"Don't invest in technology that ties you exclusively to a particular vendor. As we move more to accountable care, a lot of the technology will have to be redesigned for new revenue sources," she says.
Consider collection safeguards
Just staying on top of basic financial management is often easier said than done, notes Judy Boesen, a practice consultant Bee hired to manage several functions of the practice to free them up for patient care, and who consulted with the partners on establishing their payment model.
For her physician clients in more traditional insurance relationships, Boesen helps establish a credit card payment system so that patients are automatically billed once the insurance company processes a claim.
"If you don't do this, you know that the physician bill is usually the last to get paid because the patient now feels better and has moved on," she says.
Don't saddle an ill-trained staffer with major financial management responsibilities, says Boesen.
"You can't rely on a medical assistant or a receptionist to be the office manager anymore," she says. "You need a qualified manager to keep you compliant with OSHA, HIPAA, and even labor laws. You also need someone who can look at your expenses for ways to save money."
Even if you hire an outside accountant to manage the books, someone inside the practice needs to keep an eye on what's going out the door, Boesen says, recalling several times when she was able to flag and correct unexplained hikes in previously negotiated fees for practice supplies, while consulting with practices.
Boesen also assisted Bee's practice with defining staff salaries and handling requests for raises and time off. "When you work so closely it's sometimes hard to put on the business hat and say no to a request," says Bee. "With this arrangement that awkwardness is removed."
Plan for future challenges
Finally, don't just think about the bottom line when it comes to your practice financials, Terrell says. Think about the top line.
"If you're in a primary-care practice and 30 percent of your revenue comes from acute-care office visits, and now patients are bypassing you and going directly to Walgreens, then you need to think about new revenue sources," she says.
"I think you can expect multiple problems with financials in the coming years as we face an increasingly complex world and disruptions in revenue. It's important to anticipate this and not just throw in the towel."
Janet Kidd Stewart is a freelance writer based in Marshfield, Wis. She holds a bachelor's degree and master's degree from the Medill School of Journalism at Northwestern University. She can be reached at [email protected].
This article originally appeared in the June 2014 issue of Physicians Practice.