Q: I am new to the healthcare finance field, having previously been the CFO of a social service organization. I am the new Finance Director for an independent non-profit primary care medical practice (about 10 physicians and
20 Nurse Practitioners) located in urban Boston. It is an adult practice and includes no specialties. Our revenue streams are the following: 1) Fee for service Medicare, Medicaid, insurance plans, private payers; 2) Capitation contracts for nursing home and house calls; 3) Contracts to provide medical direction for nursing homes; 4) Some hospital rounding payments; and 5) very limited fundraising and grants. Can anyone point me in the right direction for private practice fiscal management information, models, resources, etc.?
A: The best resource for the information you are seeking is probably the Medical Group Management Association (www.mgma.com). I would advise, however, that you keep an active membership in both MGMA and HFMA. Both have tremendous resources and wonderfully-supportive members / chapters that will help you achieve success in our challenging yet rewarding field.
You can also check out my cover story in the July 2007 hfm journal, entitled "The Next Generation of Revenue Cycle Management." The article's topic is key performance indicators for healthcare revenue cycle management. It includes detailed best-practice standards and processes for both hospital and physician-practice revenue cycle operations. The sections on physician-practice management and managed-care contracting should be particularly relevant to your situation.