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First Direct Primary Care Practice in Rochester, NY!

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Missy Marsocci, owner of Cornerstone Healthcare Consulting, interviews Dr. Laura Petrescu of Athena Direct Primary Care & Lifestyle Medicine, the first Direct Primary Care (DPC) practice in Rochester, NY! Click on the video below to watch!

Whether you’re a small business owner, a physician in Residency training or someone seeking a new primary care physician, this video is for you. Tune in as Dr. Petrescu answers the following questions:

1.) Tell us about Athena DPC & Lifestyle Medicine

 2.) What is DPC? How is it different from concierge medicine?

3.) What is lifestyle medicine?

4.) What made you decide to open your own practice, using the DPC model?

5.) Are there ways for Athena DPC to work with small businesses?  

Interested to be patient of Dr. Petrescu? Check out her website at athenadirectcare.com where you can also schedule an appointment. Or give the practice a call at 585-662-5510

About Cornerstone Healthcare Consulting & Management: Cornerstone Healthcare Consulting provides multiple consulting services to physicians and medical practices. To learn more or schedule your free consultation, please visit their website at http://www.cornerstonehealthcareconsulting.com

Follow Cornerstone on social media: Instagram: @healthcarecornerstone

Twitter: @cstonehealthcon

Linkedin: https://www. www.linkedin.com/company/cornerstonehealthcareconsulting

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Buyout Should Be a Future Plan, Not an Emergency!

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It’s no secret that the healthcare industry is in a state of flux. Many things have led to changes in the way doctors and hospitals do business, and those changes are only going to become more widespread in the coming years. For many physicians, this means that now is the time to start thinking about buyout as a future plan, rather than an emergency measure. In the video embedded below, we’ll explore why buyout should be a key part of your long-term career strategy, and we’ll offer some tips on how to make it happen. So read on – your future may

depend on it!

Succession planning should not become a contentious debate among physician partners; however, at Cornerstone, we have frequently witnessed this happen with multiple medical practices. Sadly, the topic typically goes years of never being discussed, to suddenly coming up because of situations that require emergency planning, and/or junior partners possessing a feeling of being treated unfairly. With respect to the latter, don’t even think about joining a medical practice as a partner unless you’ve had the tough questions answered first. For example, ask about call schedule requirements, how money is dispersed, what happens when a partner begins to plan to retire, such as an OBGYN who discontinues doing OB, etc. Once your questions are answered to your satisfaction, then make sure they are in writing before you sign.

A part of the succession planning discussion should be physician partner buyouts, and how to plan for that. A buyout is not always the result of retirement. The discussion should also be focused on a partner becoming disabled, as well as if the need arose to terminate a partner prior to retirement. When it comes to buyout, there’s no one-size-fits-all answer. The first step is to sit down with your partners and hash out the details. In the video embedded below, we sat with Jim Ginnane and Alex Heringer from Planned Futures Financial to ask them a few questions for how to prepare for buyout. Here are the questions we asked them:

  1. At what point should the owners start exit planning?
  2. What are the different types of buy/sell agreements?
  3. What do you do when the potential successor (s) don’t have sufficient money to buy you out?
  4. What are the usual funding vehicles for buy/sell agreements?

As you can see, succession planning is important for any medical practice. By taking the time to develop a plan and put measures in place to ensure a smooth transition, your practice can survive – even thrive – after you retire or move on. If you are preparing for a buyout, make sure you work with an experienced team of advisors who can help guide you through the process and minimize disruptions to patient care. Want more tips like this? Check out our blog page! Need some guidance? Schedule a consultation today!

Reducing Medical Practice Expenses

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Do you feel like you are constantly fighting to keep your medical practice afloat? Are you looking for ways to reduce your expenses and improve your bottom line? If so, you’re not alone. In this post, we’ll explain our approach to reducing medical practice expenses, and how we saved one practice as much as $260,000!

