1. Make it easier for patients to come through the door. Sonoran Spine Center is a patient-driven practice, which means the surgeons depend upon a high volume of cases to keep the practice running. Since there are specialists in several different spine-related areas, the group can accept most patients coming their way; however, they must also focus on quality to encourage those referrals.
"We want to see everyone who walks through the door," says Dennis Crandall, MD, founder of Sonoran Spine Center in Mesa, Ariz. "We need to have sufficient quality providers to meet our need for volume. Our care must be consistent with our patients' and referring physicians' quality expectations. We have to be able to take on surgical and non surgical cases, work-related issues, tertiary or simple cases."
Currently, the practice has four spine surgeons ranging in expertise from adult and pediatric scoliosis and other major deformity correction to caring for patients with degenerative and traumatic conditions. Additional medical specialists include a pain management physician, five physician assistants and one research nurse. In the future, Dr. Crandall hopes to add additional pain management specialists, tumor and spinal trauma surgeons to further extend coverage at the practice.
"We want to develop niche areas in spine we don't have covered right now," says Dr. Crandall. "It's hard for us to meet the needs we have right now and go after new business considering how busy we already are. However, this is an opportunity for the future and we are thinking about how to take advantage of it."
2. Shorten accounts receivable days. One of the critical performance indicators David Wold, CEO of Healthcare Information Services in Park Ridge, Ill., looks at with his surgeon's practices is the accounts receivable cycle. For the practice to make a profit, billing must be sent out promptly to get a return. Any unnecessary delay will cost a center its profit. When working with orthopedic practices, he looks at what the turnaround is for billing. "Track that on a monthly basis," he says. "By tracking the percentages in your accounts receivable, you're looking at it every month for trends."
Monitoring the cycle each month will allow you to see if you need to devote more or less resources to an account and keep better track of all dollars.
3. Low staff turnover, high engagement. As a way to support patient satisfaction and manage expenses, orthopedic groups should also be focused on keeping their staff happy. "Practices have to remember that their most valuable resources are their staff and they have to work really hard to keep their staff happy," says John Wipfler, CEO of OA-Centers for Orthopaedics in Portland, Maine. "The average medical practice turnover rate is 18-19 percent and we are somewhere around 9 percent — half of the national average."
It's important to keep good staff members who know how to treat patients consistent with your group's patient-centered culture and can quickly answer any questions patients might have about their care. Training new staff members takes a great deal of time and money, and if they leave the practice quickly they are a drain on resources.
"If you want to retain experienced and good people, it makes sense to put resources into keeping them happy," says Mr. Wipfler. "Pay is only the beginning and it doesn't need to be at the top of the scale. Respecting their wisdom, giving them a voice in the practice, having working committees with staff and creating many channels for hearing about what they are thinking and feeling. We want to keep morale up and be very transparent about what is happening in the practice. Enlist them in helping you solve your problems."
4. Invest in information technology. Patients, payors and referring physicians will demand reported outcomes in the future, and the best way to collect this information is through a good healthcare information technology system. These systems should interact with hospitals and other providers so you can stay on the same page.
"Invest in information technology in a way that you can measure and report outcomes, whether to payors or hospital systems, to prove what you are doing," says Todd Albert, MD, spine surgeon and president of Rothman Institute in Philadelphia. "Be able to measure patient satisfaction as well. All these things are publicly reported, so know what they are and be ahead of the curve before your statistics end up in the newspaper."
Once you are able to track your outcomes and define your quality, insurance companies and policy makers will come to you as they create treatment protocols. "You have to prove your method works, not just say it does," says Dr. Albert.
5. Provide ancillaries with continuity of care. It's very helpful for orthopedic practices to add ancillary services, if they haven't already, and fully integrate all services to provide the best continuum of care possible. OA includes fully integrated X-ray, MRI and physical therapy services and a surgery center in addition to its clinic, so patients can benefit from several specialists who are all in communication about their individual care.
"The patients understand that their care is communicated from point to point, and they appreciate it," says Mr. Wipfler. "Ancillaries are a big part of our ability to survive over time, in part because it is more cost efficient as well as improves quality of care as a result of the continuity of care by providers who are all on the same page."
6. Expand into new markets strategically. Opening new office locations can provide a great opportunity to serve patients in a new market and create more revenue for your practice. However, you have to make sure the new market location can support your office. Practices can test the waters by meeting with hospital administrators and potentially forming a partnership, such as a co-management arrangement.
"Nowadays, you are seeing a growing trend of physicians becoming employed by hospitals," says Alexander Vaccaro, MD, PhD, a spine surgeon and one of the founding partners of Rothman Institute. "That hasn't happened with our group. When we are looking to expand to a new location, we look at the area of orthopedic care and ask what would work well with the hospital. If the area is well served, we don't have an opportunity. If the area needs more orthopedic service, we go to the hospital and see how we can work with them."
7. Use marketing tools to brand your practice. Surgeons must market their private practices to drive patient volume and promote brand recognition. Khawar Siddique, MD, a fellowship-trained spine surgeon with Beverly Hills Spine Surgery in California, says it's important for practices to have a moniker that reflects their commitment to high level care, which is why his group decided to practice under the name "Beverly Hills Spine Surgery."
"Beverly Hills denotes a quality of care," says Dr. Siddique. "The name of your corporation should tell patients about the level of care you provide; such as Premier Spine Surgeons, Inc."
Focus on any aspects that make your group special in your marketing efforts. For example, if your group includes all fellowship-trained spine surgeons, tout your expertise to show you are a quality organization.
