We’ve been continuing to research and write about the ramifications of the new health care legislation on our various Silkin Management Group blog sites. Since all Silkin Management Group clients are small businesses, we find it vital to keep a close eye on how this bill will be implemented and how that will affect not only our clients, but all small businesses.

Today I read an interesting article which you can access here: http://liveshots.blogs.foxnews.com/2010/04/26/making-sense-of-the-new-health-care/?test=latestnews. This article covered an event put on by the U.S. Chamber of Commerce in which a panel of experts discussed the legislation.

This article points out the following key issues:

• Employers are confused about adding dependants to existing policies and how much that will cost them.
• Tax guidelines for employers and employees are unclear.
• Employers who have to make decisions about their health care coverage for the next year are in a precarious position as the Department of Health and Human Service has not yet issued many needed guidelines to facilitate the decision making process.
• Yearly caps on benefits are not resolved.
• What changes plans grandfathered from the new law will have to make to maintain exempt status.
• Tax reporting requirements for small businesses will add costs for small businesses.
• Requirements for tax credits are very limited.

The article also gave a great example of how a business could use the new law to stop paying health care insurance for its employees and save a large amount of money. But, by doing so, it will increase the federal government’s cost and, if enough companies do this, it could result in another underfunded government program. Here’s the example given in the article:

“Monday’s event included the release of a study sponsored by the Chamber analyzing the impact of the new law which its backers said would insure more Americans while containing costs. The report cited a small Philadelphia trash company that has 55 full-time employees and spends $600,000/year on health care costs. In 2014, if the company decided to drop its health plan, it would pay $50,000 in fines. In other words, the study shows, the company will save $550,000 by not offering its workers health insurance and forcing them to find insurance on their own.”

We will continue to research up to date articles and information about this legislation in the attempt to keep Silkin Management Group clients and anyone reading our Silkin Management Group blogs informed about the latest questions and answers regarding this massive piece of legislation.

Dave McKevitt
Silkin Management Group Consultant

For more information about Silkin Management Group and our services, visit our website at www.silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com.

There’s been a lot of talk about how the new health care bill affects small businesses. We’ve written many blogs on the various Silkin Management Group blog sites about this, trying to present the facts as we see it, based upon research done by experts.

Since Silkin Management Group clients are all small businesses, we feel it is important to stay on top of the facts regarding this and filter through the various opinions and hot air presented by people and politicians on both sides who have vested interests.

I recently ran across an excellent article written by the South Carolina director of the National Federation of Independent Business (the country’s leading small business association). You can access this article here: http://www.greenvilleonline.com/article/20100403/OPINION/304030005/1004/NEWS01/Health-care-bill-will-hurt-small-businesses

I suggest you read this article in full, but here are some of the highlights that the author points out:

• For many small businesses, the new bill is more of a tax increase than health care reform.
• Heath insurance costs are likely to increase rather than decrease for small businesses.
• The small business health care tax credit is very limited in size and scope and provides a dis-incentive for a small business to grow.
• The increase in payroll tax for Medicare will hit many small business owners.

Read the article and decide for yourself how the new health care bill might affect you as a small business owner. Knowing how this bill works is an important management activity for any small business owner. We recommend to all Silkin Management Group clients to know all about this law and its potential ramifications for their business.

Dave McKevitt
Consultant for Silkin Management Group

For information about Silkin Management Group visit our website at: www.silkinmanagementgroup.com or email us at: info@silkinmanagementgroup.com

I ran across another article on marketing in an online publication called Small Business Trends. I thought this article was very perceptive and accurate in terms of segmenting your customers so that you are marketing the right thing to the right people. You can access this article here.

The marketing technology the article imparts is very similar to what we teach Silkin Management Group clients. You have to know who you are marketing to, and what their interests are before you market. If you don’t you’ll waste marketing dollars. Surveying is the key to this.

Check out the article, I think you’ll find it useful.

Dave McKevitt
Silkin Management Group Consultant

For more information about what we do at Silkin Management Group, how we help clients with marketing and other practice management issues, visit our website at: silkinmanagementgroup.com. You can also contact us at: info@silkinmanagementgroup.com or call 800-695-0257.

The Latest in the Health Care Reform Bill

Over the last few months, those of us at Silkin Management Group who have been contributing articles for our blog sites have been watching the progress of the various health care legislation proposals that have travelled through the House of Representatives and Senate.  You can easily find earlier writings on this subject on the various Silkin Management Group blog sites.

As most everyone knows by now, the Senate passed its first major voting hurdle on December 20 by confirming the needed 60 votes to pass their version of the legislation. What I found especially fascinating, but not at all surprising, was the numerous “pay offs” made to various Senators to get their vote.  These “payoffs” benefited specific states and constituencies while leaving out the majority of the rest of the people of the country.   In my mind, this is politics as usual: if you need votes to pass a piece of legislation, give the elected official special perquisites that will make him look good with his constituents and assure him of re-election. Democracy in action.

