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7 Effective Habits of
  Highly Profitable
  Medical Practices

                Presented by
               David J. Zetter,
  PHR, CHCC, CHCO, CPC, CPC-H, PCS, FCS, CHBC
                                            Presented by
                                            David J. Zetter,
     PHR, CHCC, CHCO, CPC, CPC-H, PCS, FCS, CHBC


                                                               1
                 © 2012 Zetter HealthCare
Disclaimer
                                                      2




• No copyright claimed on government material or
  information. This material is designed to offer basic
  information. The information presented is based on
  the experience, training and interpretation of the
  author. Although the information has been carefully
  researched and reviewed for accuracy and
  completeness, neither the author, DecisionHealth or
  Part B News accept any responsibility or liability with
  regard to errors, omissions, misuse or
  misinterpretation.


                                                          2
                    © 2012 Zetter HealthCare
Takeaways

Understand what kind of practice you
have
Real life examples of how to be more
profitable
Specifics on what and how to
implement at your practice
ZHC Dashboard & Benchmark Tool



                                            3
          © 2012 Zetter HealthCare
What Are Your Habits?

• Bad things happen to good practices
• What is causing the losses?
• How do you determine the issues?
• What can be done to turn losses into
  profits?
• What does YOUR future hold for you?



                                         4
            © 2012 Zetter HealthCare
What Are Your Habits?

Self-improvement development plan?
Staff performance evaluations &
development plans?
Annual business plan?
Daily, weekly, monthly monitoring &
measuring?
Involved with the business or just go to
work everyday?

                                       5
           © 2012 Zetter HealthCare
Change Your Habits

Be the change agent
Lead to better results
Become a colleague of the
owner(s)/physicians
Ensure the future of the business
Ensure YOUR future!



                                          6
           © 2012 Zetter HealthCare
Change Your Habits

Be the change agent
Practices that excel
  Profitability & cost management
  Productivity, patient capacity & staffing
  Accounts receivable & collection
  Patient satisfaction
Utilize staff & teams in appropriate
ways

                                              7
            © 2012 Zetter HealthCare
Effective Habits


         #1
Run the business like a
      business

                                               8
      © 2012 Zetter HealthCare
Effective Habits
#1 - Run the business like a business
    Focus – 3 phases of practice
    Job vs. career
    Strategy & vision = plan
    Seek counsel from experts
    Goals = success
     • Ever changing, living, breathing
  – Vested interest / “skin in the game”
  – Be creative
  – Evidence based management
                                                        9
               © 2012 Zetter HealthCare
Effective Habits


   #2
Cash flow



                                        10
© 2012 Zetter HealthCare
Effective Habits
#2 – Cash flow
    Everyone works cash flow
     • A/R (collections)
  – Communications (360o)
     • What works, what doesn’t
    Payer contracts & negotiations
    Daily, weekly, monthly, quarterly goals
     • Metrics
  – Billing & reimbursement compliance plan


                                                         11
                 © 2012 Zetter HealthCare
Effective Habits


         #3
Monitor productivity,
 capacity & staffing

                                             12
     © 2012 Zetter HealthCare
Effective Habits

#3 – Monitor Productivity, Capacity &
Staffing
    Physical layout affects patient flow
    Hours of operation
    Scheduling (maximize)
    Patient flow
    –   Reception vs waiting
    –   Location timing
    –   Provider flow – “handler”
    –   Care coordination


                                                         13
                 © 2012 Zetter HealthCare
Effective Habits

#3 – Monitor Productivity, Capacity &
Staffing (cont.)
    Back up plans
     – Partner w/ other practices
  • Always recruit to upgrade
  • What do you look for in a candidate?




                                                         14
                 © 2012 Zetter HealthCare
Effective Habits


        #4
Patient Satisfaction



                                             15
     © 2012 Zetter HealthCare
Effective Habits

#4 – Patient Satisfaction
    Personality & attitude
    Welcoming/inviting atmosphere
    Reception vs waiting
    Patient portal
     – Reduce time in “waiting”
  • Caring & helpful
  • Surveys




                                                         16
                 © 2012 Zetter HealthCare
Effective Habits

#4 – Patient Satisfaction (cont.)
    Where patients come from
    Internet & social media presence
    Highlight team role in PT satisfaction
    Highlight successes
    Employee morale/satisfaction




