Is Value-Based Care Too Much for Independent Healthcare Practices?

I've talked about the consolidation in the healthcare market before. I recently sat down with the folks at StrataPT to talk about PE firms buying up healthcare practices and how small, independent healthcare practices are beginning to feel the pressure. But one thing I haven't discussed on the show is what exactly has caused the consolidation in healthcare (big players buying up little players). Over the years, many independent healthcare practices have been purchased by either private equity firms or health systems/hospitals. But why?

Part of the drive for this consolidation stems from economies of scale. Big healthcare systems and hospitals leverage their size to combat rising overhead costs, declining reimbursement, and even compliance and the ability to participate in alternative payment models. That last one is an interesting take that I hadn't considered before. But, over the holidays I read an article entitled Value-Based Payment and Vanishing Small Independent Practices. In this article, the authors argue that one driving factor for the consolidation in the healthcare market stems from the fact that value-based payment models require a lot of administrative work & data management that independent healthcare practices struggle to manage. So, this week, I take a dive into this idea and discuss some ways that independent healthcare practices can maintain viability in the world of big healthcare.

What we cover in this Episode:

-Understanding how Big Healthcare benefits from value-based payment models
-How economies of scale help improve data exchange and combat decreasing reimbursement in healthcare
-Understanding Value in Healthcare
-Challenges in running independent healthcare practices
-Independent Healthcare practice as a business
-Some strategies that independent healthcare practices can employ to remain competitive
-How to create an effective healthcare positioning strategy to thrive in the current healthcare landscape

Full episode note: https://rehabupracticesolutions.com/better-outcomes-147

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

What is Healthcare Positioning?

When I talk to clients about Healthcare Positioning, the first question to address is “What is positioning?” And that’s a fair question. I usually tell people that positioning involves communicating the value you/your company creates for your customers/clients in a way that differentiates you from competitors and builds perceived credibility & authority to your ideal target market. This week on the podcast, I take a deep dive into the idea of healthcare positioning strategy. I discuss how to develop an effective positioning, some challenges and pitfalls that many of my clients have fallen victim to, and some thoughts around the nuances of positioning in healthcare vs. other industries.

What we cover in this Episode:

-Define healthcare positioning strategy
-Marketing strategies that work in healthcare
-Communicating Value in Healthcare
-The goals of healthcare positioning
-Identifying your target market in healthcare
-Using healthcare positioning to make strategic business decisions
-How to create an effective healthcare positioning strategy

Full episode note: https://rehabupracticesolutions.com/better-outcomes-146

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

A year in review: Healthcare in 2024

It seems like only yesterday that I was planning for 2024. Scheduling out projects for the year, booking speaking engagements, and lining up interviews for the podcast were in full swing. Then, in the blink of an eye, we arrive at the end of 2024. And what a year it has been. From cyberattacks to breaking healthcare innovations, 2024 has had its share of big news stories. So, this week, I take the time to do a "2024 Year in Review: Healthcare".

What we cover in this Episode:

-The Change Healthcare Cyberattack and it's downstream effects
-The Expansion of & Breakthroughs in Artificial Intelligence in Healthcare
-Hospital and Healthcare Closures and Financial Troubles
-Remote Patient Monitoring and Telehealth & Virtual Healthcare
-Anti-Trust issues and litigation in Healthcare Tech
-Health Equity comes to the forefront of healthcare policy discussions
-Integration & Interoperability in Healthcare Tech
-Leadership in healthcare amidst tragedy and turmoil
-Healthcare policy shifts and the future political landscape for healthcare in the US

Full show notes: https://rehabupracticesolutions.com/better-outcomes-145

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

How do we begin implementing technology-enabled healthcare services?

