The business of medicine becomes more complex each and every day. With the healthcare climate to become only more convoluted in the current political landscape, maximizing profits is an increasingly difficult undertaking. Navigating the maze of managed care, Medicare guidelines, and human resources is a dizzying prospect that few offices are truly prepared to address. Add to that the intricacies of contract negotiations, capital resources, and keeping up to date with IT solutions, it quickly becomes clear that streamlined and cost effective medical care are elusive. While most physician practices have developed expertise in the art of patient care, declining revenues have spawned growth of a practice management industry to lend expertise to medicines business side.
Kevin N. Fine, CEO of Prime Practices, LLC, one of Floridas most respected and proven healthcare executives, believes he has identified the most critical aspect of this business. “Delivering real returns on investments is what keeps us operating,” says Fine, “especially in an era when those returns are otherwise hard to find. This is why our clients refer their friends and colleagues. Without a meaningful impact to a practices bottom line, we would be just one more expense.”
By examining the specific needs of prospective clients, Prime develops and implements a business process improvement plan. Being vendor neutral is an important component, so that medical practices can benefit from independent relationships with legal, accounting, professional firms, and IT companies. “Our referral pipelines with medical billing, law firms and accounting firms have always been one of our strengths. They know we have the best interests of their clients in mind, and we will design an organizational structure specific to the needs of each medical practice. Clients have the opportunity to choose from a menu of offerings,” says Fine.
Dr. Randy Fink, Medical Director of the Miami Center of Excellence for Obstetrics & Gynecology, was leery at first. “Ive had a lot of people want to cash in on the success of my business,” says Dr. Fink. “I hired Prime with a single focus: to locate new office space, negotiate a new lease, and plan my space. Their service was to end with design and construction management.” Learning of additional services that Prime could provide opened the door to new possibilities for Dr. Finks practice. “I still have my office manager, but now Prime co-manages my practice. Having an extra set of eyes has only helped. New codes have been added to my superbill, equipment lease costs have been restructured and we are making more money.”
Giving a practice access to ancillary services internally allows clinicians to focus on patient care instead of administrative activities. Additionally, evaluating the complete revenue cycle and tempo of the practice allows a redesign of their business infrastructure. “What Prime does,” says Fine, “is to build a smarter practice. We deliver accountability, transparency, and responsibility. This lets a doc work smarter, not harder.”
We get in our car and immediately we have a complete overview of the cars operations, but when it comes to our business we usually wait for key reports to come to us. In todays world we have the ability to operate in real time. Is it more important to know how your car operates compared to your multi-million dollar medical practice? Just because a practice is profitable doesnt mean you are not leaving money on the table. Its not about how much money you make; its about how much money you dont make.
There is an old saying: “You dont know what you dont know.” This is why data is so powerful. The rules and regulations of each contract are complicated. Just because you are getting paid doesnt mean you are getting paid per the terms of your contracts. Most practices do not have the time or expertise to perform a revenue cycle assessment each month. Most do not have key performance indicators set to specific benchmarks. Many practices have the technology, but either do not or cannot use its power to drive revenue in real time. Competitive intelligence gathering provides a medical practice a better opportunity for improved profitability and enhanced workflow.
Even though we always hear insurance companies are not paying the providers, they do want to pay. They are just not in the business of paying when the terms of the contracts are not followed. They are complicated but with the advance of information technology and a proper infrastructure timely payments should be automatic. Technology is no longer an operational cost; its a revenue line item when used correctly.
Says Fine, “I tell my clients, Know your business, control your business, and exploit the power of data.”
