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• Nagle & Associates

Some things never change, such as the basics of practice management. Although everyone talks about changes in healthcare-and they are indeed drastic--those who have been around awhile realize that the basic principles stay the same. Buzz words and applications have changed, such as electronic health records, accountable care, pay for quality outcomes, ICD-10, and more, yet the basic tenets stay the same. Effective practice management is really an effort to return to Practice Management 101. Efficient and effective practice management still applies today and in the future.

Using an oft-quoted line from the 1985 movie, Back to the Future, "If you put your mind to it, you can accomplish anything," let's focus on the basic components of efficient and effective management, or Practice Management 101, making a concerted effort to achieve success.

• Personnel/human resources. Personnel costs remain (and likely always will) the medical practice's single greatest expenditure. Whether the practice is a private entity (seemingly diminishing) or the more likely, part of a larger hospital-employed physician network, often, at least half of the non-provider overhead is tied up in staffing salaries and benefits. Therefore, practice efficiency requires continuous management of the number of personnel employed, the hours they work, and the compensation they receive. Even with modern efficiencies surrounding electronic interchange and EHR, having a successful practice often boils down to effective staff management and related expenses.
   
• Facilities. Rent is another chief expenditure for a medical practice. Coupled with utilities and other related facility costs, rent becomes a major outflow. Unlike many businesses that have become "virtual," eliminating much of their facility's expense, most medical practices must maintain...click here to read the full article.

• Review four possible scenarios of the "employment lite" PSA model

• Explain these PSAs complex structure and how they affect revenue, billing, staff, etc.

• Discover strategic, relational, economic and functional advantages or disadvantages that can result from such a working relationship

Even as economic conditions remain a concern for much of the nation, and high unemployment rates persist, many organizations are facing unique hiring challenges. In healthcare, this trend appears to be accelerating! A close look at most any healthcare organization, including hospitals and larger physician groups, reveals a surprising number of open key leadership positions. Open posts extend from key department and service line leadership up to and including the "C suite." Unfortunately, the pool of qualified, interested candidates available to fill these positions is shallow and the competition for well-qualified leaders is fierce. Many people who apply for these positions do not possess the required background, skills, experience, and education to fill these roles.

Due in part to this supply and demand situation, coupled with the amount of work it takes to successfully manage the many complex and time-consuming aspects of the recruiting and hiring process, the challenge for many organizations is twofold: 1) how to identify, locate, and recruit top notch, quality candidates that match the specific needs of their organization; and 2) how to do so in a timely, cost effective manner. With so many open positions and the pressure to fill critical roles quickly, many organizations...click here to read the full article.

With the year end approaching, 2011 is proving to be another historic year for hospital M&A activity as healthcare reform, changing industry dynamics, and challenging economic conditions have combined to make the industry ripe for consolidation. According to Levin and Associates, 72 hospital transactions closed through the third quarter of 2011. Given that 74 total transactions were closed in all of 2010, this year is on track to be another banner year for hospital acquisition activity. The beginning of the fourth quarter saw two of the largest deals of the year as HCA closed on its acquisition of the remaining 40% stake in the Colorado-based HCA-HealthOne for $1.8 billion and Tennessee-based Mercy Health Partners was acquired by HMA for $525 million.

Ultimately, hospital acquisitions are being driven by a combination of the fact that many smaller and stand-alone operators are struggling both operationally and financially and that hospitals are required to commit significant capital outlays to invest in their facilities and service lines to remain competitive amidst sweeping healthcare reform.