A common concern echoed by physicians is the issue of working more yet earning less. On one side of the equation, everyone knows reimbursements continue to decline and insurance companies are always looking for reasons to deny your claims. We could get on a soapbox as to why you should consider Direct Primary Care/Direct Specialty Care, but we’ll save that for a different post. But what about the other side of the equation? Have you evaluated how much the practice is spending, and on what?

When Cornerstone Healthcare Consulting is retained to evaluate your practice, one of the first things we will ask you for is a copy of an expense report from the last 12 months. This report will provide us with a few initial clues for the low hanging fruit of where you are paying too much. For example, we will immediately review your medical supply costs, as well as medical waste costs. With respect to medical waste, there is a certain vendor that is notorious for ripping off medical practices. We have saved practices thousands of dollars just in medical waste services because of this vendor. To give you an example, below represents a former client who had waste services with this vendor for two of their locations. It shows what they were paying for medical waste with the former vendor versus what they are now paying with the new vendor, and total savings.

Evidently, this was a large savings, and it may seem like this was a one-time occurrence. However, it was not. Whenever we see this vendor, we know the client is paying too much money. Often, the medical practice is unaware there is a different choice than that vendor. Even if they assumed there must be an alternate vendor to the one they are using, they have no idea who that would be. Additionally, they often get locked into contracts and see it as impossible to get out. This particular vendor has been sued in the State of New York for violating contractual law, not notifying the client their contracts were set to expire within 60 days. As a result, the clients were locked into another year or more, paying these prices. Fortunately, the lawsuit against them was a success. Therefore, we have been successful in getting clients out of existing contracts with this vendor, citing the recent lawsuit.

Similarly, we always look to see who the practice is using for their medical supplies. There are a couple culprit vendors that are known to charge too much. We have a preferred medical supply vendor we like to work with, who many physicians don’t even know exist. Each time we have worked with them, they have saved our clients more than 20% on medical supply costs. Also, we have had scenarios where practices have switched to them, and suddenly their former vendor is willing to match those prices. That confirms they can significantly lower their prices. But if no one is watching the pricing as it goes up year to year, and no one knows there are options for other vendors, then they will continue to get away with charging too much.

            Another area for big savings is within employee benefits. As mentioned in a previous blog titled, The One-Stop Shop for Doctors, both the retirement plan and health plan are often in need of review and revision. Within the Cornerstone Network, we have professionals we regularly work with, who have been incredibly resourceful in assisting our clients. Planned Futures Financial primarily deals in the medical industry and is our go-to when it comes to retirement planning as well as life and disability insurance. One client they saved over $40,000 between what was saved in reducing their retirement plan expenses and group disability insurance, as well as eliminating the cost of their TPA. Azeros Health Plans is our go-to for health insurance costs. Co-owners Ron Zoeller and Kevin Gannon previously operated their own companies for years before opening Azeros together. In addition to assisting us with health plans, we also work with Azeros on Direct Primary Care initiatives.

            Although our intent is to save you money, it is also our responsibility to ensure you have the proper resources to operate your practice. If it means we need to recommend a new vendor that may cost you a little money, but you are properly covered, we will do that. One area this could happen, is with your business insurance. We collaborate with Steinmiller Insurance, who are well versed in understanding medical practice coverage needs. They are very familiar with the HIPAA laws, as well as the need for data protection. Upon reviewing your current insurance coverage, they may match what you have and save you money. But they may also suggest adding important coverage that you do not currently have, which will cost you a little more, but could protect you in a big way.

When evaluating your expenses, we don’t just go for the low hanging fruit, or the large expenses. We will thoroughly review everything, both big and small. In addition to the recommended changes, we will help facilitate them! From reviewing expenses, to negotiating with vendors, to executing the change. We have done everything from counting inventory to helping to install new phone systems to assisting with the transition form server based EMR to cloud based EMR.

With insurance reimbursements declining the ability for medical practices to reduce expenses is a top priority. We can help you! Schedule a consult today, so we can get started!

