3 overlooked ways to reduce practice expenses

Just like households, the expenses of running a medical practice are constant, and at times surge with seemingly no peak in sight.

In fact, coping with rising operating costs has been one of practice managers' top struggles for six years running, according to survey data from the Medical Group Management Association.

But there are ways to keep some expenses at bay. And as we've written previously, every little bit helps. Here are three ideas any practice can use to help stretch its budget:

1. Create an intern program. Hiring students to do administrative work in your practice not only allows you to trim payroll costs, but it may also help your organization grow its own future workforce. At Mission Hospital, an 800-licensed-bed facility employing more than 8,000 people in Asheville, the aim of inviting students as early as the junior high level to participate in intensive internship programs is just that, said Sheila Meadows, Mission's vice president of human resources, for a new FierceHealthcare eBook, Human Management in Healthcare: Hiring Right to Meet the Demands of Healthcare Reform.

Mission then keeps up with graduates of its programs through college and beyond, and currently employs some of its former interns. "We've found that it saves a lot of time. It also gives students who are just graduating a chance to not only showcase themselves but also to connect with purpose and the vision of the organization," she said. "The program has worked very well for us."

2. Be smart about your space. Indoors and out, your physical space is one of the top factors that can help turn patients on or off to your practice. As we advised earlier this month, investments in an efficient floor plan within your office and adequate, convenient parking outside could potentially pay for themselves by saving steps and frustration among patients as well as staff.

Even if you're not shopping for a new office space, there are ways to better optimize your existing one. For example, try tying a string around the finger of a nurse and have her take all of the steps that she ordinarily would when taking care of a patient, Debra Wiggs, vice president of physician's services at St. Joseph Regional Medical Center in Lewiston, Idaho, recommended in an article in Renal & Urology News. Most of the time, the result will resemble a big spider web, she said, making it clear where you could make tweaks to reduce unnecessary steps.

3. Optimize your technology. I've been a smartphone owner for at least five years. And even though I discover technological tricks to make my life easier all the time, I'm sure there are plenty more useful features I'm not using to my advantage. The same philosophy goes for your electronic health record and practice management system.

While it makes sense that when you're learning the new system, it's enough to just learn the basics you need to do your job, without becoming overwhelmed with the bells and whistles. But after your productivity is back at target, consider inviting your vendor (or a colleague using the same system) back to show you the nuances. For example, is your EHR integrated properly into your billing system? In some cases, using this technology can eliminate the need for as many FTEs in your billing department, said Owen Dahl, an independent consultant in the Woodlands, Texas. On the other hand, an incorrect setup could cost you missed revenue, he added.

For example, Dahl recounted the story of a hospital-owned practice he worked with that had integrated the practice into the hospital's

billing system, which was programmed to write off any balances of less than $30. "$30 is half a patient visit for a primary care doctor," he said. "So the primary care doctor was losing half of her revenue," he said.

With all of these examples, the moral of the story is to never become complacent that your operations are as tight as they could be. Don't be afraid to look outside the practice world for ideas, such as by adopting an idea similar to Mission Hospital's internship program. At the same time, if your practice undergoes a major change, such as a new location or sale, don't assume that everything that worked under the old structure will be optimal for the new. - Deb (@PracticeMgt)