Practice Turnaround
It was once relatively easy to have a financially prosperous practice…or at least a practice that provided a fair living wage for its owners/partners. But today, an increasing number of practices are finding it difficult to hang on, much less prosper.
There can be many causes for a practice to falter: One or two poor management decisions, excess debt, a remarkably aggressive competitor, lack of access to capital, loss of a critical provider or manager, embezzlement, loss of license or privileges, or simply adverse local economic conditions.
Whatever the cause, our turnaround consulting can potentially restore the viability of your practice, putting you back in control. Such practice consulting work is often provided on site, but much can be done off-site to spare costs.
Practice Operations
Business policies and procedures are analogous to clinical protocols: there is almost always one best approach to every business process in the practice. Developing and fine-tuning the one best way to do everything is at the core of effective leadership. Whether you have a focused problem area in the practice, or desire an overall operational assessment, we can design effective staffing models, implement comprehensive business policies and procedures, train your management staff to operate within the new protocols, and/or manage the practice for you.
Human/Resources
We provide human resources consulting and/or human resource outsourcing to physician group practices throughout the United States. We can customize HR services to fit your needs from consulting for specific objectives to full service human resources.
We integrate as part of your team to provide some or all of the following services:
- Payroll and benefits
- Recruitment
- Compensation benchmarking
- Employee handbook
- Effective onboarding
- Performance management
- Compliance audits
- Employee relations
Leadership Skills Development
Most doctors and their managers possess common sense combined with a commitment to excellence that eventually allows them to be quite good at leading their team. But for others, despite an abundance of technical skills and sincere effort, their leadership and management skills fall short of the needs of their organization.
If you think you have a leadership gap in your practice, we'll watch you in action, listen closely and confidentially to your people, assemble a composite understanding of the impact of your management style, and then gently coach each doctor and manager privately on how to improve.
Consulting services can be applied to a single individual, or to an entire management team during group retreat sessions.
Whether you're a department head, administrator, solo practitioner or larger-group managing partner, we're confident that you--and your staff--will like the results.
Provider Dispute Mediation
The most fortunate physician practices have doctors who respect each other, resolve conflicts quickly and don't hold grudges. But even the most harmonious partners can accumulate lingering conflicts. Beneath the surface, even otherwise wildly successful practices could improve their communication and conflict resolution skills.
In today's decreasing reimbursement, cost-rising world, with more competitor encroachment, and higher stakes—full-blown doctor disputes are more common than ever. Whether your practice's lack of harmony is still bottled up or “about to blow,” we can help, with a calm, rational evaluation of the underlying issues, and a neutral pursuit of fairness for each impacted party.
Strategic Planning
Whether your practice is thriving today, or in a survival mode, resolving and planning your organization's destiny can be a daunting challenge. This is why comparatively few practices have a written strategic plan. Most practices still make decisions based on a very short-term planning horizon. Working together with principals, senior staff and your other professional advisors we evaluate the opportunities in your market, your economic goals and risk tolerance, your resources for development (facilities, staff, access to capital, etc.) and help you derive the most viable plan. Together we can derive the best path forward, addressing:
- Service area
- Service mix and diversification
- Provider mix and succession issues
- Payor mix, implications, and targets
- Target growth rate and growth limits
- Governance and operational adjustments along the way
- Competitive posture
- Exit strategy
In a disciplined fashion, all subsequent near-term business decisions can then be gauged against your long-range plan.
Practice Valuation
Practices need to be valued in a variety of situations:
Buy-in and buy-out transactions
- When selling to an institution or private equity firm
- In forensic settings, such as divorce and disability
Most valuation controversies surround goodwill value. With successful experience in the quality of earnings assessment process and broker negotiations, we are in an excellent position to furnish an opinion on the overall practice, with particular care regarding the intangible or good will value.
Staff Evaluation & Training
Every initial client engagement usually includes an element of staff evaluation. In some client settings, this is the chief scope of work. We can help you better assess the productivity and cohesion of your work group and compare this to the objective benchmarks from hundreds of practices in similar settings around the nation.
A single weak link can bring down the performance of the whole group. We can validate your hunches and suggest a corrective action plan to bring the entire team to a level of performance excellence.
Cost Benchmarking & Cost Containment
Too few physician group practices review expenses or use cost benchmarking in a routine and organized fashion. Instead, the typical practice waits for a profit crisis and then cuts costs across the board. This approach often actually leads to even less profit, as the practice continues to spiral downward.
Just as every medical lab value for a patient has "normal limits," every line item on your financial statement can be examined through ratio analysis, to determine the health of your practice. Over the past several decades, we have utilized, assembled, and developed industry benchmarks. Our client assessments go well beyond the basics to include labor productivity, retention, goods costs by segment, inventory metrics, billing and collection efficiency dash boards, P&L health, and payor reimbursement compliance.
As a service business with mostly fixed costs, enhancing the profit margin ismore often achieved through revenue enhancement than through cost containment. We can teach you the right numbers to watch each month, how to be a better negotiator, and what to cut first--with the least amount of damage--if expenses must drop in a crisis.
Mergers/Acquisitions
Long before the advent of large, publicly traded Physician Practice Management Companies or Private Equity Firms, general practice physicians and/or specialists joined into larger groups to gain market clout, share costs, diversify services and improve provider lifestyles. Additional drivers may also include joint surgical and procedure facilities, succession planning for the most senior doctors, brand consolidation and satellite development.
Successful practice merger and acquisition has significant interpersonal, financial and regulatory hurdles. Working as a neutral facilitator, or as an advocate for just one side of the transaction, we can assess and forecast the economic, assist with the formal quality of earnings assessment, operational and cultural destiny of the slated deal