How We Turned Around An Ontario Medical Practice In 3 Months: Case Study
This case study explored several factors and functions of this Ontario medical practice dynamic. The practice in question was a primary care and seniors focused, had been in practice for several years, and had also been bought and sold back to the owners in the past. The team themselves had been together well over 10 years, the anchoring physician is a very bright, hard working and savvy physician who was keen to help the practice thrive, but he found it challenging to get the owners to change procedures for the better. He was also tied to his billing and finance person, who had been with him for several years. The rest of the issues were symptoms, but there were many:
Doctors weren’t getting the OHIP RA or monthly statements from the clinic management on time
Doctors didn’t see private payments in their statements, let alone get paid for those services
The administrative team were well intentioned and loved their work, but had no formal training, no iterative improvements or process measurements, and no motivation to do better in their work or improve
The results were doctors looking for work elsewhere, brutal cash flow and barely break-even profits, the company was with the bank’s Special Accounts department, and bankruptcy + closure seemed immanent.
The physician complement in this practice was mostly Ontario primary care physicians outside of a FHO and FHG, and internal medicine doctors.
Our approach:
Talk with the doctors, explain we are cleaning up the revenues and statements, and as 3rd parties, we’re able to ensure they aren’t just getting paid, but they are making more money.
Speak with the bank’s Special Accounts manager, explain the strategy and make the necessary arrangements.
Clean up the OHIP claims and errors, submitting quickly to boost revenue in the next RA cycle.
Share the statements showing the properly booked revenue and the recovery of the otherwise lost claims in the first statement the physicians receive.
Leverage the earned trust to coach the physicians, and then administration and management, to improve operations including optimizing the billings and revenue-generating opportunities for a medical practice in Ontario like theirs.
The results are in the video, but highlights:
The practice remains open to this day.
They were profitable again within 3 months.
Recruitment and growth started within 2 months, and physicians were referring colleagues to work with the practice within 2 months.
Patient, physician and management satisfaction improved significantly.
Revenue growth in the OHIP practice was over 20%, just through proper management and oversite using our Clarity dashboard.
Key Take Aways For Ontario doctors, OHIP administrators and clinic operators:
Get a 3rd party to review your claims and work as an intermediary if trust is lost between the doctors, the clinic operators and the bank. An independent group there to align interests can go a long way.
Tell stakeholders what you’re going to do, and then DO THAT THING YOU SAID YOU’D DO. Following up and actually getting things done goes a LONG way to earning trust.
The bank does NOT want you to close and does NOT want to liquidate your business. Special Accounts wants you to succeed and will work with you if they can. If you’re in Special Accounts and within 10% of profitability, OHIP cleanup may get you to profitability.
When PF came in, we REDUCED their payroll costs considerably. They thought our percentage sounded high, but the cost reduction was a key part of the turn-around. Remember that if somebody can bring your business value, and you’ll end up ahead after their fees, pay the premium, get the result and ensure everyone benefits.