Medical Practice Marketing – Getting Started!

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As a physician, you are among the brightest individuals in the country! You have survived years of rigorous schooling and training, learning words most of us cannot even pronounce. But this new era of marketing has got you scratching your head in confusion. From social media to google reviews, and beyond, you don’t even know where to start. Good news! That’s where we come in!

As fellow healthcare professionals, we understand all that you are up against. In addition to providing marketing, we are working with physicians to help them sustain their medical practices; also, we are opening new medical practices, providing practice management support and more. Who better to be the voice for physicians than a company who is living in their world, slaying the same giants? Commonly, physicians will say things such as, “I don’t understand this social media stuff”; or “We never had to worry about marketing until now, we just worked really hard providing great care, and the patients followed”. That was the era prior to Google ads, social media, and private equity backed medical groups. Let’s talk about what that all means.

As a minimum, practices need a decent website, and a social media presence. That’s assuming you have a practice name and are not just using your legal name. It may sound silly to say that, but we had a client who never had a name beyond their legal name that used their last names. They sounded more like an accounting or law firm. Prior to retaining Cornerstone Healthcare Consulting, they retained a well-known, expensive marketing agency, with the intention of identifying a name and a brand. That consulting agency charged them $15,000 but never provided them a name they liked. So, the marketing agency made out quite nicely, and the practice walked away with $15,000 less in their bank and no name. When Cornerstone came on board, we ran a contest among the staff, allowing them to propose a name they thought the practice should adopt. Upon review of the staff suggestions, they ended up selecting one of them as the new practice name, without paying $15,000. From there, we were able to coordinate the design of a practice logo, website, social media, and more.

Most of the time, physicians recognize the need for a good website. They realize a website is the present-day version of the yellow pages. However, they don’t always grasp the importance of social media. Why is social media important? This is where potential patients are! When patients need a new physician, the first places they are likely going to are Google, and possibly Facebook. On Google they are checking out your reviews, and on Facebook, they are reviewing your photos to get a sense of who you are, what the environment is like, etc. Beyond that, content is king! While we are all looking for the quick easy fix to increase our website search engine optimization (SEO), it is often the same laundry list of tasks that need to be done to be successful in that endeavor, with one of the items on the list being content creation.

It’s not just potential patients who are reviewing your social media accounts, but also potential employees. Like potential patients, potential employees are checking out your Facebook pictures, attempting to gain a sense of what the environment is like, if the staff look friendly, etc. The social media pages can say a lot about the practice. One of the ways Cornerstone seeks to be different, is we shy away from boring “corporate-like” posts that have the look of desperation for just putting content out. We take pride in being personable, promoting the physicians and staff, and the amazing things they are doing. Also, because of our healthcare background, we actually have some knowledge for what we are promoting. This is especially useful when generating blogs, and how certain topics may create more patient questions than answers. Understanding the practice operations significantly helps as well. It allows us to consider how the marketing will impact the staff answering the phones, and other practice logistics. And let’s not forget about HIPAA! Yes, we are well informed of those laws, abiding by them regarding patient photos, information, etc. Working with a marketing agency that does not understand these laws can leave a practice vulnerable.

 We understand it is a big jump for most practices to agree to launch social media pages. The big question they often have is which pages are needed to get started. There are many ways to answer this question, such as based on specialty, target market, etc. First and foremost, a Google My Business page is a necessity. If you want to keep it simple, a Facebook page is a great start. If you create a Facebook page, it just makes sense to also have an Instagram page. If your practice isn’t quite ready to spend the money on a marketing agency, there are lots of resources that are easy to use, and either very affordable, or even free. A few examples of these resources are as follows:

Canva – Allows you to create attractive content. There is both a free version, as well as a very affordable Pro version. There are already custom sized templates available per the size requirements of the social media platform you are posting on.

