Planning Your Practice Future

Do you have goals for your practice? Do you have a strategic plan to help you reach your goals? Or does your practice have no aims, instead reacting to challenges as they arise, often wasting a great deal of time and effort? I believe that it is much better to plan. You are more likely to have firm goals in mind and are more likely to reach them. Also, with the experience of creating and executing plans, you are more likely to be able to handle unexpected challenges adroitly. As Nick Fabrizio stated in the article “Strategic Planning Gives Clear Direction” on ModernHealthcare.com September 2012, “Effective strategic planning will help prepare physicians and their medical groups for the myriad changes expected in tomorrow’s healthcare environment.”

Strategic plans, no matter what the business, have several common features. Most begin with a vision statement. For instance: Provide quality healthcare with a lower cost. This happens to be the number one challenge of healthcare providers according to a 2013 Medical Group Management survey. I believe that being patient-centered, providing quality care efficiently and improving the bottom line is a good vision for a practice.

Vision statements are very broad. Your strategic plan must include some details of what actions you need to take to reach your vision. The vision statement of a practice will remain stable from year to year but the actions will need to change every two to three years. In order to remain flexible to the changing environment of providing quality care strategic plans should be created to last two to three years. In the past strategic plans were written to last five or more years. The rapid changes occurring in all businesses require that strategic plans have a shorter life.

What might be some actions that could be undertaken to provide care that is patient-centered, efficient while providing high quality, and improving the bottom line? One path to improve being patient-centered is to improve communication between physician and patient, helping the patient to set his own goals for his care. Improved communication between other clinical providers and office staff also improves patient-centered care. Care that is more patient-centered is usually more cost efficient and leads to improved income for a practice. This has been shown in studies of patient-centered medical homes, one pathway to improvement in being patient-centered.

A path to improvement in efficiency, a part of my suggested vision statement, is upgrades in health information technology. It will be necessary to update practice management software and other HIT in a practice in the coming year to accommodate ICD-10 coding. With the new coding, practices will be better able to manage care at the population level, which will keep patients with chronic diseases healthier. Managing care at the population level is more effective, efficient and of higher quality.

Who should be involved in creating a strategic plan? According to the article “Reduce Healthcare Costs without Sacrificing Quality and Flexibility” in the March 2014 issue of MGMA Connection those involved vary by practice size, culture, management style and structure. “Team representatives could include an administrator, a physician, a clinician, information technology, and administrative support,” according to the article.

As stated earlier, strategic plans should have a life of two to three years. After writing yours, be sure to make sure all of your employees are familiar with it and understand it so that they can be effective in helping the practice implement it. I would recommend that practices review their strategic plan three or four times a year so that physicians and staff will keep the goals of the vision statement in mind.

After a team has created a strategic plan it will be necessary to create annual implementation plans that detail how the practice is to achieve the goals set forth in the strategic plan. Implementation plans contain specific actions, who is responsible for seeing that the actions are completed, by what date the action will be completed and what indicators will be used to measure how effective the actions were in achieving the goals.

Presently I am working with a health department in developing an implantation plan for the coming fiscal year. One of the goals is to provide better community integration of prevention and treatment services for those with substance use disorders. Thus, one of the first actions could be to have a member of the heath department’s prevention team make contact with the primary care providers in the county by either mail or personal contact to provide information to the PCP about screening for substance misuse and to see how the health department can support the PCP in this effort. The implementation plan could set a nine-month goal of reaching out to 50% of the primary care providers in the county, as recorded in a spreadsheet.

I believe that actions detailed in an implementation plan are best carried out by a team using a well-defined strategy. For instance, if the action is to prepare a practice for the use of ICD-10 coding it will be necessary to use a team to oversee the details of the implementation of a plan to ready the practice for its use. The plan could use a Plan-Do-Check-Act strategy to be sure that coding staff and clinicians understand ICD-10 well, that HIT is upgraded and tested, that sufficient resources are set aside to cover the costs of it implementation and that communication about the implementation to all staff is effective. Results of the measurement phase of the strategy should be reported regularly to those overseeing the strategic plan.

Practices usually fall into one of three categories in regard to strategic plans. One, the practice does not have a strategic plan and reacts ineffectively and inefficiently to new problems and challenges. Two, the practice creates a strategic plan and then shelves it, never bothering to review it until the time arrives for creating a new one. Three, a practice creates a strategic plan and reviews it regularly to make sure the implementation plan is working towards achieving the goals set forth in the plan. Those who fall into this third category usually find their work much more satisfying and rewarding.