Over the last few years the growth of medical practice acquisitions has continued to grow at a past rate as insurers have begun to join health systems in the practice buying spree.
Recently Centene, Humana and Anthem have followed in the foot-steps of long-time acquisition leader UnitedHealth Group and are buying up medical practices and outpatient facilities employing physicians. The reason they are doing this is are similar to hospitals acquiring practices: to increase market share and control expenses as they face financial pressures due to value-based reimbursement changes and rising operational costs. Additionally, insurers are hoping to blunt the impact of rising hospital/physician practice consolidations.
So an insurer or hospital has acquired a medical practice, what should happen next? Acquirers should proactively ensure a seamless integration of services within their new practices. This means they should minimize any interruption of daily patient flow while also maintaining and improving the standard of care for their patients. This is especially important as they not only expect it but they also depend on it.
The key to a successful acquisition of a major medical foundation and integrating a pair of specialty physician practices is six rich lessons.
1. Establish an Integration Team
Unless you are apart of an organization that is regularly handling several medical practice acquisitions and has an already established in-house team to handle all practice integrations, then you will need to appoint and establish an integration team chosen for this task. Deciding who will be apart of this team will be dependent on different factors: your organization, the type of practice being acquired, a cross-functional array of clinical managers, credentialing specialists, compensation analysts, IT analysts and facilities development experts. Also you might consider hiring an experienced, third-party consulting organization to objectively oversee and direct this integration team unless you have this kind of expertise already in-house and readily available.
2. Assess the current state of the practice, then create an integration plan
You will want to perform a gap analysis of the current practice in order to evaluate all of the aspects included in the operations. This will include factors like the physical layout of the practice, the IT infrastructure and systems (including data conversion needs), all of the medical records, operational workflows, staffing ratios, payer mix, and clinical considerations. This information is needed in order to integrate things like credentials, payer enrollment, and EHR training. This can also potentially improve practice efficiencies and fluidity. Members of the integration team should conduct information-gathering events that include site walk-throughs, workflow observations, physician and staff interviews, and documentation reviews. From this information they should be able to create an overall integration plan that includes key milestones and dependencies that can be tracked across work streams.
3. Emphasize robust communications
Other than poor planning, inadequate communication is the a key reason for issues to arise during a medical practice acquisition. When acquiring a medical practice you want to be mindful that change, even when positive, can be a distraction and distressing to any and all involved. So you will want to establish and maintain strong communication channels throughout every step of the acquisition and integration process. This includes both within your organization and throughout the practice being acquired. You especially want to have strong lines of communication within the physicians and practice administrators. You will want to emphasize regular two-way communications while also focusing on the strategic value and priority of your efforts. You will also want to ask for input from the physicians and staff members in regards to key decisions throughout the acquisition. You will also want to keep them informed throughout the process in order to build awareness and trust among the whole staff.
4. Integrate operations and cultures
The success of this step is dependent on your ability to properly execute the preceding steps. Decide to shortchange planning or communications? Well then do not be surprised if you encounter some post-acquisition operational and cultural issues. In order to help avoid such than problems, then you will want to pay attention to the pre-acquisition daily operations of the practice. You will then want to employee your operational expert to observe the daily workflow. Have them watch for cultural norms/ nuances and flag any operations/ duties that might negatively affect the care quality or be incongruent with your organization’s brand or structure. You want to build a strong relationship with the current practice administrator(s) and ensure you are both on the same page when it comes to cultural values, operational structure, workflows, and technology. You should identify and follow-up on any needs for personnel training and onboarding, particularly around job roles and responsibilities.
5. Ensure an on-time closing
When going through a practice acquisition it is imperative that all tasks and events included in the process are completed by a target closing time with zero downtime. This is very important for tasks in relation to daily clinical operations. You want to have this work be seamless for the staff and be invisible to the patients. You want to work on managing and synchronizing your efforts across all important work streams so you are able to ensure an on-time delivery of non-negotiable critical path activities. This includes things like access to legacy clinical records, IT infrastructure installation, and EHR training. You should consult with practice administrators to be sure all facets of facilities development, patient communications and advertising/marketing (if applicable) have been handled properly.
6. Plan for post-acquisition feedback
You will want to schedule and plan ahead of time for gathering and acting on all relevant post-acquisition feedback. This should not just be from the staff but also patient perspectives. This is a critical task not only for fine-tuning and improving on your acquisition but it can also be used as a template for any future acquisitions. You will want to create mechanisms for collecting input. You should also hold a post-event learning session with the integration team to analyze and discuss what worked functionally and what needs improvement. Expect and be open to opportunities for improvement. You will want to decided on any changes needed and assign employess to follow up on them.
The main goal of your newly acquired practice should be to minimize any disruptions during the transition as well as continue to provide high-quality care, regardless of who owns the practice. By proactively planning your acquisition strategy and operational execution, you will be more likely to achieve this goal as well as enjoy strong employee engagement and collaboration. You will also create a successful roadmap to use for any future acquisitions that should take place.
CONTACT PRACTICE ADVISORS
Now that you have read some basic tips and things to consider you are ready to purchase a practice. After you have found a place that meets your needs you will still need to make on offer, secure financing, sign the practice sale agreement and lease, and complete the purchase. As you can see a lot of important factors go into this decision. Make sure you are being properly advised. Practice Advisors 360 is the nation’s leading dental advisory company. Contact us today at (844) 360-8360 or visit us online at practiceadvisors360.com