It is no secret that successful people surround themselves with experts.  In the business of medicine, one often considered such an expert is a Certified Healthcare Business Consultant.  So, when it comes to the business of healthcare, when should a medical practice hire a healthcare business consultant and why?

Let us consider how you may be assessing the financial health of your practice.   For example, is your revenue cycle well managed?  Do you renegotiate or renew insurance contract language annually? Are you utilizing your non-physician providers optimally?   If not, perhaps there is money being left on the table that may justify engaging a healthcare consultant to right the course.   While there is no guarantee that more favorable result will prevail, the analysis performed often provides valuable information about your practice that can help to achieve more profitable results for years to come.

The competencies of Certified Healthcare Business Consultants (CHBC) are extensive.  Their knowledge base includes professional standards, organizational governance, business management, financial management, human resource management, revenue cycle management, business operations management, compliance, quality, information management, risk management, tax and retirement planning proficiency. Additionally, certain consultants have contacts in payer companies that may facilitate addressing these and other significant matters.

Typically, the consultant will perform one or more services that might include trend and other analysis, review of contract language, comparison of payers, or reconciliation of deposits to productivity reports.  Starting the process often begins with a question, followed by an evaluation of data.  For example, what added services can primary care providers bill to increase their top line revenues? Can we increase cash flow by negotiating language in our contracts with insurance companies to get paid faster?

It is most essential that the consultant engaged have the requisite expertise for the issue at hand, especially relating to the subject of the restrictive guidelines pertaining to confidentiality of payer contracts.  Many healthcare business consultants will have their own personal area of expertise and may not be able to address every question.   This is where the CHBC’s network of healthcare business professionals is invaluable to assisting their clients.   Numerous resources and references are available to a CHBC by virtue of this affiliation.

As in any business, the basic business principles apply to the practice of medicine.  To thrive and be profitable you must provide quality service, know your industry, know your competitors, promote your services, develop great staff, understand organizational structure and design, use capital and cash flow wisely, and understand fundamental principles of accounting and finance.   If we can be of any assistance in helping you develop a successful business, please contact our office.

Article Submitted by – Terri L Marakos, CPA, CHBC