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| Dear Friend,
No, you’re not Ebenezer Scrooge from Charles Dickens' 1843 novella A Christmas Carol, but Sam Walton’s ghost can teach you a lesson about your future.
No, it’s not buy low and sell low. It’s something very different.
Before Walton founded the Wal-Mart chain, he operated variety stores. (To anyone under 50, see Wikipedia.)
His first store was wildly successful. That is, until he realized that he had signed a short-term lease with no renewal option. At the end of the first, short lease term, the landlord not only took back the space, he took over the operation of the store.
Has your medical group made the equivalent mistake? Many have. They’ve put themselves in the position that the hospital or another medical group can take over their business as legally, easily, and cheaply as Walton’s landlord took over his store at the end of the lease.
For example, a hospital-based group, let’s call it Trusting Falls Medical Group, has a three-year exclusive contract with St. Mark’s Community Memorial Hospital. Its leaders spent scores of hours recruiting physicians to the group. They’ve developed trust with the referring physicians, with the medical staff at large, and maybe even with the local community in general.
Then, towards the end of the contract term, the hospital announces that it’s not going to renew the contract with Trusting Falls. Instead, it’s going to send out a request for proposal to four large, national groups. How will the “winning” group staff the facility? With most of Trusting Falls’ physicians.
You can do much to avoid this type of situation by taking to heart what Walton did next. He made sure that he always held very long-term lease rights. I’m not saying that you can get a 99-year exclusive contract, but you can build protections into your current contracts that diminish the economic burden in the event of non-renewal and that make your “store” less likely to be shifted to new ownership.
Note that this issue, in slightly different dress, also impacts office-based practices. For example, you wouldn’t be the first cardiac surgery group to find that the hospital has recruited more than half of your surgeons to become the “poster docs” for the hospital’s new cardiac care center. Your position in the new regime? There isn’t one.
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| | | Business Life in the Time of Coronavirus Mini-Series
The coronavirus crisis caused a short term economic crisis for many medical groups. Our mini-series shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
[If you haven't already seen them, follow this link to watch our entire series.] |
| | Watch Tuesday's video here, or just keep reading below for a revised, more polished version:
You may be familiar with the concept of “Know Your Customer.” It's a banking concept in which the bank is required to “know” with whom they’re doing business. In other words, that’s a nice way of describing making the customer prove that they are who they really say they are, in terms of preventing money laundering and other criminal activity involving the bank’s unwitting participation.
Well what about you? Especially if you’re an office-based physician or practitioner, where it’s far more likely to happen. How well do you know with whom you’re doing business. In particular, how well do you know the people who say they’ll provide management and billing services for you?
Often times the scheme I’m going to describe happens when a physician (not quite thinking perhaps) is approached by someone who says, “Well look, we can make your practice so much easier! You don’t have to go and work for some hospital. Just come align yourself with our MSO – after all we have better rates and we already manage 12 other physicians.”
Or, sometimes, it's “We run a Medi-Spa; we've formed a physician management company and we’re looking for physicians to come and help become the medical director for our spas.”
Or even, “Oh no, this isn’t one of those spa medical director scams. We want you to come and locate your consumer-focused practice here in our suite. We’ll rent you some space and don’t worry, we’ll make this easy for you because we’re going to do your billing and collection for you.”
Now some of those arrangements, although they are all problematic, might be above-board in terms of protecting your identity.
Unfortunately, many of them are not.
The usual way this works is that once the schemers have your identity, in other words your SSN, EIN, Medicare/Medicaid numbers, and so on, they begin working the system. They begin submitting claims for cases that were never performed, at times on patients that don’t exist, or if they do, certainly weren’t really your patients. You find out about this one day because Medicare comes knocking or the state Medicaid authority comes knocking. Or, you find out you’re under investigation (or even worse indictment) because of your involvement in the scam.
Of course, the best way to prevent this, is to know your customer, know your manager. Who are you really dealing with? What’s their background? What sort of an investigation have you done on them? Were you represented in connection with structuring the deal? If you were, you probably wouldn’t have entered into any of them, but who knows.
Once you smell trouble, that’s certainly when you need counsel and certainly when you might need to immediately pull out of the deal.
None of these arrangements get better over time. They get worse. You are the most vulnerable participant – even if you didn’t mean to participate. After all, to the outside world (insurance companies, payors, Medicare, state authorities) it's you who ripped them off.
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| | How to Deploy the Secret Sauce of Opportunistic Strategy
Webinar On Demand
They say that COVID-19 has changed the world, creating the "new normal." Many of your colleagues and many hospital administrators are running scared.
Others, leaders like you, know that crisis means opportunity.
Let me provide you with the strategic tools and insights that you need in order to seize opportunities, whether they’re in the context of your current business relationships, the expansion of your business activities, or the creation of new ventures.
You will learn:
•Defense as a defective default: It’s necessary, but not sufficient.
•Exploiting weakness: Drop the guilt and identify opportunity.
•Flat line negotiation is fatal: Understand its myths and limitations.
•Negotiation reality: Learn to identify and deploy on multiple planes to affect the outcome.