                                                      17
              © 2012 Zetter HealthCare
Effective Habits


        #5
Monitor, evaluate &
  communicate

                                             18
     © 2012 Zetter HealthCare
Effective Habits

#5 – Monitor, Evaluate & Communicate
   MBO
   MBWA
   Job descriptions w/ responsibilities
   Training, cross training & education
   Regular evaluations and communications
   Accountability




                                                      19
              © 2012 Zetter HealthCare
Effective Habits


         #6
Strategic planning &
      budgets

                                             20
     © 2012 Zetter HealthCare
Effective Habits

#6 – Strategic Planning & Budgets
    Ensure/insure your future
    Budgets?
    Not increasing prior year revenues & expenses
    Built from scratch
    Careful consideration
    Review admin & clinical staffing levels
        – Largest expense & most control




                                                        21
                © 2012 Zetter HealthCare
Effective Habits

#6 – Strategic Planning & Budgets (cont.)
      Benchmarks/Best practices
      Contracts & fee schedules
      – Tremendous revenue leaks
  •   Owner goals
  •   Your goals
  •   Complacency
  •   If not growing… Doomed!


                                                       22
               © 2012 Zetter HealthCare
Effective Habits


         #7
Practice dashboards
 & benchmarking

                                             23
     © 2012 Zetter HealthCare
Effective Habits

#7 – Practice Dashboards & Benchmarking
    What is monitored & measured?
    What’s important?




                                                     24
             © 2012 Zetter HealthCare
Effective Habits




                                        25
© 2012 Zetter HealthCare
Effective Habits

Gross Collection Ratio
 Payments / Charges = GCR
 Selected timeframe based on dates of service


Adjusted (Net) Collections Ratio
 Payments (less credits) / Charges (less
approved contractual adjustments) = ACR
 Selected timeframe based on dates of service


                                                      26
              © 2012 Zetter HealthCare
Effective Habits

Days in A/R
 Total current receivables net of credits /
practice’s average daily charge amount


A/R > 120 Days
  Dollar amount of A/R > 120 from date of
service / Dollar amount of total A/R




                                                       27
               © 2012 Zetter HealthCare
Effective Habits

First Pass Rate
  Total clean claims / Total claims
  The percentage of claims that can be
submitted without any problems or human
involvement
  Use a designated period of time

Denial Rate
 Total dollar amount of denied claims / Total
dollar amount of submitted claims
 Use a designated period of time
                                                       28
               © 2012 Zetter HealthCare
Effective Habits

Average Paid Percent
•Sum of payments / Sum of submitted charges

Average Reductions Percent
  Sum of payer’s contractual and other
reductions / Sum of submitted charges




                                                       29
               © 2012 Zetter HealthCare
Effective Habits

What are we accomplishing today?
Have a plan…
Take the business to the next level
Visualize
  Steps
  Strategies
Vs. being controlled


                                                       30
               © 2012 Zetter HealthCare
Effective Habits

Cash is KING!
From your ear to the bank account
Evaluate all systems/processes &
controls




                                                  31
          © 2012 Zetter HealthCare
The Facts – Highly Profitable Practices


Less bad debt
Collect receivables more quickly
Implement operational efficiencies
Hire more qualified staff
Utilize mid-level providers properly
Have higher patient satisfaction



                                       32
           © 2012 Zetter HealthCare
In Closing

     Inspect what you expect.


You cannot manage what you do not
            measure!




                                           33
         © 2012 Zetter HealthCare
For Follow-up & Further Questions
               Contact:



             David J. Zetter,
PHR, CHCC, CHCO, CPC, CPC-H, PCS, FCS, CHBC

                 717.691.7100
          Email: djzetter@zetter.com

         Subscribe to our newsletter at




             Follow us on
           www.twitter.com/djzetter
                     and


          www.linkedin.com/in/djzetter

                                              34
              © 2012 Zetter HealthCare

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7 Effective Habits Of Profitable Medical Practices

