Revenue Boosting and Cost Cutting Strategies for Smaller Medical Practices

A Sermo poll conducted in 2010 found that 26% of solo physicians (single physician practices) had either closed their practice or were considering closing. For the smallest practices, cash flow concerns are such that a delay in reimbursement can jeopardize their survival.

Some solo physicians are switching to a cash-only model and/or becoming non-participating insurance providers. Many solo physicians and smaller medical practices have turned to practice management companies for assistance but these relationships don't always solve their problems.

When cash flow is an issue, consider the following strategies for bringing in additional revenue and trimming operating costs:

1. Find revenue opportunities

Most solo practices find that income is limited by the number of patients seen per day. If the physician cannot see additional patients, it may make sense to add nonphysician providers (NPPs) who can deal with routine cases. If the physician has additional capacity, then consider adding a wider range of related services, econsults, and extended hours.

2. Take a close look at staffing and productivity

With the high cost of staffing, it's important to make the best use of your staff. Start by comparing your staffing levels with your peers and find ways to increase staff productivity. Technology (e.g., EMRs, electronic billing) can be tremendously helpful.

Some practices have no support staff. This is not to say that support staff are unimportant but that certain aspects can be outsourced or automated using technology (e.g., adding an online patient portal can reduce demands on your existing staff and allow patients the convenience of paying bills, requesting appointments, making prescription refill requests and so forth, online.)

Appointment reminder calls and other routine correspondence (e.g., account balance notifications, lab test results reporting) with patients can easily be handled with greater reliability and at a much lower cost by a good automated telephone reminder service. These services usually automatically capture contact attempts and the results of each contact attempt. They can also offer multilingual messaging, custom scripts, and so forth.

Replacing your live answering service with an automated answering service is another way that technology can save money for your practice. A good automated service can provide all the services of a live answering service (e.g., message taking, new message notification, on-call physician scheduling) with superior speed, accuracy, and consistency.

3. Control your no shows

Every practice should track no shows and rescheduled appointments. Tracking is the first step to understanding the extent of the problem and the urgency of finding solutions to improve one's no show rate. Physicians should be alerted of no shows and the tracking data should be analyzed for patterns (e.g., missed appointment rates could vary by date, by time, by how many days in advance the appointment was set, type of appointment, etc.).

It's important to actively manage your no shows. Be sure to send appointment reminders. Lower no shows further by asking for confirmations. For missed appointments, a good follow-up process, one that emphasizes the importance of the appointment, should improve kept appointment rates.

4. Take advantage of federal incentives

The federal government offers several incentive payment programs, including those for ePrescribing, electronic health records systems, Value Based Purchasing (VBP) incentives, and reporting of quality measures to Medicare under the Physician Quality Reporting System (PQRS).

Adopting new strategies that increase cash flow and improve productivity can keep your small practice afloat and increase its value when you decide to retire or sell.
Susan Linton is an expert in healthcare technology.