Practice Reboot After Administrator Retirement
When one of the partners and the long-term administrator for 20/20 Eye Physicians of Indiana both decided to retire in 2013, things got rough. The remaining partners realized they needed help when the new administrator turned out to be a poor fit. To take charge of the situation they hired Accountable Physician Advisors to provide interim leadership and help them develop a plan for the future.
APA got things under control quickly from a management perspective, and performed a comprehensive operational assessment of the practice. APA found that in the years leading up to the administrator's retirement, the practice wasn't properly positioning itself to remain viable for the ten to fifteen year window the doctors still intended to practice. Determined to make the needed changes, the partners modernized the following pieces of their infrastructure with help from APA:
- The decade-old computers and IT network was replaced, improving performance and saving the practice money on costly repairs
- The substandard and costly internet service agreements were renegotiated, dramatically increasing speed and productivity
- Staff members were issued email accounts for the first time, improving communication ease and accountability
- The failing analog phone system was replaced, enabling call management to be integrated for the separate office locations
- The practice's dated looking website was overhauled to include a modern look and new patient-friendly functionality like online bill pay, with a significant decrease in recurring costs for hosting
Despite all of these improvements, the group still faced an even greater hurdle. During its initial assessment, APA learned the group had taken no steps toward the adoption of electronic medical record software, and was facing steep future reimbursement cuts as a result. Although the physicians understood the penalties they faced, they were highly skeptical that their practice could withstand the productivity loss associated with EMR adoption.
Through a careful search and selection process, APA found a solution, and in less than one year helped the practice implement a user-friendly EMR product and successfully attest for meaningful use. In less than two years, the providers in the group regained their pre-EMR productivity levels and added a non-physician provider (optometrist) to expand capacity. In less than three years, the average profit-per-partner was higher than it was prior to the retirements and EMR adoption.
"I was the biggest skeptic when it came to EMR adoption, and for years I believed that the productivity loss would be insurmountable. Honestly, we put it off until the last possible minute. But Teri helped us find a product we could learn to live with, and although the transition wasn't easy, we all made it and my income is higher than it ever was."
Daniel J. Robinson, MD
"Hiring APA was a life-saving move for our practice when our administrator retired. They provided competent and highly professional management, and helped us gain clarity about what we needed to do to prepare for the future.
When the time came to hire a full-time administrator, we were worried that we might lose some of the gains we'd made under APA's management. Teri worked with us to create a seamless plan, and helped set our new administrator up for success by serving as her business coach during the transition."
John N. Giesel, MD
Creating a Regional Resource for Patients in Need
When Dr. Christopher LeSar decided to start over, he knew he wanted to build a practice that would specialize in the prevention of amputation in patients with critical limb ischemia. As the busiest vascular surgeon in Chattanooga, he had the clinical skills needed to achieve his goals, but he didn't have the business experience to do it on his own.
Dr. LeSar engaged Accountable Physician Advisors to guide him through the process of launching his new private vascular surgery practice and specialty center for limb preservation. APA provided comprehensive planning and management services during the start-up, including:
- Early stage planning and business plan development
- Acquisition of start-up capital
- Identification and leasing of the office locations
- Acquisition and financing of major medical equipment
- Staff recruitment and human resources program development
- Development of the IT infrastructure
- EHR implementation
- Payer contracting and revenue cycle management
- Financial management
- Onboarding of permanent practice administrator
In phase one, Dr. LeSar's new practice was up and fully operational in a temporary location less than 90 days after he retained APA, and the practice was profitable shortly after launch. When the phase two location opened just thirteen months after the new practice commenced operations, Dr. LeSar had already hired three additional providers to join him because the demand for the center's services was so great.
The Vascular Institute of Chattanooga is the only center of its kind in the region, with a multidisciplinary staff dedicated to the prevention of amputation in patients with peripheral vascular disease. The 8200 square foot facility has three operating rooms, four ultrasound suites, a patient education center and ample clinic space to support the enterprise as it continues to grow. And with the continued expertise of APA at his side, Dr. LeSar is convinced that the Vascular Institute of Chattanooga is poised to help many of his patients declare victory in their fight to preserve their limb and their health.