•Maneuver: Harness the power of maneuver, both in overall strategy and in specific negotiation strategy.
Others see a crisis and freeze in fear. Learn how to see the opportunities and obtain the tools to increase your odds of obtaining them.
The price to attend is $479. The cost of not attending is astronomical. |
| | | Wednesday - The Odds of Medical Group Survival - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
My dog stood body frozen stiff yet ready to lunge. His eyes fixed on the only object in his world, the squirrel eating seeds off the ground 14 feet away.
The squirrel matched the stare, glanced at the tree about four feet distant and then, continuing to eat the entire time, just turned his back as if he were the only one who would be doing any eating that day.
Businesses, including medical groups, do the equivalent. In a complex system there are who-knows-how-many unseen risks. But there are many significant, obvious risks as well, risks that may be acknowledged intellectually but ignored as unimportant either because the observer is lying to himself or is unprepared to deal with them.
The squirrel's bet was a good one. My dog's never caught one. But maybe one day he will. For the squirrel it will be low odds times high potential damage (death) equals high risk, ignored.
But it's not that the risk wasn't there every time. It was; it's just that the odds came out in the squirrel's favor that day. For the squirrel in the yard, the odds of being eaten had come out in his favor his entire life.
Medical groups that have had successful 20 year or 30 year or even longer runs have benefited from a similar run of the dice.
Several years ago, I had another dog, Showlow. I had the task of removing squirrel parts from the back yard on a regular basis, even once having to tell her to drop the head as if we were playing the Addams Family version of fetch. |
| | | Listen to the podcast here, or just keep reading for the transcript.
You don’t have to have read any Hemingway or have had an uncle with a taxidermied marlin on the wall of his den to know about fishing for big ones.
And you don’t have to know very much at all to know about phishing for big ones. In fact, all you need to know about that thrilling online “sport” is encapsulated in the following story.
In accordance with its obligations under federal and state law, Orlando Family Physicians, LLC, recently announced that in April 2021, an unauthorized person, that is, a criminal, gained access to the email account of one of the practice’s employees through a phishing email. Eventually, the unauthorized access spread to a total of four employee email accounts.
Although the practice has announced that it is unaware of any misuse of the personal information about patients or other individuals, the following types of personal information were present, not necessarily all for any single person: name; demographic information; health information, including diagnoses, providers and prescriptions; health insurance information, including legacy Medicare beneficiary number derived from the individual’s Social Security number or other subscriber identification number; medical record number; patient account number; and passport number.
Several lessons can be drawn from the event:
- Although the details of the practice’s operation are unknown, the breath of information that was exposed by way of the attack is shocking. What is all of that information doing within email accounts? Where is your patients’ PHI stored, and where is it, really?
- Orlando Family Physicians discovered the breach and reacted within days. How quickly might you discover a similar breach? What processes do you have in place? What active security and privacy policies have you not only documented, but put into place? How long ago? When were they last revisited and revised?
- That shiny object dangling in front of your eyes might not be the Mercedes S-Class or that Patek Philippe you’ve always wanted. It might be a hook. Don’t open wide, unless it’s to call me to discuss how to avoid being caught with, well, to mix metaphors, your pants down.
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| | | Calibrate Your Compass
Read our exclusive RedPaper to guide you through this evolving situation.
The coronavirus crisis caused a short-term economic crisis for many medical groups. Our RedPaper shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
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| | Help Us Help You With Helpful Content
What tailored content would you most like to see during this
time? How can we focus on solutions to your most pressing strategic concerns?
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| | | | We all hear, and most of us say, that the pace of change in healthcare is quickening. That means that the pace of required decision-making is increasing, too. Unless, that is, you want to take the “default” route. That’s the one is which you let someone else make the decisions that impact you; you’re just along for the ride. Of course, playing a bit part in scripting your own future isn’t the smart route to stardom. But despite your own best intentions, perhaps it’s your medical group’s governance structure that’s holding you back.
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| In fact, it’s very likely that the problem is systemic. The Medical Group Governance Matrix introduces a simple four-quadrant diagnostic tool to help you find out. It then shows you how to use that tool to build your better, more profitable future. Get your free copy Free.
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| | | | Whenever you're ready, here are 4 ways I can help you and your business:
1. Download a copy of The Success Prescription. My book, The Success Prescription provides you with a framework for thinking about your success. Download a copy of The Success Prescription here.
2. Be a guest on “Wisdom. Applied. Podcast.” Although most of my podcasts involve me addressing an important point for your success, I’m always looking for guests who’d like to be interviewed about their personal and professional achievements and the lessons learned. Email me if you’re interested in participating.
3. Book me to speak to your group or organization. I’ve spoken at dozens of medical group, healthcare organization, university-sponsored, and private events on many topics such as The Impending Death of Hospitals, the strategic use of OIG Advisory Opinions, medical group governance, and succeeding at negotiations. For more information about a custom presentation for you, drop us a line.
4. If You’re Not Yet a Client, Engage Me to Represent You. If you’re interested in increasing your profit and managing your risk of loss, email me to connect directly. |
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