Medical practices today face a perfect storm of financial pressures. Rising operational costs, declining reimbursement, staffing shortages, and growing patient expectations are squeezing margins like never before. With economic uncertainties and regulatory shifts becoming increasingly common, practice leaders must proactively find innovative ways to boost revenue, streamline operations, and maintain cost efficiency to ensure sustainability and growth.
Successfully navigating these challenges requires a multifaceted approach — one that harnesses technology, refines the patient experience, optimizes the revenue cycle, and tightly manages expenses.
The following categorized list of strategies is designed to guide practice administrators in identifying key opportunities for improvement across their organizations. Each strategy includes key implementation tips and aligned key performance indicators (KPIs), rooted in MGMA benchmarks, to help monitor success and drive measurable results.
In most cases, practice leaders will want to layer multiple strategies within a category or across categories. For example, the interrelationship between patient access, revenue, and practice reputation may call for a combination of operational, patient experience and revenue cycle initiatives to achieve the greatest impact.
Operational Efficiency
Extend office hours
- Importance: Improves patient access and increases revenue opportunities.
- Considerations: Adjusting staffing schedules and evaluating patient demand for extended hours.
- KPIs: Use MGMA DataDive Financials and Operations to benchmark no-show rates, same-day appointment availability, and other patient access metrics; reference MGMA DataDive Provider Compensation for total encounters per physician and APP.
Reduce provider downtime
- Importance: Maximizes available resources and patient care capacity.
- Considerations: Strategic scheduling and flexible staffing support.
- KPIs: Use MGMA DataDive Financials and Operations to benchmark provider-to-staff ratios and assess coverage efficiency.
Cross-train staff
- Importance: Increases operational flexibility and efficiency.
- Considerations: Aligning training with employee skill sets and offering periodic retraining.
- KPIs: Use MGMA DataDive Management and Staff Compensation to track continuing education hours that support cross-training goals.
Optimize scheduling
- Importance: Minimizes idle time and maximizes appointment efficiency.
- Considerations: Balancing provider schedules with patient flow and effective waitlist management.
- KPIs: Benchmark third next available appointment using MGMA DataDive Financials and Operations.
Patient Experience
Improve patient retention
- Importance: Sustains long-term revenue through patient loyalty.
- Considerations: Consistent patient communication and proactive follow-up systems.
- KPIs: Regularly monitor patient attrition rates and declines in established patient visits; benchmark panel size using MGMA DataDive Financials and Operations.
Boost your practice’s online presence
- Importance: Attracts new patients and enhances credibility.
- Considerations: SEO investments and consistent social media engagement.
- KPIs: Use MGMA DataDive Procedural Profile to track new vs. established patient volume over time.
Referral and reputation programs
- Importance: Drives patient growth through word-of-mouth and digital reviews.
- Considerations: User-friendly referral processes and reputation monitoring tools.
- KPIs: Monitor new patient volume, new vs. established patient ratio, and patient visits per day per provider.
Revenue Cycle Management
Negotiate payer contracts
- Importance: Increases revenue through better reimbursement rates
- Considerations: Annual reviews and strategic payer mix assessments.
- KPIs: Net collection rate, gross collection rate, contractual adjustment rate, revenue per visit/encounter, payer mix, cost-to-collect ratio, clean claim rate, denial write-offs, first-pass resolution rate.
Patient self-pay programs
- Importance: Improves cash flow with transparent, patient-friendly options.
- Considerations: Clear pricing and simple payment options.
- KPIs: Track self-pay revenue as a percentage of total revenue; monitor program cost and patient satisfaction.
Audit and optimize billing
- Importance: Prevents claim denials and accelerates reimbursement.
- Considerations: Routine coding audits and accuracy checks.
- KPIs: Coding accuracy, modifier usage rate, claims processed per biller, claim lag time, and first-pass claim acceptance rate.
Use digital payment systems
- Importance: Streamlines payment collection and reduces admin burdens.
- Considerations: User adoption and system compatibility.
- KPIs: Digital payment adoption rate and volume, days in A/R, bad debt reduction, patient satisfaction, data breach incidents.
Technology Integration
Telehealth and eVisits
- Importance: Expands access and reduces no-shows.
- Considerations: Reliable technology platforms and staff training.
- KPIs: Telehealth adoption rate and patient satisfaction metrics.
Use AI and automation
- Importance: Cuts costs and reduces administrative errors.
- Considerations: Workflow compatibility.
- KPIs: Workflow efficiency, error reduction, diagnostic accuracy, and satisfaction rates among staff and patients.
Switch to cloud tools
- Importance: Reduces IT overhead and improves accessibility.
- Considerations: Data security and user training.
- KPIs: IT spending as a percentage of revenue, ROI, app performance, cybersecurity compliance, and user satisfaction.
Remote patient monitoring (RPM)
- Importance: Enhances chronic care management and patient engagement.
- Considerations: Device reliability and patient adherence.
- KPIs: RPM enrollment and satisfaction, reduced readmission rates, and reimbursement earned.
Cost Control
Outsource strategically
- Importance: Reduces overhead while maintaining focus on care delivery.
- Considerations: Partner quality and service accountability.
- KPIs: Overhead as a percentage of total revenue and service level agreement (SLA) compliance rates.
Join group purchasing organizations (GPOs)
- Importance: Lowers costs for supplies and equipment.
- Considerations: Evaluating the best-fit GPOs.
- KPIs: Supply expenses per provider and vendor performance scores.
Review leases and contracts
- Importance: Ensures competitive pricing and reduces unnecessary spending.
- Considerations: Regular contract review and vendor negotiations.
- KPIs: Facility cost per square foot (MGMA benchmark), and average contract dispute resolution time.
Monitor utility use
- Importance: Lowers unnecessary operational expenses.
- Considerations: Implementing energy-saving technologies and practices.
- KPIs: Utility costs per square foot (MGMA benchmark).
Minimize overtime
- Importance: Prevents payroll inflation.
- Considerations: Effective workforce planning and schedule balancing.
- KPIs: Overtime hours as a percentage of total hours worked.
Revenue Enhancement
Add new services
- Importance: Diversifies revenue streams and meets emerging patient needs.
- Considerations: Market analysis and service feasibility.
- KPIs: Revenue generated from new services.
Direct primary care (DPC) or hybrid models
- Importance: Creates consistent alternative revenue streams.
- Considerations: Community demand and pricing structure.
- KPIs: Revenue from DPC/hybrid model subscriptions and associated patient satisfaction.
Expand group visits
- Importance: Boosts revenue by serving multiple patients efficiently.
- Considerations: Staffing, space management, and patient education.
- KPIs: Revenue per group visit and patient satisfaction.
Compliance and Training
Prevent embezzlement
- Importance: Protects financial integrity.
- Considerations: Internal controls, segregation of duties, and regular audits.
- KPIs: Incidence of financial discrepancies through audits and report reviews.