Leading a Highly Profitable Practice in an Age of Uncertainty A Workshop for Doctors

Transcription

1 Leading a Highly Profitable Practice in an Age of Uncertainty A Workshop for Doctors

2 Leading Profitably in Uncertain Times The Goal of this Workshop Equip you with the tactics, strategies, tools, and methods you need to make important (and any) decisions you face

3 Where are you Sitting? Solos Docs with Solo Docs Mutli Docs with Multi Docs Good balance per table?

4 The Agenda 8:35-9:15 Lecture from the presenters 9:15-10:00 Work as a Team at Your Table 10:00-10:30 Break 10:30-12:00 Board Presentations and Discussion

5 Using Data to Act Decisively as a CEO Copyright 2016 Top Practices,

6 The information contained in these presentations will help you make prudent decisions during the workshop exercise! Copyright 2016 Top Practices,

7 Emotionally React or Intellectually Respond The Choice is YOURS

8 Understanding Profitability and Costs

9 Leverage

10 Fixed Versus Variable Expenses

11 Fixed costs do not vary with output, while variable costs do

12 Fixed Costs Variable Costs Rent Supplies Insurance Staff Loan Utilities Payments Executive Lab Fees Salaries Depreciation Opportunity Costs

13 Hidden Costs

14 Opportunity Costs The cost of an alternative that must be forgone in order to pursue a certain action, or the benefits you could have received by taking an alternative action.

15 In making many decisions, it s essential to understand how the decision affects fixed, variable, and opportunity costs.

16 A contract is proposed that could bring in 500 new patients. What information do you need to decide if that contract is a Hero or a Zero?

17 üpayer Fee schedule/ demographics üyour Current Total Costs Per Patient üyour Current Variable Costs Per Patient üa Prediction of Your Opportunity Costs üyour Customer Acquisition Costs ü An Acceptable Margin

18 Price Versus Costs

19 Suppose you buy a gallon of gas for $1.99. How much did it cost you?

20 Lets assume that your total federal income tax, state income tax, local taxes and Social Security and Medicare taxes come to about 35 percent of your salary

21 That means that your need to earn $3.00 in order to pay for $1.99 worth of gas after taxes.

22 So while the PRICE of a gallon of gas is $1.99, it COST you $3.00 worth of sacrifice. You MUST use that same type of thinking in your practice decisions

23 Then There are Externalities Externalities Explicit/Im plicit Costs

24 Explicit Cost + Large Negative Externality Explicit Cost + Large Positive Externality

25 Externalities are pervasive in practice management decisions!

26 Leadership Great leaders develop leaders around them. They get the entire team involved. Do your potential growth areas have the needed leaders to accomplish the task?

27 Executive Personnel Marketing/P R Finance/Account ing Production Quality Control Hiring/Trainin g Increased Claims Increased Rejection Rate Practice Overhead PVV Capacity Issues # of Tx Rooms # of Docs # of MA s R or =Q P&S

28 Recruiting Anticipate team capacity and talent needs Job one is WHO Always be hiring Recruit for where you will be, not where you are...if you can

29 Eric Schmidt, Executive Chairman, Google Copyright 2016 Top Practices, LLC Do Not

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32 Recruiting Measure for leadership potential Go slow Interview deeply Value yourself and your business highly

33 Creating Buy-In Leadership knows the critical goal/s Meet with your team Relate critical goal/s Reasons why... (Change is hard) Communicate upside and downside.

34 Creating Buy-In Upside... We have a new opportunity with X, Y, Z Group and this is really going to feed our patient load. This will allow us to X, Y and Z...

35 Creating Buy-In Downside... This will require a few changes in our systems. But if we don t do this... all kinds of bad things will happen.

36 Creating Buy-In Simple... Communicate the upside? Communicate the downside?

37 Creating Buy-In Leadership knows the critical goal/s Meet with your team Relate critical goal/s Reasons why... (Change is hard) Communicate upside and downside.

38 Creating Buy-In Who should determine the critical steps? Those within 12 feet of the job! W. Edwards Demming 14 Points of Quality

39 Creating Buy-In The team determines critical steps Leadership approves & provides feedback Leadership steps back Meet with this team regurlarly Discuss ONLY this goal Coach for performance.

40 Managing a Project What needs to be done? By When? Who s responsible? Break it down in 12 week plans

41 Marketing and Budgeting Any Decision like this is greatly helped if you are already set up in your marketing pillars. Just use it!

42 Marketing and Budgeting Online Marketing: Website, social media, ads( build an ad budget for this) videos, s Referral Marketing: Increased Outreach to all medical and non-medical referral sources (this can include printed materials to be handed out)

43 Marketing and Budgeting Internal Marketing Direct Mail: newsletters, letters, postcards campaigns Social Media Campaigns with videos Signage in office Staff Training and scripting Events (educational in the office)

44 Marketing and Budgeting External Advertising, print and online TV/Radio Event marketing

45 Your Scenario As the CEO of a podiatry practice, you are faced with an interesting proposal. An Accountable Care Organization (ACO) is interested in having you become their dedicated podiatrist. It could possibly mean that you will now have access to 10,000 lives that you currently do not have. They will provide you (complimentary) with an electronic health record that you must use for their subscribers, which differs from the one that you use in your office. In order to accommodate the needs of some of their disabled beneficiaries, they are mandating that you build a ramp for easy access from your parking lot to your office. They will not cover this cost.

46 Your Scenario Your role as CEO is going to be to guide your team using the knowledge learned during today's presentations. Ultimately, you MIGHT be delivering a presentation to your Board of Trustees addressing the following 6 areas:

47 Your Scenario ü Your decision and how and why you made the decision ü A short verbal Executive Summary of your decision (Financial implications) ü Leadership skills needed to gain acceptance of the decision (learning curve of the new EHR, etc) ü Any recruitment plans (HR) ü Budget and Marketing plan (Marketing) ü Roll out and execution (Operations)

48 Data from your practice Ø Total Operational Overhead 62% Ø CURRENT Total Patient Volume 12,000 visits/ year Ø CURRENT Variable Expense per patient $25 Ø CURRENT Per Visit Revenue $ Ø CURRENT Staff Level 4.5 FTE Ø Marketing Budget $50,000 /year Ø Cost of ramp $11,000 Ø Based upon your CPT analysis compared to the ACO s fee schedule, the average Per Visit Revenue across your most widely used CPT codes is $100.00

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