Services (What I Can Do For You)
These days the "practice of medicine" and the "business of medicine" run full-force into each other on a daily basis. They're inextricably linked.
In this volatile, bottom-line-driven health care environment it's no longer good enough for doctors to be great practitioners. A reception area full of patients may seem to indicate a thriving, successful practice. But if each of those patients is not brining a reasonable profit to your bottom-line then maybe you've won the battle (gaining access to patients) but ultimately you've lost the war (providing care at unsustainable reimbursement rates).
This is today's reality for physicians and administrators: You're running a business, and you're certainly not in that business to provide care for free or at a loss. If you're on this website then you're looking for realistic answers and practical business solutions that will allow you to do the work you enjoy and, at the same time, have a better quality of life and build equity in the practice.
You've come to the right place.
You can be confident selecting me as your practice management and/or managed care consultant. This site and my focus are all about helping you to implement effective business solutions to sometimes-complicated operational issues.
Here is a partial list of the business services and solutions I provide:
- Managed care contract review and analysis
I will explain in a clearly written report what a contract (Provider Agreement) really says and means to your practice from a business perspective. I will provide suggested ways to make the contract more physician-friendly. I will also suggest alternate, sample language that can be used as a starting point for discussions and negotiations. With this information in hand you will be able to make confident, informed decisions if contracts make sense for your practice.
- Third-party contract negotiation strategies
I will teach you how to negotiate with payers. You'll learn from my years of experience on the "inside" working on contracts for a national HMO. I'll explain which terms can and should be negotiated, which cannot, which terms can be given-up if necessary, and which are the deal-breakers (and why).
- Third-party negotiating
I will work with you to "craft the deal," and support your negotiations with payors. Or, if you prefer, I will negotiate directly with payors and represent your practice or ambulatory surgical center.
- Fee schedule analysis
I will work with you to assure that your fee schedule(s) is in order so that you receive the maximum allowable reimbursements from all third-party payors and leave no money on the table.
- Patient satisfaction surveys (including Mystery Shoppers) and referring provider satisfaction surveys
I will review existing documents or construct new survey instruments designed to effectively measure how well you're doing in the eyes of your patients and those practices that refer patients to you. I will help you through the data collection portion of the survey and with data analysis. Finally, I will show you how to use that data to effect meaningful change and then to measure your progress over time.
- Requests For Proposals (RFPs)
If you are purchasing instruments, equipment, or inventory for the practice I'll show you how to offer up an RFP designed to secure favorable pricing. If you are asked to respond to an RFP (for example, an exclusive contract proposal from an HMO), I'll show you how to respond so that decision-makers give it notice.
- Patient census and demographics analysis
If your patient census and revenues have dropped off unexpectedly, I will help you track down the source(s) of the problem and effect solutions to rebuild that which has gone missing.
- Benchmarking tools and analysis
I will help you identify key practice metrics that will allow you to track the practice's performance over time and measure its progress against baseline standards.
- Capitation rates development and analysis; Risk analysis
If you are considering a capitation or other at-risk contract I will help you understand both the administrative dynamics of accepting risk and the its potential impact on financial performance. You will understand the bottom-line results of per-member-per-month payments as well as the dynamics of utilization and population demographics. I will help you through the entire process so that if you do choose to negotiate capitation or other at-risk arrangements it will be from a position of knowledge and confidence in the numbers rather than from a feeling of fear and hopelessness.
- Optical dispensing A to Z
For those in eye care, I will help you construct and equip a new dispensary. Or I can help you with the management and operations of an existing dispensary, with hiring/firing and training, with personal policies, inventory control, purchasing, pricing, managed vision plans, and other issues central to running a profitable optical dispensary. I can also provide sales and lifestyle analysis training for opticians and other support staff.
- Designing and implementing local vision care plans
Again for those in eye care, if you're thinking of offering a local vision plan to the business community I will help you design a benefit package that will be attractive to patients, cost-effective for employers, and profitable for your practice. I will help you to evaluate the marketplace and identify the buyers, what they want, what they will pay for, and who makes up your competition.
- Operational reviews and analysis
Some of my clients have not identified specific issues but elect to engage me to come into their practices to provide a dispassionate, arms-length review of daily operations. While at first blush this might be perceived as the consultant going on a "fishing expedition" looking for problems it is, in fact, a search equally focused on determining strengths that can be built upon as well as weaknesses that need correction.
Projects typically start with a Letter of Understanding wherein I describe the services I am to provide to the client. The Letter of Understanding will also specify the professional fees and reimbursement of expenses, if any.
Fees depend on a project's complexity and length. Shorter engagements typically are billed on an hourly basis. Some longer projects are invoiced at a monthly rate or on a project (flat fee) basis. Still longer projects or those needing regular review can be done on a retainer.
Questions? Comments? Click here to send me an e-mail.
Or call (321) 433-0623.