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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!

Making Private Medical Practices Sustainable

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In today’s world of big corporate health care systems, private practices are a space for patients who want a different experience and physicians who do not want to work in a big system structure. Private practices often face sustainability issues, many physicians find themselves looking at the possibility of selling or ceasing operations. Melissa Marsocci, the founder of Cornerstone Healthcare Consulting and Management, is an expert in healthcare administration and management, specializing in guiding private physician practices into a more sustainable future, increasing business and quality of patient care.

Marsocci has a long history of successfully running multiple practices of her own and was offering telemedicine well before the COVID-19 pandemic made it so popular. Now, she is working to help private practice physicians turn their business around with her unique and highly effective turnaround consulting method. Her goal is to keep private practices in business and allow practitioners to focus on their area of expertise, treating patients.

Marsocci ‘s approach is distinctly different than most, setting her apart from other healthcare management consultants. Most consultants come in, review the practice, identify problem areas, develop a plan to address them, then leave. Marsocci explains that she takes a whole-picture approach, she is not just going to give a practice a once over and some suggestions. Instead, she conducts a thorough, very in-depth examination of the business, getting into the details about literally everything to gain a full perspective of how the business operates, and where things can be improved. Her goal is to reduce both operating costs and overhead, once she is done identifying areas and methods of improvement, she sticks around to implement them.

Marsocci focuses on areas that are often overlooked when practitioners are trying to figure out why their business is not sustainable. Part of the process is in-depth, confidential interviews with every member of the staff, and determining if personnel are in the right positions for their education and skills. It is often the case that someone who may not have the right skill set is making decisions about things like benefits packages, vendors, supply chain contracts, and more that end up costing the practice money. Marsocci goes through the practice top to bottom with a fine-tooth comb, then develops a detailed plan, specific to that practice’s needs, to move forward.

One of the areas that showcases Marsocci as a changemaker is that she is willing to do whatever it takes to help a private practice turn around its business and has the skills to back it up. She will do everything from implementing websites and marketing, doing social media, rebranding, engaging the staff, and more. A big part of the work is improving outdated technology, Marsocci is hands-on, she will install phone systems herself if need be!

Marsocci is passionate about high-quality medical care and is a shining example of an independent woman in business. She always had an entrepreneurial mindset, starting a lawn mowing business in college to support herself. Originally, she planned to study clinical medicine, eventually realizing her skills were better placed in management, where she made her passion for providing the best possible care for patients come to life. As an only parent to her young son, Marsocci is an amazing example of a driven businesswoman who has made her mark, building a business to meet her own needs as well as those of her clients. Learn more about Marsocci and her impressive model of turnaround consulting on her website, and connect with her on LinkedIn, Instagram, Twitter, and Facebook!

New Physicians Choosing Private Practice Again

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As the workforce evolves and younger generations are entering into the mix, there has been a big push for independence and working for oneself. This is true in every industry, and especially so in the healthcare world. Many younger physicians and medical specialists are looking for options involving private practices, not wanting to be tied down or restricted by big hospitals and healthcare systems.

Melissa Marsocci, Founder of Cornerstone Healthcare Consulting and Management, specializes in helping practitioners make the jump into private practice and expects to see a lot more of them popping up in the next few years. This is in part due to patterns she sees that resemble what happened a few decades ago, and due to the business and healthcare management environment of today.

As Marsocci explains, this draw towards opening private practices stems in part from younger generations entering the workforce, and not being satisfied with the status quo. Many people now want to go into the entrepreneurial space, while still working one-on-one with patients.

Some physicians feel reluctant to get into a contract with a big healthcare system because they are limited in how they can practice, these systems often have patient quotas, specific treatment timeframes, and treatment limitations. In other cases, it is simply a practitioner wanting to focus on a more customer-centric model, and wanting the freedom of owning their own business.

Start-ups of any kind are easier now more than ever, without the requirement of a brick-and-mortar space there is no limit to how practitioners can connect with patients. Cornerstone Healthcare Consulting and Management has a turnkey solution that can get private practices up and running quickly, with everything they need to provide the best patient care.

They also work with practitioners looking to purchase or partner into an established practice, going through all the pros and cons, helping them decide which route forward best serves their needs.

Marsocci has been in the business a long time and has herself started multiple successful private practices in the Greater Philadelphia Region and New York area, so she knows what it takes both from the management side of it and the owner side. She is not a practitioner, she is an expert in healthcare systems management, and knows the industry inside and out.

Because part of her business is working with practices looking to sell, or improve their sustainability, she knows all the different areas where things can go wrong or need improvement. Her company helps with every single phase of the process, she will do everything from the ground up, including scouting out retail space, coordinating the website, installing the phone system, literally everything.

Marsocci is so successful because she never loses sight of the objective, providing the best care and making things better for the patient. She strives to be cutting edge and on top of trends in the industry, looking at all the new methods and business models that are working.

An example of that is telemedicine, which she was offering well before the COVID-19 pandemic made it so popular. As an entrepreneur herself, she knows exactly what struggles and challenges these practitioners will face and has a ready-made way to approach it.

Marsocci is an incredibly positive and insightful person, deeply committed to helping both physicians and patients. As a single mother, and woman in business, she understands how important work-life balance is and incorporates that into everything she does.

Connect with Marsocci on social media through LinkedIn, Instagram and Facebook, and visit the Cornerstone Healthcare Consulting and Management website to see how they can help get your private practice started.

Are Non-Compete Agreements Enforceable?

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If you have ever taken a position with a healthcare facility, regardless of whether it is a hospital or medical practice, then you know that non-compete agreements are often a key part of the offer letter. What can you do with your career if you sign one? Is it worth it to sign one in order to get that job? In this interview with top healthcare attorney Brigid Maloney, we discuss non-compete agreements and how enforceable they really are.

Brigid Maloney is a Partner and the Co-Leader of the Health Law Practice at Lippes, Mathias, Wexler, Friedman Law Firm in Buffalo as well as Albany New York. With over 20 years in healthcare law, Brigid has done it all…from representing digital health companies, to hospitals, medical practices, and everything in between. Therefore, who better for us to meet and discuss the various aspects surrounding employment law in healthcare. Although non-compete agreements were a main focus of this interview, Brigid provided us with so much more. Below are the questions posed to Brigid from Cornerstone Healthcare Consulting’s President, Missy Marsocci. Be sure to watch the video, this is full of valuable information!

  • Is it necessary to involve an attorney for review of an employment agreement?
  • What is a non-compete agreement? Should I sign it?
  • Once employed, are non-compete agreements enforceable?
  • One additional question you’ll have to watch to discover.

Interested to learn more about Brigid and/or contact here? Follow this link to read her bio and gain her contact information. https://www.lippes.com/team/brigid-m-maloney-57

Have a healthcare consulting need you’d like to discuss with Cornerstone Healthcare Consulting? Click her to schedule a consult! https://cornerstonehealthcareconsulting.com/contact/