovative accountable care initiatives will grow and provide higher quality care to more than 13.2 million people with Medicare in 2023. More than 700,000 healthcare providers and organizations will participate in at least one of the three initiatives – the Medicare Shared Savings Program and two CMS Innovation Center accountable care model tests. This growth furthers achieving CMS's goal of having all people with Traditional Medicare in an accountable care relationship with their healthcare provider by 2030.

Practice Management
Investigation of Hospitals Hiding Prices from Patients:The Federal Hospital Price Transparency Rule helps Americans know the cost of a hospital item or service before receiving it. Compliance is mandatory. The regulation aims to improve the affordability of hospital care by promoting price competition. However, a low compliance level among hospitals would compromise the operational effectiveness of this regulation.

Practice Management
Top 5 Ways Medical Practices Can Combat Inflation:Inflation is affecting many businesses, but medical practices tend to see the brunt of its effects because of the way payment structures are dictated by insurance payers. Even more worrisome, practices have had to increase wages significantly and the current job market tends to favor employees.

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Archived Sections

G: Gather the Information and Conduct a Thorough Assessment of the Current Practice

R: Review the Data and Prioritize Your Easy Wins

O: Optimize the Practice and Implement Changes

W: Watch KPIs and Actively Adjust the Practice Until You See the Results You Are Looking For in Terms of Practice Growth

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