This workbook is intended to bolster the long term viability and business success of physical, occupational and speech therapists who already have established a therapy practice/therapy based business. The workbook presents concrete ways to analyze a practice to determine strengths and weaknesses in order to develop strategies for continued growth, and ideas on how to adapt to the changing business conditions we face today. Preliminary considerations about second locations, the sale, acquisition, merger, and valuation of a practice are also covered. Trends for the future are also identified and discussed. Consolidations in the healthcare market place have occurred on two fronts. In the 1990’s there was consolidation in the provider sector – merging of hospitals, institutions, and acquisitions of practices by larger organizations. In the early 2000’s to present, consolidations are continuing, only this time in the payor sector (insurance end) of the industry. Managed care is a permanent entity that must be dealt with, and there is increasing competition from all sectors for a percentage of the money that is spent by the consumer on health care. It can be a challenge to determine whether you have adapted in the best way possible as both a therapist and business person to current conditions including increased competition and managed care. Some therapists might suspect a “problem “ in their practice, but may not clearly see what the problem is, or determine the solution. Others may have pinpointed certain issues in their practices but need validation that they are on the right track for the solution. Most of us have wondered at some point whether we should strive to grow bigger either through acquisitions or joint ventures or stay within a defined specific market that we feel most comfortable in. A few of us are concerned even though we have experienced short term success – when demand exceeds supply it is difficult NOT to do well in the short term. The challenge is to make sure that your success will be sustained and continuous because of your good management, forward strategic thinking, and of course, good service.
Written by Iris Kimberg MS PT OTR
INTRODUCTION 4
SUMMARY OF CURRENT CHALLENGES AND CONSIDERATIONS/TRENDS
TO KEEP IN MIND……………………………………………..5
STUDY SNAPSHOT OF YOUR PRACTICE – ASSESSING STRENGTHS AND WEAKNESSES/ PROFIT MAKERS VS.PROFIT TAKERS……………………………. 6-8
YOUR CURRENT POSITION IN MANAGED CARE / INSURANCE CONTRACTS
CONSIDERATIONS BEFORE DROPPING A PLAN………………………………………..9-10
BEST PRACTICE MANAGEMENT of CANCELLATIONS AND NO SHOWS…………..10-11
EVALUATING YOUR CURRENT ROLE IN THE PRACTICE AND THOSE OF YOUR STAFF 11-12
A WORD ABOUT INDEPENDENT CONTRACTORS VS. EMPLOYEES 13-14
KEY EMPLOYEES: CAN YOU LOSE THE EMPLOYEES and KEEP THE BUSINESS?
TIPS FOR RETAINING STAFF……………………………………………………………..14-15
TRENDS FOR THE FUTURE TO CONSIDER BEFORE ANY EXPANSION…………….16-17
THE EXPANSION PROCESS/HOW TO KEEP GROWING……………………………,,,, 18-25
EXPANDING AN EXISTING LOCATION
STARTING A SECOND OFFICE OR MULTIPLE LOCATIONS
VENTURING INTO COMPLEMENTARY AREAS
CONSIDERATIONS FOR PEDIATRICS AND ADULTS
BECOMING AN AGENCY/ COMPETITIVE BIDDING FOR CONTRACTS ..26-27
APPLICATION OF THE STARK LAWS FOR PRIVATE PRACTITIONER…………28-29
FINANCIAL MANAGEMENT, NEEDS AND ISSUES ……………………………………30-32
NECESSARY LEGWORK PRIOR TO THE SALE or ACQUISITION OF A PRACTICE …33-35
CONCLUSION……………………………………………………………………………… 36