  • 1. 7 Effective Habits of Highly Profitable Medical Practices Presented by David J. Zetter, PHR, CHCC, CHCO, CPC, CPC-H, PCS, FCS, CHBC Presented by David J. Zetter, PHR, CHCC, CHCO, CPC, CPC-H, PCS, FCS, CHBC 1 © 2012 Zetter HealthCare
  • 2. Disclaimer 2 • No copyright claimed on government material or information. This material is designed to offer basic information. The information presented is based on the experience, training and interpretation of the author. Although the information has been carefully researched and reviewed for accuracy and completeness, neither the author, DecisionHealth or Part B News accept any responsibility or liability with regard to errors, omissions, misuse or misinterpretation. 2 © 2012 Zetter HealthCare
  • 3. Takeaways Understand what kind of practice you have Real life examples of how to be more profitable Specifics on what and how to implement at your practice ZHC Dashboard & Benchmark Tool 3 © 2012 Zetter HealthCare
  • 4. What Are Your Habits? • Bad things happen to good practices • What is causing the losses? • How do you determine the issues? • What can be done to turn losses into profits? • What does YOUR future hold for you? 4 © 2012 Zetter HealthCare
  • 5. What Are Your Habits? Self-improvement development plan? Staff performance evaluations & development plans? Annual business plan? Daily, weekly, monthly monitoring & measuring? Involved with the business or just go to work everyday? 5 © 2012 Zetter HealthCare
  • 6. Change Your Habits Be the change agent Lead to better results Become a colleague of the owner(s)/physicians Ensure the future of the business Ensure YOUR future! 6 © 2012 Zetter HealthCare
  • 7. Change Your Habits Be the change agent Practices that excel Profitability & cost management Productivity, patient capacity & staffing Accounts receivable & collection Patient satisfaction Utilize staff & teams in appropriate ways 7 © 2012 Zetter HealthCare
  • 8. Effective Habits #1 Run the business like a business 8 © 2012 Zetter HealthCare
  • 9. Effective Habits #1 - Run the business like a business Focus – 3 phases of practice Job vs. career Strategy & vision = plan Seek counsel from experts Goals = success • Ever changing, living, breathing – Vested interest / “skin in the game” – Be creative – Evidence based management 9 © 2012 Zetter HealthCare
  • 10. Effective Habits #2 Cash flow 10 © 2012 Zetter HealthCare
  • 11. Effective Habits #2 – Cash flow Everyone works cash flow • A/R (collections) – Communications (360o) • What works, what doesn’t Payer contracts & negotiations Daily, weekly, monthly, quarterly goals • Metrics – Billing & reimbursement compliance plan 11 © 2012 Zetter HealthCare
  • 12. Effective Habits #3 Monitor productivity, capacity & staffing 12 © 2012 Zetter HealthCare
  • 13. Effective Habits #3 – Monitor Productivity, Capacity & Staffing Physical layout affects patient flow Hours of operation Scheduling (maximize) Patient flow – Reception vs waiting – Location timing – Provider flow – “handler” – Care coordination 13 © 2012 Zetter HealthCare
  • 14. Effective Habits #3 – Monitor Productivity, Capacity & Staffing (cont.) Back up plans – Partner w/ other practices • Always recruit to upgrade • What do you look for in a candidate? 14 © 2012 Zetter HealthCare
  • 15. Effective Habits #4 Patient Satisfaction 15 © 2012 Zetter HealthCare
  • 16. Effective Habits #4 – Patient Satisfaction Personality & attitude Welcoming/inviting atmosphere Reception vs waiting Patient portal – Reduce time in “waiting” • Caring & helpful • Surveys 16 © 2012 Zetter HealthCare
  • 17. Effective Habits #4 – Patient Satisfaction (cont.) Where patients come from Internet & social media presence Highlight team role in PT satisfaction Highlight successes Employee morale/satisfaction 17 © 2012 Zetter HealthCare
  • 18. Effective Habits #5 Monitor, evaluate & communicate 18 © 2012 Zetter HealthCare
  • 19. Effective Habits #5 – Monitor, Evaluate & Communicate MBO MBWA Job descriptions w/ responsibilities Training, cross training & education Regular evaluations and communications Accountability 19 © 2012 Zetter HealthCare
  • 20. Effective Habits #6 Strategic planning & budgets 20 © 2012 Zetter HealthCare
  • 21. Effective Habits #6 – Strategic Planning & Budgets Ensure/insure your future Budgets? Not increasing prior year revenues & expenses Built from scratch Careful consideration Review admin & clinical staffing levels – Largest expense & most control 21 © 2012 Zetter HealthCare
  • 22. Effective Habits #6 – Strategic Planning & Budgets (cont.) Benchmarks/Best practices Contracts & fee schedules – Tremendous revenue leaks • Owner goals • Your goals • Complacency • If not growing… Doomed! 22 © 2012 Zetter HealthCare
  • 23. Effective Habits #7 Practice dashboards & benchmarking 23 © 2012 Zetter HealthCare
  • 24. Effective Habits #7 – Practice Dashboards & Benchmarking What is monitored & measured? What’s important? 24 © 2012 Zetter HealthCare
  • 25. Effective Habits 25 © 2012 Zetter HealthCare
  • 26. Effective Habits Gross Collection Ratio Payments / Charges = GCR Selected timeframe based on dates of service Adjusted (Net) Collections Ratio Payments (less credits) / Charges (less approved contractual adjustments) = ACR Selected timeframe based on dates of service 26 © 2012 Zetter HealthCare
  • 27. Effective Habits Days in A/R Total current receivables net of credits / practice’s average daily charge amount A/R > 120 Days Dollar amount of A/R > 120 from date of service / Dollar amount of total A/R 27 © 2012 Zetter HealthCare
  • 28. Effective Habits First Pass Rate Total clean claims / Total claims The percentage of claims that can be submitted without any problems or human involvement Use a designated period of time Denial Rate Total dollar amount of denied claims / Total dollar amount of submitted claims Use a designated period of time 28 © 2012 Zetter HealthCare
  • 29. Effective Habits Average Paid Percent •Sum of payments / Sum of submitted charges Average Reductions Percent Sum of payer’s contractual and other reductions / Sum of submitted charges 29 © 2012 Zetter HealthCare
  • 30. Effective Habits What are we accomplishing today? Have a plan… Take the business to the next level Visualize Steps Strategies Vs. being controlled 30 © 2012 Zetter HealthCare
  • 31. Effective Habits Cash is KING! From your ear to the bank account Evaluate all systems/processes & controls 31 © 2012 Zetter HealthCare
  • 32. The Facts – Highly Profitable Practices Less bad debt Collect receivables more quickly Implement operational efficiencies Hire more qualified staff Utilize mid-level providers properly Have higher patient satisfaction 32 © 2012 Zetter HealthCare
  • 33. In Closing Inspect what you expect. You cannot manage what you do not measure! 33 © 2012 Zetter HealthCare
  • 34. For Follow-up & Further Questions Contact: David J. Zetter, PHR, CHCC, CHCO, CPC, CPC-H, PCS, FCS, CHBC 717.691.7100 Email: djzetter@zetter.com Subscribe to our newsletter at Follow us on www.twitter.com/djzetter and www.linkedin.com/in/djzetter 34 © 2012 Zetter HealthCare

