Existing Medical Practices

You went to medical school and beyond with the desire to help patients. But the reality is that you’re running a small business with increasing financial pressures from insurance companies and the government, along with rising costs of doing business. Like using a compass to keep from being lost in the woods, GPP offers benchmarking information that provides you with ways to compare your practice with standards for your specific area.

Armed with this information, you can set expectations and objectives for the efficiency and profitability of your practice. We’ll give your practice a “physical” – taking a look to assure that you are:

• Generating profitable revenue
• Optimizing the back office
• Minimizing costs
• Maximizing cash flow

We analyze aspects of your practice such as:

• Organizational structure
• Accounts receivable and payable
• Work flow
• Staff training
• Billing and collection procedures
• Internal controls
• Compliance

As a result, you’ll have a picture of your practice’s strengths and areas of opportunity. We’ll recommend an action plan reflecting ways to enhance revenue and improve your profitability.

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Start-Up Medical Practices

If you are starting a new practice right out of medical school or breaking off from an existing group, we have seasoned professionals that can work through the details with you.

The procedures for the establishment of a new practice can make or break your profitability as a business. We’ll help guide you through the potential pitfalls that can harm your practice. Areas where we offer help include:

• Selecting the entity type, such as corporation or partnership
• Assisting in obtaining start-up finance
• Aiding in lease vs. buy decisions: office space and build-out
• Creating compliant systems, policies and procedures for medical records
• Assisting in appropriate billing and collections services
• Guiding in selecting optimal software
• Establishing professional fee schedules
• Developing marketing plans

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Medical Services

Medical Practice Management– accounts receivable management, medical claims coding, records audit

Advisory Services – practice management reviews and medical records management

HIPAA Compliance– assessment, staff training, conformity, policy procedure manuals

Legal Advisory Services – buy/sell agreements, contract negotiations, employment agreements, physician compensation planning, practice business valuations

Strategic Planning – financial projections, entity selection, business planning, etc.

Tax Strategies – tax compliance, tax planning, cost segregation

Consulting Services – benchmarking, startups, internal controls

Accounting Functions– payroll service, external controllership, accounts payable, accounts receivable

Individual Planning – family wealth planning, college planning, retirement planning

Marketing Strategies– goal setting, market analysis, staff coaching

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2009 First Quarterly Update

Hospitals Struggle as Patients Put Off Care - Hospitals nationwide are struggling as patients put off medical procedures and other care after losing jobs and health insurance coverage. Elective procedures, mostly a profit center for hospitals, are down, even as care for uninsured patients is rising, according to a survey by the American Hospital Association. Hospitals also are putting off capital or IT improvements due to the credit crisis.

Healthcare Spending Slowed Slightly - The rate of healthcare spending rose 6.1 percent in 2007, down from 6.7 percent in 2006, according to a report by the Centers for Medicare and Medicaid Services. Spending was affected by lower growth in sales for prescription drugs and in Medicare spending. Other aspects of healthcare grew at a faster rate; hospital spending grew at more than 7 percent. Overall, healthcare spending grew faster than the overall economy's 4.8 percent growth in 2007, and accounts for more than 16 percent of Gross Domestic Product (GDP).

American Medical Association Sues Insurers - The American Medical Association (AMA) has joined lawsuits against Aetna and Cigna, claiming the insurers systematically underpaid out-of-network doctors. The lawsuit claims the companies used the Ingenix database, an industry database that determines usual and customary rates, to alter payments. Ingenix is maintained by United Healthcare Group, which has already paid $350 million to settle a separate AMA suit. Aetna is also being sued by patients over the same issue.

National Legislation Expands SCHIP - A new US law reauthorizing and expanding the State Children's Health Insurance Program (SCHIP) was enacted in February 2009. The bill reauthorizes SCHIP through September 2013, and provides healthcare coverage to nearly 11 million American children, up from about 7 million covered by the previous program. The reauthorization and expansion, applauded by the American Medical Association (AMA), come at a time when sharp increases in unemployment will likely add more children to the ranks of the uninsured. A federal tobacco tax increase will fund SCHIP's expansion.

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2008 Fourth Quarterly Update

Physician Reimbursement Grows - In 2009, physicians will see at least a 1.1 percent reimbursement increase from Medicare compared to 2008, with the potential for up to a 5.1 percent increase. The Centers for Medicare & Medicaid Services (CMS) note that the maximum increase would be for doctors adhering to new electronic prescription reporting guidelines, designed to reduce errors in the prescription system. It was only recently that doctors thought they would receive over a 10 percent reimbursement reduction in 2009; a situation corrected through legislation in 2008.

Medical Travel Changing Quickly - Traveling to another country to receive medical care used to be only for minor surgeries, but industry experts note that consumers are now willing to travel for serious procedures, which is impacting doctors and medical care centers. The Deloitte Center for Health Solutions says that by 2010, 6 million US patients will go to another country to receive healthcare each year. Further, Deloitte notes that medical travel took about $16 billion away from the US healthcare industry in 2007. The result may be that doctors will have to charge less or cut costs in other ways to stay competitive. 

Doctors as Financial Counselors - Physicians, particularly those who own their own practices, have a variety of duties, and increasingly, financial services may be one of them. According to the American Academy of Family Physicians, doctors are often unable to adequately advise patients on treatment options based on their health insurance plans. This is largely due to the increased number of patients with high deductible insurance plans, which are more affordable amid rising healthcare costs, but which may put some treatments out of reach.