Deb Beaulieu

The Medical Group Management Association (MGMA) last week released its latest report on the traits that make for a successful practice. For the study, MGMA identified 549 "better-performers" from its 2010 cost survey. As always, MGMA provided the caveat that participation in the survey was voluntary so the results don't represent everyone. Nonetheless, all practices should take notice of the traits that make top practices stand out from the many that are struggling.

According to the report, better performers had the following four traits in common:

• Less bad debt. Top practices reported less bad debt due to fee-for-service activity per full-time employee (FTE), reporting bad debt ranging from $6,900 to $14,000 less than other practices.
• Better collections. Better performers reported less than 10 percent of their accounts receivables were more than 120 days past due, while other groups reported rates between 19 percent and 35 percent. Not surprisingly, better performers collected between 90 percent and 100 percent of patient copayments at the time of service.
• Attention to patient satisfaction. Successful practices relied on patient feedback to help them improve. Popular survey questions included those about patients' overall experience, appointment availability, wait times and professionalism of staff. According to the report, more than 60 percent used patient satisfaction surveys to evaluate and improve practice operations, and more than 55 percent educated physicians and staff about behavior based on survey results.
• Use of nonphysician practitioners and support staff. Stand-out practices paid attention to having the right people (and often more people) doing the right things at the right time. In particular, about 63 percent of better performers reported hiring nurse anesthetists, nurse practitioners or physician assistants. They also used physicians' time more efficiently by spending more on support staff per FTE physician than lower performers.

It's interesting to note that not all four aforementioned characteristics are directly financially related. Although it makes sense that practices with tighter revenue cycles would be more prosperous, the survey suggests that struggling practices may be underrating the bottom-line impact of patient satisfaction and having an optimized staff.

But if you think about it, and as the MGMA-ACMPE report clearly shows, the "softer" topics and the hard dollars are inseparable. No matter how hard you try to crack down on patient balances, for example, most people will be more likely to pay up (or return for more services) if they are happy with the way they're treated by the practice. Likewise, busy, stressed physicians are going to be more productive when they're able to delegate to other team members with confidence.

Did anything about this year's better-performers report surprise you? How much weight do you think practices need to give the latter two points to be successful with the first? - Deb @PracticeMgt