We cover this topic a lot on the show, but technology-enabled healthcare continues to receive a lot of attention. Much of the conversation and media around technology and healthcare innovation revolves around the innovation itself. We hear about the benefits, features, and capabilities of these new solutions and innovations. But, one often overlooked topic in healthcare innovation includes practical implementation. How do you actually take these new innovations and tools and use them to meaningfully improve healthcare? How do we make sure that a new software, device, or platform ends up actually making healthcare better, rather than just a neat marketing ploy?

So, this week, I dive into the research around technology-enabled healthcare. Parts of this podcast come from a few different presentations I've recently given on this topic covering digital health, implementing virtual healthcare services, and using data in healthcare decision-making.

What we cover in this Episode:

-Define digital health & virtual service delivery
-Applying digital health tools in clinical practice
-Research around digital health and its effectiveness
-Remote Patient Monitoring and Telehealth
-Will artificial intelligence replace clinicians?
-How technology enabled healthcare solutions will alter reimbursement and revenue models
-Achieving Better Outcomes by implementing technology in healthcare

Full show notes: https://rehabupracticesolutions.com/better-outcomes-144

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

A Few Thoughts on Healthcare Positioning Strategy

I'm talking to a lawyer the other day about business, scaling, growth, and specialization. As we're talking, he says something in passing that totally exemplifies both the concept and the power of a strong positioning strategy. He says, "You know, it's like if I was a furniture maker and someone asked if I could give them a price to build a deck. Sure, I have all the tools necessary to do that job, but if I say yes, they're not going to be happy, and I'm not going to be happy. So I just say "no" to those types of inquiries, even if there's good money involved."

I know I've said this before on interviews: but the worst deals I've ever put together —the worst clients, worst results, most stressful projects— have all come from saying "yes" to jobs that I should have rejected. I quickly learned with my consulting work to only accept projects and clients that fit in my positioning. And, in broad areas, healthcare has adopted this idea of specialization. Orthopedic MDs don't accept cardiology referrals etc.However, within each specialty area, there are countless specializations or sub-specialties. For example, take Physical Therapy as an example...Often times, I hear one of two problems from practice owners, each of which can be fixed with a good dose of positioning:

1. Too many referrals
2. Not enough referrals

Interestingly, no one ever says "I think we're good. We have enough referrals." It's either "we have way too many" or "we need any referrals we can get". But how does positioning help solve either of these problems? It solves these problems like this:

Too many referrals? Look through the variability in those referrals. If you have a selected specialization (positioning strategy), and you have more referrals than you have capacity to handle, you simply take all of those excess referrals that don't fit in your stated specialization and refer them out to other providers.The patients will be happy, because they're not on a wait list. The referring provider will be happy because their patients will get seen sooner, AND they'll think of you with more respect in your area of specialization...

Too few referrals? Reach out to ONLY the referral sources that match your stated positioning (specialization). Often, when the schedule gets light, clinic owners and managers reach out to anyone who could possibly refer them a warm body to treat...

This does harms the practice in 2 ways:

1. Patients don't get the best results (which means less positive reviews and likely less referrals from that referring provider)
2. They just sound desperate (no one like groveling...)

In addition, you only have so many resources to commit towards marketing & business development. Having a clear and specific positioning keeps you from spreading those resources too thinly to make a real, meaningful difference in referral generation.

What we cover in this Episode:

-Positioning Strategy in Healthcare
-Putting positioning to work in Lead Generation
-Building a team and culture at a healthcare business using positioning
-Reducing the stress involved in business development strategy
-Achieving Better Outcomes by dialing in your healthcare positioning strategy

Full show notes: https://rehabupracticesolutions.com/better-outcomes-143

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Feeling Burnt Out in Your Healthcare Practice?

We hear about it all the time: low margins, increasing costs, decreasing reimbursement, staffing issues, etc. And those are just the most common issues cited by people within the industry. But, as I've already shared, private healthcare practice has the potential to be a great business. So, if you're a practice owner who's feeling burnt out, here's one thing I think will transform your healthcare practice.