8. Provide cash-pay services. To combat declining reimbursement, Geoffrey Connor, MD,'s medical practice, D1 Sports Medicine, made the decision last year to begin targeting cash pay patients for his practice. While he is a trained orthopedic surgeon and performs joint replacement surgeries regularly, he also offers services such as platelet-rich plasma injections and in-office fiberoptic arthroscopy on a cash basis. Additional cash-based services include sports performance measures, such as body mass index and nutritional analysis, to create an environment of concierge sports medicine.
"If more subspecialists turn to the cash patient model, Medicare patients may have to wait longer for care or choose to pay more out-of-pocket," says Dr. Connor. "I don't want to scare Medicare beneficiaries, but hip implants and surgeries are expensive and the proposed rates just aren't viable. I set up a system like plastic surgeons or bariatric care; I'm trying to evolve an orthopedic practice that captures patients who need medical services with added value."
However, transitioning to a more cash based practice, including patients with a high deductible plan, isn't as easy as hanging a sign outside your front door. When patients are paying out of pocket for these services, they'll want the most bang for their buck. "With more out-of-pocket costs, patients will be far more demanding and expect a higher level of care, caring and services that are rare to find in today's orthopedic practices," says Mr. Champion.
Related Articles on Spine Centers:
Dr. Frank Cammisa: 8 Top Challenges for Spine Surgeons This Year
5 Trends Impacting Outpatient Spine in 2012: Thoughts From Dr. Thomas Schuler
7 Top Concerns for Spine Surgeons in 2012
8 Ideas for Orthopedic Practices to Improve Their Bottom Line FeaturedWritten by Laura Dyrda | Thursday, 24 January 2013 16:16
Here are eight ways orthopedic practices can improve their bottom line.
© Copyright ASC COMMUNICATIONS 2016. Interested in LINKING to or REPRINTING this content? View our policies here.
- 9 Mayo Clinic strategies to quench the physician burnout flame
- Rochester Regional Health in NY acquires Finger Lakes Bone & Joint Center: 5 key notes
- What not to wear — Physician's attire elicits mixed responses in outpatient orthopedic centers
- 7 trends in healthcare digital transformation
- What are the driving forces behind Medicare reimbursement for total joint arthroplasty? 7 key notes
Top 40 Articles from the Past 6 Months
- 20 new MIS spine devices in 2016
- 21 smart spine surgeons with gifted business minds
- 44 MIS spine devices to know | 2016
- Top 12 most-liked spine surgeons on the internet
- Police investigate death of American Spine Center's physician accused in federal kickback scheme: 6 things to know
- Consumer Reports: 34 top-rated US hospitals for hip replacements
- Suicide likely cause of Dr. Sandeep Sherlekar's death, police report shows: 6 things to know
- Dr. George Rappard performs 1st US MIS procedure with Sony heads-up display: 5 observations
- Zimmer Biomet to acquire LDR in $1B transaction — 9 things to know
- Annual & hourly orthopedic surgeon salary — 10 latest statistics
- Trusting a robot — Dr. Juan Torres-Reveron on performing 1st US ROSA Spine surgery
- 12 statistics on social media's presence in the healthcare space
- 5 key notes on the Zimmer Biomet-LDR acquisition & its impact on Texas
- 38 female spine surgeon leaders to know
- Dr. Gregory Sherr sues HealthEast, CentraCare & 6 neurosurgeons for allegedly ruining his reputation & career — 6 things to know
- Oregon spine surgeon implicated in $22M lawsuit for paralyzing patient with dropped instrument: 5 things to know
- UPMC to pay $2.5M+ to settle neurosurgery-related False Claims Act violation allegations: 7 things to know
- 4 North Carolina orthopedic practices merge to create EmergeOrtho: 5 key notes
- US News & World Report: Top 10 hospitals for orthopedics
- 7 things to know about Mazor Robotics & Medtronic's plans to roll out Mazor X
- The state of minimally invasive spine surgery: Dr. Frank Phillips on devices, payment & outpatient ASCs
- 11 highest-paying states for orthopedic surgeons: New Jersey tops the list at $494.5k
- Beyond the implant — DePuy Synthes pushes innovation inside & out of the OR
- Zimmer Biomet jumps into robotics with MedTech acquisition: 5 things to know
- Orthopedic surgeon Dr. Michael Russin dies following plane crash: 5 key notes
- 34 latest trends in the global orthopedic devices market
- 21 statistics and facts for orthopedic surgeons — compensation, net worth and more
- 19 more things to know about orthopedic bundled payments — September 2016
- Are Stryker's hip implants about to be recalled?
- Trump or Hillary? The physicians have voted
- FDA regulation, insurance coverage: Dr. Raj N. Sureja talks challenges in regenerative medicine
- Do you know what patients really care about when choosing a spine surgeon?
- 13 facts and statistics on Baby Boomers for spine surgeons to know
- 5 trends for orthopedic surgeons to watch in 2017
- 3 orthopedic clinics to pay $2.39M to settle False Claims Act allegations: 5 things to know
- 10 thoughts and statistics on medical malpractice claims against orthopedists
- Evolutionary vs. revolutionary: The future of surgical devices and spine surgery
- Robotics is here to stay — Drs. Kornelis Poelstra & Dennis Devito on working with Mazor technology
- UCLA pays $8.5M to settle 2 lawsuits after undisclosed spine surgeon relationship with Medtronic: 5 key notes
- Medtronic, SeaSpine, Zimmer Biomet & more: 17 key notes