by Anthony Cirillo

I attended a conference in Charlotte last month where Terry McGeeney, MD, President and CEO of TransforMED, gave an interesting presentation on how to transform a medical practice into a medical home.

Much of what he said I had heard before, with one exception. He contended that the foundation of any medical home must be built upon sound practice management. I would agree.

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Practices are businesses. Yet primary-care practices often are not managed as such. They require disciplined financial management; cost-benefit decision-making; identification of revenue enhancement opportunities; coding and billing expertise; personnel/HR management and change management skills. And that only scratches the surface. Compliance issues alone can drown a practice.

Physicians have been forced to become businessmen. Most are not trained--much less have a desire--to run a business. Yet the pressure to generate revenue often becomes as important as how they practice medicine. Before we can even get to pay-for-performance founded on evidence-based medicine, we need to establish a solid business framework from which practices can operate.

Doctors will then be incentivized to take the time to counsel and guide patients, improve their communication with patients, try new modalities such as group visits and e-visits and get back to practicing without worrying. Many physicians solve this by selling to hospitals.

But stand-alone or owned, providers need to reach out to the experts in the field who can help them navigate these turbulent waters and build the sound foundation they need for success. Eliminating the operational inefficiencies in a practice translates into increased revenue and provides the basis for the other components of the medical home to lie upon.

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in patient- and person-centered care and strategic marketing for healthcare facilities.