This week, I share the one thing that can transform a private healthcare practice. Here it is: Set aside one full day of "business work". On this day, you will work on ONLY one of the following:

-Working on the business (developing SOPs, etc. to guide routine operations)
-Business planning or vision-casting
-Thinking about the business
-Reading/Learning/Self-development in the area of business & entrepreneurship (NO CEU courses!)

I'm not saying this will "make it rain" at your business, but I've been doing this since 2021 and here's what it has done for me:

-It gives me dedicated time to fix "problems" in the business that area always nagging but never get done if you're in the clinic all day
-It gets me excited about the business & the team
-It helps get my head out of the daily grind and into the 30,000ft view
-It has greatly reduced stress.

What we cover in this Episode:

-Value-Drivers in a healthcare business
-The importance of taking time off to work on the business
-Building a team and culture at a healthcare practice
-Putting pieces in place for growth and scale
-Reducing the stress involved in managing a private healthcare practice
-Understanding the importance of identifying key metric in your healthcare practice
-Achieving Better Outcomes by working on personal & professional development as a practice owner

Full show notes: https://rehabupracticesolutions.com/better-outcomes-142

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Is Big Healthcare a Net Positive or Net Negative for Society?

We hear this all the time: in the news, online, and during interviews with healthcare professionals. We hear that "Big Healthcare" is causing extreme damage to society. People cite things like: delayed authorizations, denied care, reducing provider reimbursement or payment, etc. Books have been written about how Big Healthcare Became Big Business. It seems large healthcare conglomerates garner most, if not all, of the criticism for problems within the healthcare system. But one must ask the question: are large healthcare companies inherently a negative thing within the industry? Do they play a role in cost reduction and access to needed healthcare services?

This week, I talk a little bit about this idea of "Big Healthcare" and whether it's a net negative or a net positive for society as a whole. I also discuss what small healthcare business owners should think about when it comes to running their businesses planning for the future.

What we cover in this Episode:

-Value-Drivers in a healthcare business
-Understanding the role that large healthcare companies play in the industry
-The problems with a Fee For Service system in healthcare
-Maintaining Human Connection within the big healthcare space
-How the incentives in today's healthcare environment lead to clinician burnout and wasted time
-Understanding the savings flow in industries like healthcare
-Achieving Better Outcomes by creating a valuable healthcare business

Full show notes: https://rehabupracticesolutions.com/better-outcomes-141

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

Real value-drivers in any healthcare business involve more than simple accounting trickery. Increasing value involves mitigating buyer-side risk after the sale.
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What are the real value drivers in healthcare businesses?

If you do a search on the internet for healthcare business valuations, you end up getting results that mention EBITA, multiples, and add-backs. Often the discussion falls into "accounting tricks" that can increase the sale price of the business by a few thousand dollars. Or, the conversation begins flying high in the sky, giving a 30,000 ft view of the "strategic" changes that owners can make to "dramatically increase the value" of their businesses. The problem is that those conversations rarely get down into the tactical.

So, this week, I talk about specific actions business owners can take to not just increase the "valuation" of their business, but actually increase the value of their business. When I say "increase the value", I mean increase the multiple of EBITA used to create a purchase offer. For example, I want to discuss ways to go from a purchase price of 1-2x EBITA to 3-4x or even 10x.

What we cover in this Episode:

-My journey of purchasing a physical therapy clinic
-Value-Drivers in a healthcare business
-Leadership and management in a valuable healthcare business
-Building a team to delegate key business functions to
-Go to Market Strategy for a successful healthcare business
-How to prevent burnout and wasted time
-Achieving Better Outcomes by creating a valuable healthcare business

Full Show Notes & Links: https://rehabupracticesolutions.com/better-outcomes-140

Learn More: https://rehabupracticesolutions.com
Podcast: https://www.betteroutcomes.show
Get the Book: https://amzn.to/3M2UZ6x
Book a call with me: https://calendly.com/rehabu/discovery
Connect with Me: https://www.rafisalazar.com

If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!