Increasing efficiency
State of independence: How practices survive in a challenging healthcare climate

By: Leslie Small

Regardless of the degree of collaboration or affiliation an independent practice chooses, its survival in an increasingly regulated, often financially strapped healthcare industry hinges largely on how efficient it can be.

In order to operate at peak efficiency, practices must accomplish two major goals: cut costs and increase patient volume, said David Gans, pictured, right, vice president of innovation and research for the Medical Group Management Association. And luckily, he said during an exclusive interview with FiercePracticeManagement, "private practices are doing both."

For example, Brandon Betancourt, pictured left, the administrator for an independent pediatric practice in suburban Chicago, uses group purchasing organizations (GPOs) in order to receive bulk discounts on medical supplies. Using GPOs to find the best price is particularly useful in procuring vaccines, which are among the priciest items that pediatric practices must purchase, "so any savings in that regard can be significant," he said.

While Betancourt estimates that his practice does about 60 percent of its billing inhouse, it outsources some tasks when appropriate. "The parts we feel that other people are better at it, we outsource that portion of it," he said during the exclusive interview.

The practice also contracted out a recent office redesign, he added, since it wanted to use top talent to create an environment that set it apart from other practices in its effort to remain competitive.

Being able to group purchase along with the other members of the Centers for Advanced Orthopaedics also helps Louis Levitt, M.D., keep his orthopedic practice costs down, he said, noting that deeper discounts are offered for a larger volume of business.

The Centers also bills patients as one company, though each practice does maintain its own distinct staff and in many cases, its own unique electronic health record (EHR) system, Levitt said. But unlike many other independent practice associations that require members to switch to one common EHR system, the Centers was able to avoid a "major expense" by employing a system that allows each distinct system to talk to one another. "We've been quite creative in technology," he said.

Indeed, the use of cloud-based technologies for EHRs, practice management, billing and even clinical systems has helped many practices reduce the costs of owning and maintaining these technologies inhouse, Gans said.

Furthermore, he said, independent practices have an advantage over larger health systems in terms of increasing volume because they are better able to hire staff that works the best with specific doctors.

"They work with that doctor closely and become very familiar with the operation, so they can become more efficient," Gans said, adding that independent practices "can better implement workflow changes without going through large bureaucracy."

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