The delivery of high-quality care is the number one priority for emergency medicine physicians — but quality should be supported by sound financial management. Let’s take a look at four steps you can take to help you understand what is driving the bottom line at your practice.
Review basic financial reports and key metrics monthly
Three reports – the income statement, cash flow forecast and balance sheet – can give you a clear, concise indication of your group’s financial performance. From these reports, you can learn: How is your organization’s cash flow? How is revenue trending? Are there any outliers in expenses? What is the forecast for cash flow based on procedure volume, modality mix, payer mix and payment trends?
You want to compare current periods with prior years’ performance and against the budget to reveal variances and trends. Reviewing measures such as revenue per FTE, compensation package per FTE, and overhead as a percentage of total expense will also help you understand whether your practice’s performance is in line with your business plan and how your practice compares with other practices nationally.
Define relevant benchmarks
With regard to benchmarks, be sure to benchmark data that you consider important to the growth of your practice. Common measures are: work relative value units (wRVU) per shift worked, average patients & procedures per labor hour, average collections per hour and/or shift, average collection per patient, average W2 per wRVU, charges per day, average patient charge, E&M distribution, critical care percentage, procedures per patient and RVU per patient. Obtaining these measures is critical, but even more important is using this information to drive business decisions.
Start with accurate documentation and properly negotiated contract.
Although claim denials may end up in the business office, they often start in the physician’s office due to a lack of required, proper documentation. As an independent business owner, you need to stay up to date on proper documentation methods and continuous coding changes to lessen the likelihood of payment denials or long AR cycles. Identifying trends in front-end denials should lead to corrective training, education and action.
Similarly, practices must maintain and regularly review their payer contracts to ensure payer compliance and market rates are in place. For further guidance on payer negotiations, read the recent HFM magazine article by McKesson’s Rob Saunders on 5 Ways Physician Practices Can More Effectively Manage Payer Contracts.
Connect the dots
You need to keep in mind that each decision you make should comply with your group’s financial, strategic and patient care objectives. Therefore, your group should have a decision framework in place that provides an efficient process for making business decisions. For example: Who has authority to decide? What are the financial & shareholder compensation implications? Is there a downside/upside? How soon must the decision be made?
Jeff Akers, CPA, specializes in financial, business advisory, and practice management services for medical practices. As vice president of Financial Management at McKesson Business Performance Services, Akers provides strategic and financial analysis, performs practice reviews, prepares compensation plans, implements financial management best-practices and internal controls, and prepares cash flow forecasting for medical groups. Prior to joining McKesson, Akers provided consulting services to physician groups for a national healthcare services organization and spent five years in public accounting specializing as an auditor of healthcare systems.