Editor's Notes

  1. The situation could be traumatic or catastrophic, as in an office fire or computer crash, or – more likely – it could be subtle and compounding, as in unnoticed embezzlement, billing irregularities or an increase in overhead. If you kept track of every administrative detail in your practice, you wouldn't have time to see patients. You have to triage this work in order to be effective and efficient. Just as you work with your clinical staff to monitor the vital signs of your patients, you and your front-office staff can monitor the “vital signs” that reveal your practice's financial health.
  2. The most productive and profitable group practices have the most efficient workflows The right people, doing the right job at the right time
  3. 3 phase of practice revenue, expenses, profit/net income/owner compensation
  4. Everyone works cash flow scheduling/recalls/phone people check-in/front desk clinicians/triage providers ancillaries check-out billing dept OM/Administrator accountant consultants
  5. Reception vs waiting cabel/wi-fi/kids toys/reading materials, etc Surveys Act on information and disseminate
  6. Employee morale/satisfaction direct impact on patient satisfaction Patient satisfaction culture Bragging patients Word of mouth advertising Innovate / embrace change TRANSPARENCY is here!
  7. MBWA Walk in their shoes 360 evaluations & staff meetings allow staff to set portion of the agenda Regular review of work & special projects What about meetings with owners Rewards & recognition
  8. Real budget isn’t prepared by simply increasing prior year revenues and expenses by an arbitrary percentage; it’s built from the ground up and requires careful consideration of each line item.  From a revenue perspective, be sure to consider any changes in patient demographics, variances noted in the procedure mix, and changes to insurance plans accepted. From an expense standpoint, really spend some time on administrative and medical staffing levels as well as their compensation packages. This is one of the areas where the management team has the most control when it comes to costs.
  9. http://www.linkedin.com/in/djzetter