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Guiding strategies for keeping acquired practices profitable

Doug Fielding, Vice President of Product Strategy, ZirMed
Doug Fielding, Vice President of Product Strategy, ZirMed

As hospitals and health systems acquire independent practices, they must strike a delicate balance – strengthening business operations without disrupting the day-to-day work of staff and the experience that patients are accustomed to.

There’s no absolute “right” set of action to take, but there are simple guiding principles that help illuminate the right decisions in the myriad situations that arise due to differences in patient populations, specialty, practice size and office culture.

Keeping patient satisfaction at the forefront

Small and medium-sized practices are dependent on – and driven by – word-of-mouth in a way that larger healthcare organizations aren’t. Successful, well-established practices have earned trust within the community, and in all likelihood their patients are doing the bulk of their marketing (in the sense of recommending them to family, friends, and colleagues).

Using patient satisfaction as the starting point ensures that the steps you take and any changes you make build on and enhance that trust – so that the practice doesn’t lose existing patients or inadvertently dampen the enthusiasm of those who are its best advocates.

So: as a first step, aggregate historical patient satisfaction surveys or data that the practice may already have on hand. You’re looking for two key themes – what patients say could be improved, and what patients love most. The former is a working list of potential steps you can take to ensure patients feel the practice is “even better” since the acquisition; the latter is a list of potential third-rails, things you should be wary of changing in the months following the acquisition, or at all.

More generally, examine existing front- and back-office processes to see where they can be tweaked to increase transparency, convenience and other qualities that matter to patients as consumers. Is the practice currently able to provide accurate estimates of patients’ financial obligation before the time of service? Have front-office staff been trained on best practices for discussing financial matters with patients? (For example, are they clear on the dollar amounts that should prompt them to suggest a staggered payment plan rather than requesting payment in full?) Can patients use whatever method of payment they prefer and make payments online as well as over the phone or in person? Are patient statements easy to understand, and can patients elect to receive them electronically rather than via snail mail?

Then take it a step further: How are patients currently able to communicate with providers, and could that process be improved? What about medical records? Can patients request and receive them electronically or do they have to call or visit during business hours? (Ditto all of these considerations forbilling inquiries and appointment-related requests.)

Convenience matters – it communicates to patients that you understand their time is valuable.

Give acquired practices the benefits of your organization’s scale – without scaling demands on their time and attention

Often, practices run on different systems or follow different processes than large healthcare organizations. Even practices that at first glance seem similar may turn out to have very little in common as far as PM system, HCIS, or workflows – this is especially important to remember if you’re acquiring multiple practices. These differences aren’t necessarily a problem, but they can create problems down the road – data siloes, gaps in reporting, or time-consuming manual reporting processes (think death by spreadsheet).

Yet a hardline one-size-fits-all approach to standardization can cause problems as well. This is the backbone of the argument for interoperability—in theory, it shouldn’t matter what HCIS or PM system a practice uses, because those systems should be able to export and share information with systems from other vendors.

Of course, the reality is that’s not always the case, which can make it tempting to decree system changes as part of the acquisition. To do so, however, can be so disruptive or frustrating for staff that it risks the operational and financial health of the practice – you can damage the very things you’re trying to strengthen.

This is where data aggregation and normalization solutions can play a key role, and it points to why cloud-based interoperable software can be your best friend. Cloud-based software enables you to extract and normalize the data you need to gain a holistic view of your enterprise and to compare what otherwise would be apples and oranges (or apples and elephants). It can also provide continuity across the continuum of care and support easy information-sharing among providers and staff who use different systems, in different locations, in different healthcare “worlds” such as the care setting vs. the central business office.

There are undoubtedly benefits to standardization—witness this recent article in Becker’s Hospital Review. But for the practices being acquired, and for the people managing the acquisition, the most important consideration isn’t what could change. Everything could change; anything could change. Being honest, and being data-driven, about what changes will lead to improvement is the most important and in many respects the most difficult management challenge that any leader will face during the acquisition process. That’s true on both sides of the equation – i.e., for the acquirer and acquired. 

Setting aside fear of change and preconceived notions of what “should” or shouldn’t change will enable all parties to remain focused on patient care and the patient experience, and will ultimately keep practices profitable even as it keeps them running smoothly.