MGMA 2009: Practice leaders discuss "managing in hard times"

While Sunday is still the "slow day" at conferences like MGMA 2009, the knowledge-sharing sessions are already rolling along. One example of what late attendees are missing was this street-level view of the squeeze on medical groups by two practice leaders from an Oxford, MS gastroenterology practice.

To warm up the crowd, practice administrator Roger Frank, MHA of Gastroenterology Associates of North MS [1], and David Harano, MBA, MHA, executive director of the practice, got audience members talking about their toughest challenges. Responses ranged from patient no-shows, to the cost of EMRs, to coping with patients whose high-deductibles (up to $25,000 in one case!) leave them virtually uninsured for routine care.

Then, the talk got even more depressing. Even if there wasn't the rough economy to consider, the speakers noted, there's the usual regulatory and reimbursement challenges practices face, including HIPAA and OSHA compliance. And of course, coping with CMS requirements--and the RAC audits that may follow--are particularly scary. What's more, practices face not only competition from practices in their specialty and neighborhood, but also hospitals that hire physicians and bring those physicians' referrals with them.

Sounds pretty hopeless, no? Well, not necessarily, the two suggest. In their experience, there's a wide range of options practices can consider to expand their income.

For example, they suggest making sure your practice has revenue streams in place beyond the core business. In gastroenterology, that might mean an in-house pharmacy, hypnotherapy ultrasound, banding, argon lasers and even real estate investment [2], just to name a few of their examples. (Though they didn't mention this, readers know that primary care practices have tons of options too, including "medical spa" options [3] like Restylane and Botox, laser hair removal, wellness services such as massage therapy, in-house dispensing and even complimentary medicine.)

Other options they suggest include negotiating higher rates from managed care players, increasing charges, using mid-level providers in addition to physicians, decreasing room turnover time, extending hours and improving collections [4].

Meanwhile, cutting costs is smart too. Frank and Harano suggest steps like decreasing staff benefits, using refurbished equipment, eliminating unprofitable services, consolidating offices and even contemplating a merger to decrease overhead. They're also fans of implementing EMRs, which they say can cut staff time spent searching for charts and transcribing notes, among other benefits.

Truth be told, it seems like Frank and Harano have developed one heck of a checklist to consider when you're trying to tighten up your financial ship. 

For many more detailed recommendations, including methods for incentivizing staffers and measuring ROI on services:
- read this HCPLive piece [5]

Related Articles:
MGMA: Finances, EMR top 2009 challenges for practices ... [6]
Investors choosing medical real estate as safe haven [7]
MGMA AC 2008: Survey shows practices' expenses rising faster than revenue [8]