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| Dear Friend,
What sort of business relationships are you creating?
Most business relationships that we enter into in our life are transactional. I want to buy that car. I want to sell my house.
Those relationships have the transaction as the focus.
And once that transaction is complete, the relationship is over. In other words, there is, at the closing, a parting of the ways.
Other sorts of relationships, for example, the standard concept of an exclusive contract between, for example, a radiology group and a hospital, involve creating a relationship that continues past the closing. Instead of being the end, the closing is the start of the term. It's not like the delivery of the car, which is transactional. It's the beginning of a relationship.
But query at the same time, when you're selling that hospital on the creation of a relationship, whether you also go to the next level, being not simply the creation of a relationship between your group and the facility, but the creation of a transformation for the benefit of the facility.
What are you bringing to the facility that will change it, that is, will transform it for the better, as a result of entering into the relationship with you?
That's a far more powerful selling proposition. It's uses a more powerful set of actions to cement the relationship between your group and the facility. It also requires another way
of thinking.
It's not just a continuation of providing coverage from “x” hour to “y” hour five-days a week, and a slightly different schedule on the weekends. Rather, it's a series of interactions that are aimed at improving the facility so dramatically that their position is forever changed and continues to improve and evolve. If you can do that, they really have no logical choice but to continue to do business with you, moving into the future.
So, think about that: Transaction. Relationship. Transformation.
What would you rather obtain? What would you rather provide in order to maintain the longest possible profitable business relationship? |
| | | 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 transcript:
Counting the day this newsletter is being published, there are 56 days left in the year. What do you have left to accomplish?
Many people are saying the year has been “blown” due to the impact of Covid-19. I know that for some of my clients, and some of my friends in the healthcare industry, indeed 2020 has been a crappy year.
For others though, they’ve rebounded just fine.
Either way, there are still 80 days left.
What goals do you have for this year? What can you accomplish? What can you not put over until next year? How can you avoid using “only 80 days left” as an excuse?
Sure, it’s easy for me to say this. And, it’s also easy for you to say, “I’m going to get moving!”. . . and then just not do it.
But you actually have far more control over your future than you imagine.
If all you do is think about doing it, but never act, nothing is going to get done. The key is to actually get moving, to actually get “doing”. So, get moving. It’s that simple. Hard perhaps,
but simple. |
| | 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 - What Do You Call Other Than “Bankrupt”?
Watch the video here, or just keep reading below for a slightly polished transcript:
Evolutionary psychologists say that the
reason we see a stick on the trail ahead of us as a snake is that it's far better for our survival to see sticks as snakes than snakes
as sticks.
This and other biases cause us to more readily focus on the relatively immediate threat as opposed to the long-term one.
So, when earlier this month CMS released its various proposed 2021 payment
schedules, physicians quickly focused on what's in it (or, rather, out of it) for them,
that is, for their specialty.
But at the same time, a focus outside one’s own immediate specialty reveals other trends, ones that may have a longer term but more significant impact on your career.
As anyone who's been reading my posts and articles (and my book, The Impending Death of Hospitals, available here for download) over the past six or so years knows that the trend of shifting procedures from the hospital setting, including from the hospital outpatient department setting, to the ASC setting is of tsunamic proportions.
In accordance with that trend, CMS’s August proposed payment pronouncements have hundreds of procedures moving to the ASC setting. For example, they propose moving more than 266 orthopedic procedures from the inpatient-only list, which means soon to be done in an ASC.
Even more revealing is that CMS is proposing to eliminate the inpatient-only list in its entirety over the next 3 years.
Shh . . . hang on for second. Can you hear that? Yes, it's the American Hospital
Association screaming.
In the long run, for those physicians performing facility-based services, such as anesthesiologists, these very strong continuing signals, in fact, stronger signals than
in the past, are clear signs that unless your business model takes into account the fact
that hospitals as we know them will soon no longer exist, your business might soon no
longer exist.
And, on the flip side, those physicians who understand that competing with hospitals on the facility-side is becoming easier and easier, it's time to consider ASC development.
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| | | Listen to the podcast here, or just keep reading for the transcript.
The coronavirus has closed their office doors, but the U.S. Department of Justice is still prosecuting healthcare crimes and extracting painful settlements.
Last week, the DOJ settled a case involving what might be described as a twist on the "free with purchase" promotion so popular with regular merchants, "regular" in the sense of not having anything to do with healthcare. Here, the allegations were "free with referral."
In the case at point, the allegations were that the defendant physician, Mubashar Choudry, M.D., a cardiologist who treats patients for peripheral arterial disease in Maryland and Washington, D.C., and three medical practices with which he's associated, Washington Cardiovascular Institute, Advanced Vascular Resources, and Washington Vascular Institute, performed free "ankle-brachial index" tests on the patients of other physicians and allowed those physicians to bill for the procedures, thereby providing remuneration in exchange
for referrals.
On April 17, 2020, the DOJ announced that Dr. Choudry, and the three medical practices have agreed to pay the United States $750,000 to resolve the underlying False Claims Act allegations that they knowingly billed Medicare and TRICARE for claims in violation of the Anti-Kickback Statute ("AKS"). As mentioned above, the defendants allegedly induced patient referrals by providing ankle-brachial index testing on patients under agreements with the referring physicians but without collecting from the physicians the fair market value for
the tests.
As readers are well aware (right?), the AKS prohibits the knowing and willful payment of any remuneration to induce the referral of services or items that are paid for by a federal healthcare program.
Kickbacks can take many forms, from good old cash in a bag, to free rent, to undervalued services (e.g., the so-called company model of anesthesia services problem), to, well, tests that someone else can bill for.
One final point, one that falls into the category of "last, but not least" - the settled allegations arose from a whistleblower action brought by Steven Pringle, a former sales and operations employee of the practices, under the False Claims Act, which permits private parties to sue on behalf of the government for false claims and to receive a share of any recovery.
"Who'll ever find out?" is a question that many physicians ask themselves when hatching too-clever plans. The answer, of course, is your own staff.
In the Choudry settlement, the "why" for the whistleblower probably includes the fact that he's about to receive a check for his share of the government’s recovery. |
| | | 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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