Physicians who are managing medical practices and clinics have unique challenges.
The Jones & Roth Healthcare Team works with medical practices and clinics across Oregon & Southwest Washington providing a comprehensive suite of services including practice management, advisory services, retirement plan administration and tax & accounting services.
Our services are designed to ease the business-related pressure of practice operations and ownership:
- Practice assessment
- Key performance indicators
- Income Allocation
- Physician compensation
- Business plan development
- Establish procedures and policies
- Coding and documentation
- Contract review and negotiations
- Billing and collections reviews
- Employee recruiting, evaluation and development
- Retirement Plans
- Computer systems evaluation and implementation
- Interim practice administration
- Practice appraisals
- Financial advisory services
- Tax, audit and accounting services
- Payroll services
- Coding and documentation
“Medical practice management has become increasingly challenging. Our goal is to provide a level of guidance and service that results in superior financial management that facilitates excellence in patient care”
— Jeremy Prickel, CPA & Medical Practice Advisor
Jeremy Prickel, CPA
Nicole McOmber, CPA
Brian Newton, CPA
Mathew Hamlin, CPA
Elliott Tracy, CPA
Jennifer Howard, CPA
by Sophia Bennett
Declining reimbursement rates are one of the top problems facing medical clinics today. Given that private and government insurance plans are facing challenges of their own, this trend is likely to continue for a long time.
But there are things medical practices can do to combat the problem of shrinking reimbursements—and smaller profits overall. It’s important to really examine and understand your practice’s reimbursement contracts so you’re in a good position to negotiate with insurance companies.
And there are other things medical practices can do to keep expenses low and the bottom line looking healthy. Jeremy Prickel and Nicole McOmber with Jones & Roth CPAs and Business Advisors, one of Oregon’s largest CPA firms, share several of the tips they give clients looking to save money while never compromising patient care.
Be Proactive about Contract Negotiations
When it comes to securing better reimbursement rates from insurance companies, there are several things medical practices can do to put themselves in a powerful position. McOmber points out that it’s important to be proactive about when it’s time to negotiate.
That way, if you feel like you’re getting a bad deal, you can take the first available opportunity to approach the insurance company and ask for a better rate.
To determine what that rate should be, and make the case for why you need it, pull all your existing contracts and “really comb through them to determine who your higher volume payers are,” McOmber says. “That will help your practice analyze your entire contract situation and determine where you need to dive deeper.”
If an insurance company really isn’t paying enough to cover the cost of serving your patients, it may be appropriate to reject a contract. In making that decision, it helps to have good financial statements that truly reflect income and expenses. It also helps to have an experienced partner who can help you determine the best course of action.
There’s a perception that CPAs can only help prepare financial statements and file taxes.
The right firm can do much more. Jones & Roth routinely helps medical practices with things like determining physician compensation schedules, business planning, establishing policies and procedures, and helping with contract review and negotiation.
“There’s a whole spectrum of challenges doctors run into, from dealing with human resources issues to technology changes and policy reforms,” McOmber says. “Our role is to come in and help them with anything they need.”
Prickel often asks the question: “Even if you have a CPA who does taxes, do you have a CPA who helps you manage your business, your efficiency and your practice overall?” There have been instances where Jones & Roth worked on everything but a medical practice’s tax returns.
Take Advantage of Cost Savings, Economies of Scale
Even if a company can get their reimbursement rates to remain the same, costs are going up all the time. Medical practices can also improve their financial situation with some basic belt-tightening and best practice implementation.
“Physicians need to learn how to save better and be really efficient in their practices,” Prickel says.
That means examining everything from supply costs and staffing ratios. It can sound like a painful process, but there are some relatively easy ways to do it. “We use a tool from Medical Group Managers Association that provides ratios for best practices,” Prickel says.
“We can actually take a group’s financial statements and benchmark them with their peers. It helps them get an idea of how they’re doing in terms of expense management, production and salaries.”