InShot and CapCut – Video editing apps for your phone that are very easy to navigate. CapCut even has a shortcut version that designs videos using the content you populate it with. Like Canva, they offer both a free version, as well as very affordable pro versions.

Hootsuite – Looking for efficiency, with the ability to post the same content across multiple platforms? Hootsuite is a great option. The free version allows you to add up to three of your social media platforms.

Later.com – When browsing Instagram, you may have seen the Link in Bio feature. To add this feature, you can do so for free on Later.com. Like Hootsuite, you can schedule and publish social media posts from this one location. Their free version offers up to 15 social media platforms.

MailChimp – In need of something to help you with email marketing? MailChimp provides a free version that allows you to have up to 2,000 contacts.  

Many of the above resources can integrate with other programs. MailChimp, for example, can integrate with Facebook, as well as Survey Monkey, who you may be using for your patient satisfaction surveys. If that all still sounds way too confusing, and you just want to outsource your marketing, give Cornerstone a call! We will work with you on a plan that complements your practice in all the best ways possible, including affordability.

Lastly, once medical practices make the decision to develop a marketing program, they tend to get a bit overzealous and want us to dive into everything immediately. While we love and respect your enthusiasm, you will hear us recite the need to first form a foundation for which we can build from. Marketing isn’t the only service we recite the need for a foundation. In fact, I think we recite that for all our service lines, because we think it’s that important. With respect to marketing, it must start with a website, then social media, so on and so forth. Google ads for example, can be very effective, but without an established website, you are limiting the effectiveness. In addition to Google ads, once the foundation is laid, we can work on patient satisfaction programs, physician referral programs, and more. Interested to learn more about how Cornerstone Healthcare Consulting can help you with your marketing needs? Click HERE to schedule a consult!

The One-Stop Shop for Doctors!

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After years of consulting for doctors and medical practices, Cornerstone Healthcare Consulting has built a network of highly regarded business professionals to collaborate with. When consulting, we often discover similar problems at each practice. A couple common denominators are in the areas of benefits, as well as human resources. As we tackle practice level problems, it is not unusual for us to identify individual physician problems, such as poor retirement planning or lack thereof, and more. Let’s dive in further to how we collaborate with some of these great professionals and provide solutions for physicians!

We recently coined the term, One-Stop Shop for Doctors! As a physician centric healthcare consulting company, we seek to provide solutions to physicians whether they are a solo practitioner, employed by a group, and/or own their own practice. We could provide examples for how we are assisting physicians in each of these areas of employment. Whether it is to manage their social media, providing them brand identity as a hospital employee, to open them a practice, or fix an existing one, we can do it all. And in the areas, we may not have the skillset or expertise to provide, we can facilitate solutions through top professionals within what we call the Cornerstone Network.

When consulting for medical practices, employee benefits is regularly an area in need of repair. The two areas of benefits we have found big savings in are the retirement plan, as well as health plan. Typically, what happens is the practice selects a broker relationship in both these areas years prior. Over time, the brokers earn a commission for essentially doing nothing. Annually, health plan premiums go up, and practices just accept that as a norm and move on, and the retirement plan goes under the radar, without regard to what percentage rate the practice is paying, how the investments are doing, etc. When providing healthcare consulting services, Cornerstone reviews everything; the practice owners are shocked by the findings. We have discovered practices paying over 2% on their retirement plans, egregious TPA costs, inappropriate employee fees, etc. One private practice, we saved them close to $40,000 on their retirement plan!

When reviewing practice health plans, we could take the easy route and just look for lower cost options, but that isn’t really providing a solution. Instead, we take a hard look at the practice size and opportunities that exist as a result. For example, one practice was large enough to become partially self-funded in the State of New York. As a result, they were scheduled to save as much as $30,000 in the first year, and no less than $8,000. Each year, as they better understood their annual expenditure, they could become more aggressive in their risk and potential savings.

