enhancing services to new & existing physician practices
DESCRIPTION
Enhancing Services to New & Existing Physician Practices. Reed Tinsley, CPA. Why I Don’t Like My CPA. Not enough attention Doesn’t help me in my business Brings few new ideas to my attention NOTE: IT’S RARELY ABOUT PRICE IF THE VALUE IS THERE. How to Enhance Services. - PowerPoint PPT PresentationTRANSCRIPT
Enhancing Services to New & Existing
Physician Practices
Reed Tinsley, CPA
Why I Don’t Like My CPA
Not enough attention Doesn’t help me in my business Brings few new ideas to my attention NOTE: IT’S RARELY ABOUT PRICE
IF THE VALUE IS THERE
How to Enhance Services Add Value to Current Accounting
& Tax Services Develop Specialized Healthcare
Services Create Client Contact Program
– Formal Management Meetings– Fixed Meeting Dates– Get In Front of the Client Often!!!!
Specialized Services to Consider
Contract Review Practice Management Reporting EOB Review Billing/Collection Analysis Accounts Receivable Review Visit Coding Worksheet/Analysis Managed Care Contract Negotiation Physician Compensation
Specialized Services to Consider
Regulatory Review– Stark– OSHA– HIPAA
Strategic Planning Practice Transition Practice Valuation
Adding Value to Current Services
Practice Financial StatementsPractice Financial Statements
Why so Important and What to Look For– Balance Sheet
• Aging of Accounts Payable• Excessive Non-Strategic Debt
– Income Statement• Proper Presentations• Compare revenue to payments posted in billing
system
Financial Statement Financial Statement AnalysisAnalysis
Financial Statement Review– Analyze overhead % of collections– Comparison to prior year
• Must see comparative financials• First step: compare total overhead
amounts
– Line item overhead category analysis– Department overhead analysis
Comparison - % of Comparison - % of CollectionsCollections
Industry Benchmarks– MGMA– Medical Economics– National Society of Certified
Healthcare Consultants– Other client practices in similar
specialties
Comparison - % of Comparison - % of CollectionsCollections
Flaw in this Analysis– Assumes practice has maximized its
collections– Assumes there has been no decrease
in production/collections– Assumes a comparison of “apples to
apples”
Provide Opportunities for Overhead Reduction
Payroll CostsPayroll Costs Analyze Total Personnel Needs
– Too many or too few? Analyze Actual Compensation
Levels– Overpaying for specific positions?– How to handle long term employees
Analyze Overtime Pay– Exempt vs. non-exempt employees– What is causing excessive overtime?
Employee BenefitsEmployee Benefits
Analyze Health & Other Insurance Costs– Benefit coverage– Employee subsidy
Analyze Retirement Plan Costs Hidden Costs
– Vacation leave payouts– Sick leave payouts– PTO payouts
Supply CostsSupply Costs
Medical, Office, Drugs, etc.– Inventory control
Review Vendor Relationships and Pricing– Bid periodically– Centralized management– Use purchase order system– Utilize internet purchasing
Unique Cost Saving StrategiesUnique Cost Saving Strategies
Merging Medical Practices MSO Formation/Utilization IPA Formation Adding a Physician Changing the Physician Compensation
Formula Office Sharing with Another Practice Implementation of EMR Make Stakeholders out of the Employees
Help Build New Revenue
Opportunities
How to Build Revenue – How to Build Revenue – GenerallyGenerally Adding Ancillary Services Adding Non-Ancillary Services Adding Physician Extenders Adding Locations Improving Practice Operations Creating Alliances (Merger) Research Six Sigma – Practice Reengineering
How to Build Revenue – How to Build Revenue – GenerallyGenerally Renegotiate Managed Care
Contracts Implement EMR
– Track Quality Measures Have a Strict Recall Program Pay Attention to Lower Portion of
Referring Doctor Report After Hours/Saturday Clinic Surgery Center Development
How to Build Revenue – How to Build Revenue – GenerallyGenerally Do You Have a Practice That
Patients WANT to Refer to? Meet Human Resource Director at
Largest Employers in Your Service Area– What Services Can You Provide On
Site?– What are Educational Opportunities
for Employee Group?
How to Build Revenue – How to Build Revenue – GenerallyGenerally Walking and Talking – Free Talks
– Churches– Senior Centers/Assisted Living
Facilities– Neighborhood Associations– Schools
Integrate Yourself with Hospital’s Marketing Program
Build a Public Relations Program
Review and Review and ImplementationImplementation
Of Practice Internal ControlsOf Practice Internal Controls
The Front DeskThe Front Desk
Billing/CollectionBilling/Collection
The Business OfficeThe Business Office
Accounts PayableAccounts Payable
Look for Signs of Financial Look for Signs of Financial ProblemsProblems
Sudden Change in A/R Tendencies Failing to Reach Benchmarks Sudden Changes in Production by
Doc Escalating Overhead Costs Doctors Holding Their Paychecks Cannot Pay Vendors Timely Borrowing Money
Are you taking care of the physician’s personal finances Adequately insured Asset protection Retirement planning Is a will in place Estate planning Building Net Worth
Example of Specialized Service
PRACTICE MANAGEMENT REPORTING
(You can’t manage what you don’t measure)
ConceptsConcepts
Numbers Don’t Lie!!!! Benchmarking
Only one benchmark that counts: Did the physician make more money this year than last year
Practice Management Practice Management ReportsReports
PMR For the Practice By Individual Physician On a Comparative Basis
Clinical Activities Reports Accounts Receivable Reports Dashboard Indicator Report
The NumbersThe Numbers
• Gross Collection Percentage• Net Collection Percentage• Days in A/R• A/R Ratio• A/R in excess of 90 days old• This year better than last year?• Clinical Encounters• Provider Work RVUs• Referring doctor trends
Organizations to Join
Medical Group Management Assn– www.mgma.com
American Health Lawyers Assn– www.healthlawyers.org
Healthcare Listservs
MGMA Discussion Groups– www.mgma.com
Part-B Listserv– www.partbnews.com
AHLA listservs
Keys to Success
Quit using the “I don’t have time” excuse Make a commitment as a Firm Stay very hands-on with your MD clients
– Stay visible!
Work for free if you have to (to shorten the learning curve)
Questions and Answers
Reed Tinsley, CPA, CVA, CFP, CHBC