ISSUE 142, Special Section: Cancer Care

Know A Good Doctor? We Do.

How to Assess Your Healthcare Practice Operations

We understand the pressure you are experiencing during this crisis and know you may have questions about how the uncertainty is affecting your current and future state of operations, as well as current and future financial performance as a business.

During a healthcare crisis, like the one we are currently experiencing, medical practices face multiple business hazards and decreased resources, as well as increased pressure to navigate in a changing regulatory environment. Whether you are assessing current practice operations or evaluating how to bring business back to usual, practices of any size and structure should be asking many questions (and know the answers to them before making critical decisions).

Short Term Operations

What parts of the practice are working and what part of the practice need to be re-engineered? What can you outsource temporarily or long term to ensure nothing gets backlogged or “lost in the shuffle?”

While every day may seem like a challenge, now is the time to be asking some very poignant questions and getting very clear answers quickly in order to keep your practice afloat, optimize cash flow, and be able to get back up and running at full speed when the time is right.

Cash Flow:

Are you maintaining the processing of transactions and month-end reconciliation processes? Is it working well? What do you need to make it work better?
How are cash disbursements being processed? What about cash receipts and getting them deposited into the bank?
Are you maintaining the segregation of duties?
Consider that the current situation might open up the fraud triangle – more opportunity to commit fraud if controls break down, and people feeling increased pressure (especially if a spouse/partner/ significant other has lost their job).
Are you preparing the cash flow forecast and performing the required analysis? Do you have the skill set or even time available to prepare it?

We recommend monitoring your cash flow daily. If you need assistance or if you need other short-term accounting and financial help, we have the tools and team that can help you.

Coding:

Are you taking advantage of the new coding guidance for COVID-19? Do you have coding staff that are turning around things fast enough for your practice?

Optimizing CARES Act Benefits:

Have you analyzed government programs and made it a priority to understand all of your options? What is best for your specific practice?
Have you applied for a Paycheck Protection Program (PPP) Loan or Economic Injury Disaster Loan?
Have you received PPP funds? How will you optimize, gather, analyze, and report expenditures for the eight week period to maximize forgiveness requirements?
Did you receive a deposit from Health and Human Services as part of the CARES Act stimulus? Have you considered or applied for the accelerated Medicare payment?

HIPAA Compliance:

Are you maintaining HIPAA compliance?
The Office of Civil Rights states, “Covered health care providers will not be subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur in the good faith provision of telehealth during the COVID-19 nationwide public health emergency. This Notification does not affect the application of the HIPAA Rules to other areas of healthcare outside of telehealth during the emergency.” The Office of Civil Rights will communicate with the public when this guidance expires.

Remote Technology:

How well have you adapted to a paperless environment? Are you still dealing with transferring pieces of paper between individuals?
How robust are your IT systems in allowing remote access, virtual meetings, etc.? Are you doing this via a secure environment, minimizing cybersecurity risks?
How is your telehealth solution working? Can you optimize this solution once business gets back to normal?
Which telehealth solution best fits your specialty and is most user-friendly for your patients?

Personnel:

Do you have coverage for key employees that may become sick? Is there a backup plan? What if someone needs to take leave under the CARES Act Guidance or cannot return to work when you want them to because of it?
How do you plan to address your backlog of patients?
Are you adapting your practice’s business plan/forecasts/budgets to consider both a slowdown of patients now and the need to see many more than usual soon?
What patients get priority when normal returns?

“While every day may seem like a challenge, now is the time to be asking some very poignant questions and getting very clear answers quickly in order to keep your practice afloat, optimize cash flow, and be able to get back up and running at full speed when the time is right.” — Adam Shewmaker

Long Term Strategy

It is imperative that as you are working through your short-term operations, you take time to consider your practice’s long-term strategies, which include some of the same topics mentioned above. You most likely had to make quick decisions a few months ago, but you should be thinking about how to make your practice better than it was before COVID-19 now (even if you are restarting from the ground up) and what you need to change in order to take advantage of this opportunity:

Be honest about your practice’s strategic strengths and weaknesses
Understand the healthcare environment and what has changed – post-pandemic medical practices will look very different than your pre-pandemic environment
Understand your opportunities – patients, services, etc.
Know your team – identify key roles, structure, employment contracts, consider outsourcing non-essential activities such as accounting, human resources, and marketing to free up internal resources and gain access to external resources
Know your needs – evaluate your supply chain
Know your community – key relationships such as stakeholders, significant vendors, legal counsel, tax/accounting, human resources, real estate, and more
Prioritize your marketing plan
Plan for next time
Establish the vision for what the business will be
Communicate… then communicate some more

Dean Dorton has one of the largest healthcare practice management consulting teams available to assist in assessing your current practice’s operational and financial portfolio, financial and staffing projections, and other short-term strategies to help your practice survive but also plan strategically for the future in order to make sure you can handle any disaster scenario and return to a thriving practice, while taking advantage of the CARES Act benefits available to you.