Planned Futures Financial is who Cornerstone collaborates with to tackle medical practice retirement plans. In working with Planned Futures Financial, they also review the practice’s Group Life and Disability Insurance, as well as whether a practice has buy-sell insurance. We regularly discover that most practice owners have no idea what buy-sell insurance is, and upon learning about it, wish they had started a policy years prior. Although buy-sell insurance is necessary, before purchasing a policy there should be a succession plan in place. Sadly, most practices we have consulted for have avoided the topic of succession planning, and it regularly becomes a topic for debate. There are many pieces of advice we could provide to a physician considering becoming a partner in a practice, but one of the most important things we could tell you, is to ensure there is a succession plan first. Each specialty has their uniqueness as well. For example, within an OBYN practice it is important to discuss how partners are treated financially once they stop doing obstetrics. These conversations are important early on, as many times they do not end positively if discussed later. Need a good healthcare attorney to support you in these discussions? We have that relationship as well! If employee benefits are being reviewed, it is imperative to also review your human resource department entirely. Often time, we see practices without job descriptions for their staff, or job descriptions that are paper written and haven’t been updated in more than ten years. If the job descriptions haven’t been updated or are non-existent, the employee benefits manual is also either in severe need for an update or non-existent. It’s always baffling to us how practices are hiring without either a job description or an employee manual. It’s inappropriate and there is nothing to hold staff accountable. As you may have assumed, we unfortunately discover these practices have toxic employees that have contributed to many of their organizational problems, but the practice has no process for disciplining them and/or terminating them. Therefore, they are allowed to continue to spread toxicity, of which invariably leads to other toxic employees joining them.

Has your medical practice had a check-up lately? Just having us review an expense report could save you thousands of dollars! Or maybe your practice is in great shape, but you’re unsure if you yourself have the best retirement planning in place, or proper disability insurance. Or maybe your practice is running smoothly but has no idea how to market on social media. Or maybe you’re a physician who is employed by a hospital, needing help with maintaining your own brand identity, and how to market that. Whatever it is, we can help! Click here to visit our website to learn more about our healthcare consulting services and schedule a consult!

Consultant to Patient – Hip Surgery Post Op Visit

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Like everything, you spend so much time in anticipation of something you’re waiting for, and then it’s quickly here and gone! That is no different with my recent hip surgery.

It was my third time going “under the knife” on this right hip. My initial injury was the result of a Shaun T Insanity workout that tore my labrum and iliopsoas tendon, as well as leaving me with some hip impingement. The surgery was a success, and life went on. That is, until I had this idea during COVID, that while everyone else was sitting around putting on the pounds, I was going to get into the best shape of my life. It was a great idea until I participated in a cross fit style workout and once again, tearing my labrum. That time, I tore it worse than the second, but at least my tendons were in good shape (have to look on the bright side). Also, at least while he was in there, he was also able to repair some abnormal bone growth. That was in November 2020.  

After the second surgery, I wasn’t progressing as well as the first. Many individuals were kind enough to remind me I was six years older this time around, and that I may not heal as easily or quickly. That was quite accurate, upon realizing there was a third tear to the labrum! Although, I’m not exactly sure how I did it that time. So, I went back into surgery on November 5, 2021.

Eleven days later and I am doing great! I have not taken anything for pain! Yesterday, I went for my post-op appointment, which was rather insightful. My surgeon agreed I am doing well, but there are more questions than answers for what my future hip health looks like. During the surgery, he discovered my labrum is ossifying (turning to bone) and I have some arthritis that has formed. Because he did not see those things only one year prior, I was concerned about how quickly they had formed, and what that means going forward. Unfortunately, there is no real way to tell. He explained that some people may progress very quickly, while others it may be years before any further progression occurs. Therefore, he said we will take this one day at a time, and as I continue to see him for subsequent post op appointments, he will continue to evaluate my situation.

What’s next? I get to gradually transition off crutches this week! Woohoo! These things are such a pain! Also, I will start physical therapy and work toward being 100% again. Stay tuned for more updates!