Thanks to Prickel and McOmber’s years of experience in Jones & Roth’s healthcare niche, they can share ideas designed to help medical practices achieve better economies of scale. In urban areas, doctors are connecting with hospitals and larger medical groups. In rural areas, medical practices can propose becoming a satellite office for one of the larger providers in their region. Even people with extreme specialties can partner to cut overhead and other costs.
“We see them partnering with practitioners in a specialty that complements theirs,” McOmber says.
Having a partner that’s aware of industry trends can be a huge benefit to medical practices. Part of Jones & Roth’s expertise comes from their practice of loaning their staff out to offices that need an administrator on a temporary basis.
“It gives us experience managing medical practices,” Prickel points out. “We learn how to fix things and troubleshoot problems in the real world.”
All staff members get some of that real-world experience by visiting every new medical practice when they begin working with them.
“It allows us to meet the staff and gives us a good feeling for how things operate,” Prickel says. “We ask lots of questions. Whether the front desk is collecting copays, that kind of thing.”
That visit can also hold unexpected benefits for the medical practice.
“It’s not uncommon that we find something when we do the visit. In the process of going out and doing an on-site meeting we’ve actually found fraud,” Prickel relays.
More often, however, they find kind folks with a similar mission to help people and make a positive difference in the world. “Our goal isn’t to just cycle through and have a product come in and go out,” McOmber says. “It’s about having a relationship. We think of ourselves as a member of your team.”
Jones & Roth’s healthcare niche offers regular online webinars that are free of charge and open to the public. Contact us to learn more about these webinars and the other services the firm can provide.
Sophia Bennett is a freelance business writer based in Eugene, Oregon. Her work has appeared in Oregon Business, 1859 Oregon’s Magazine and many other publications.
Webinar: “Benchmarking Your Key Performance Indicators”
Presenters: Jeremy Prickel, CPA & Brian Newton, CPA
Many practice managers do not perform any kind of benchmarking and therefore never realize the true potential of their practice. With minimal improvements, a practice can see a significant increase in cash flow and a better bottom line.
In this complimentary webinar, you’ll learn the 10 most important figures that every healthcare practice should be benchmarking on a regular basis.
Benchmarking is the process of comparing your practice data to data from other, similar practices, and using the outcome to determine how your practice is performing. When you have benchmarking data, especially on a continuing basis, you are able to identify problems that need to be addressed, find appropriate solutions, and then monitor the success of the changes.
About the Presenters:
Jeremy Prickel, CPA is a partner and shareholder at Jones & Roth. His practice specializes in working with a wide variety of healthcare companies including medical and dental clinics. Jeremy is a member of the Medical Group Managers Association and the American College of Medical Practice Executives and is often called upon to be a featured speaker at medical conferences across the Northwest.
Brian Newton, CPA is a partner and shareholder at Jones & Roth. He is a healthcare specialist working with both for-profit and nonprofit healthcare organizations. Brian holds expert knowledge working with Federally Qualified Health Centers across the Northwest and is often called upon to be a featured speaker at FQHC conferences across the nation.
On November 2, 2016, the Centers for Medicare & Medicaid Services (CMS) released the Final Rule for 2017 Medicare Physician Fee Schedule. It will be important for all practices and specialties to review the CMS ruling to see how they will be affected in the coming year. Elizabeth Woodcock’s newsletter article is a good overview of some of the changes.
Many of our clients will see positive and negative changes in the CMS release. The following are some of the changes outlined in the release and in Elizabeth Woodcock’s newsletter article:
- 2017 MPFS conversion factor (CF) increased to $35.89 (2016 CF $35.80)
- Ophthalmology and Urology see 2% reduction
- Behavioral health sees new benefits in payment policies and new codes
- Film-based imaging must use modifier –FX and will result in a 20% reduction in payment
- Certain surgeons preforming select, high-volume, high-cost surgeries will be required to report post-operative care
Elliott Tracy, CPA is a Healthcare CPA and a member of the Jones & Roth Healthcare Team. He specializes in practice management, advisory services, and tax & accounting services for medical practices and clinics across Oregon & Southwest Washington.