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| Dear Friend,
Labor. As in work.
That's the topic of this past Monday's blog post, Laboring On [About] Labor Day. You can follow the link to read the post online, or just keep reading for the rest of the story.
[Today, I'm waxing philosophical. If you want to wax along with me, then keep on reading. If not, then please peruse the rest of this newsletter.]
I'm writing this today, September 4, 2023, Labor Day here in the U.S.
Originally proposed by union leaders, Labor Day commemorates American workers. Just as unions have mostly outlived their usefulness to all but union leaders, Labor Day has become a day for barbecues, family gatherings, and just plain old fun.
Some claim that there is a thing called "work-life balance." My opinion is that we have only one life (I'm not betting on reincarnation) and that work is an essential part of it. It's a main driver in why we're here. Work gives us a purpose in life.
I've often heard people say things akin to "I have four years left," in reference to the time until they "retire." I shake my head in wonder, both because it seems to me as if they're talking about a prison sentence (i.e., four years until parole) and because it seems as if they believe that work is getting in the way of some idealistic "life" that hasn't yet begun.
I'm certainly not advocating that you work, work, work and have no fun, for what is life without fun. I believe that we should approach work and non-work as building blocks for your day. You not only have to work smarter (do the right thing) but there's no getting around the fact that you also have to work harder.
I can almost guaranty that your competitors are not just sitting around the pool today, they're also doing some thinking about how they can snatch away your opportunities. Even if I'm wrong and they're all floating around on inner tubes, it's even more of a reason for you to outwork them into the ground.
I took some time off this morning. Now I'm about to get back to work preparing for a meeting. After all, it's Labor Day.
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| | | Tuesday - UnitedHealth Profits Up, Payment Practices Down - Success in Motion
Watch the video here, or just keep reading below for a slightly polished transcript:
Let’s talk about UnitedHealth group.
It's August 2023 and the U.S. Department of Labor has filed suit against UnitedHealth Group, in particular one of their subsidiaries, an entity called UHR, which is a third-party administrator, claiming that they've failed to follow requirements under the Affordable Care Act by denying 100% of all urine drug screenings between August 2015 and August 2018. Yes that’s right, 100%.
According to the lawsuit, from August 2018 to the present, UHR allowed some urine screenings performed in an emergency setting, but then changed its denial code on the rest of the screening claims so as to make things confusing as hell. The government claims that their Explanation of Benefits form didn’t describe the reason for denial and didn’t mention the appeals process.
I don’t want you to feel too bad about UnitedHealthcare’s internal operations. After all, UnitedHealth’s gross revenues are up from $287 billion in 2021 to $324 billion in 2022 and their earnings, their profit from operations, moved up to $28.4 billion from a measly $24 billion.
We know they can do some things right, like make a tremendous profit.
If they could only pay you for your services, think how much better things would be.
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| | Wednesday - The Inflation Tax - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript: “Now, here, you see, it takes all the running you can do, to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that!” -- The Red Queen in Lewis Carroll’s Through the Looking Glass
Just like hypertension, inflation is the silent killer, the hidden tax on your business, dreams, and desires.
Providers from physicians to ASCs celebrated when CMS’s final fee schedules for 2022 either weren’t cut as deeply as expected (an average reduction of 3.85% for physicians) or were increased slightly (2% for ASCs).
Yet, with 20% of the dollars in circulation having been created in 2020, the inevitable result is quickening inflation, a hidden tax on all concerned.
The general Consumer Price Index jumped up approximately 7% last year. But data from the Bureau of Labor Statistics shows a 50% year over year increase in the cost of gasoline, food prices up 6.3%, and new car prices up close to 12% . . . if you’re lucky.
Unless you were prescient enough to have negotiated CPI increases into your payor agreements, costs may eat you alive while the inflation indexed value of reimbursement shrinks. Combine that with labor shortages in the healthcare industry that are pushing salary expectations, often expressed as take it or leave it demands, many practices and facilities are slipping into the danger zone.
Even if you weren’t that perceptive, renegotiate up what you can now. Don’t let contracts auto-renew. Don’t sign whatever contracts come in the door. Don’t think that going into hospital employment or selling your facility to a hospital is anything more than a short-term solution to a much larger long-term problem.
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| | | Listen to the podcast here, or just keep reading for the transcript.
Right now there's a storm of uncertainty targeting healthcare.
"Where will our patients come from?"
"What if our contract is terminated?"
"Will the hospital's ACO exclude us?"
"Should we sell our practice?"
Many physicians and other healthcare providers are jumping at any deal they can find, believing that they are jumping to safety.
But just as not all deals in any other context are good deals, not all deals to acquire your practice, or to merge with it, or to employ you are good deals.
Bigger or larger or more providers or more locations do not, in and of themselves, make a stronger business. Think Sears plus Kmart.
Move, move decisively, but consider your alternatives and become as certain as you can be before jumping into what you think is a life raft. It might turn out to be just a pool toy.
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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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