Gosh, I thought the health care legislation was to help everyone in the country. That’s what we were told. Where did I go wrong?  OK, enough snide comments on the obvious politics as usual. It doesn’t seem to matter which party is in control, they both end up doing the same thing.

I read n article in the New York Times that got me thinking about this.  You can link to that article here:

http://www.nytimes.com/2009/12/21/health/policy/21healthcare.html?th&emc=th

Here are just a few of the special benefits given out:

• Money for people exposed to asbestos from a vermiculite mine in Libby, Montana which secured the vote of Senator Max Baucus, Democrat of Montana (who happens to be the chairman of the Finance Committee.
• Additional Medicaid money for the state of Nebraska in order to secure the vote of Nebraska Senator Ben Nelson.
• $100 million to an unnamed “health care facility” affiliated with an academic health center at a public research university in a state where there is only one public medical and dental school.  Who is this for?

There are several others you can read about in the NY Times article.

As small business owners, Silkin Management Group clients must learn to live on their own production, management expertise and capabilities.  Our programs are designed to help them do so as we all know that we aren’t getting the government handouts.

For more information about Silkin Management Group contact us at: info@silkinmanagementgroup.com or call 800-695-0257.  You can also visit our website: www.silkinmanagementgroup.com

Jack Hennessy

Consultant, Silkin Management Group

Below is the second part of my response which had to do with hiring and training the right employees. I hope you find it informative and useful.

“The other underlying issue I see here is having the right people in the first place and having them properly trained. There are three key steps in this process.

1. How to attract the right kind of employees
2. How to determine who to hire
3. How to train them to do their job properly after you’ve hired them

When you are looking to fill a new position, the wording of your ad/listing is key. Where to advertise is also key. Utilizing employment agencies that pre-screen applicants to YOUR qualifications can greatly increase the quality of candidates you see, weeding out the lower quality people ahead of time.

Determining who to hire is often a “shot in the dark” for most doctors. A doctor might just read a resume, conduct an interview and then take a shot on that person as they have no other means to evaluate the applicant. No one ever writes on their resume that they are chronically late, don’t take direction and can’t get along well with others. What you see on a resume is only what the applicant wants you to see. Similarly, all you hear in an interview is what they want you to hear. They say the right things or at the very least what they think YOU want to hear in order to get the job.

After a person is hired they usually stay on their best behavior until they get comfortable and then they become themselves. Only then do you know who you’ve hired.

We believe you need a more objective way to screen and hire people so that you have a better idea of who they are, what kind of personality they have, their responsibility level, their aptitude and their work ethic. Corporations have been hiring people this way for years. Small businesses suffer through much higher turnover rates due to their lack of successful hiring techniques.

We teach doctors to test applicants. Personality tests, IQ tests, Aptitude tests are all implemented to get a feel for who a person is and how they will fit in to your practice and interact with the staff and more importantly your patients. Doing all of this as part of your “weeding out” process during hiring greatly increases the odds of you bringing on a good staff member.

Once you have hired the right person, you then need to make sure you train them properly. This is where detailed and up to date job descriptions and office policies come into play. It is vital that you equip your new employee with the proper tools to do their job rather than throw them to the wolves and hope they pick up the proper way to do things as they go.”

As mentioned above, Silkin Management Group provides its clients, as part of our overall management training and consulting program, an Office Policy and Job Description Manual with detailed job descriptions for nearly every position in an office, including the often overlooked job description for the owner of the practice.

If you would like any help with any aspect of your practice, call us at 800-695-0257 or email us at info@silkinmanagementgroup.com. You can also visit our website at silkinmanagementgroup.com/offers/ask.html and ask questions via our “Ask a Consultant” feature on the website.

Ken DeRouchie
Silkin Management Group’s “Ask A Consultant”

Please see our other blog at: practicemanagementblog

As has been discussed, the first thing you need to do with any area or job position is to determine exactly what the product that area or job should be producing. This may take some figuring out by carefully inspecting the job or area in terms of what you really need coming out of the area. Previous blog articles discussed this concept in terms of a receptionist and treatment plan presentations. I’d like to present what Silkin Management Group has found very workable for the management of the collection area of a health care office.

What is the product we’d expect out of this area? How about:

Patient fees collected in a timely manner.

It seems like that would be an excellent product for the collection area to accomplish. If it accomplished this product regularly, the income of the office should be in good shape with very low receivables.

Now, how would one best measure that so one could actually manage the area by a metric? There are several stats that would give you a good measurement of how the area is doing:

• Total collections received.
• Total accounts receivables over thirty days. (Graphed as a reverse graph with zero at the top.)
• Percent of collections to services.

Needless to say, one would have to use some “smarts” when looking at the second statistical graph as it would also to be compared to the production in an office. Obviously if the office’s production was rising, the total receivables would likely be rising too, so a comparative analysis would have to be made. The third statistic above helps with this.

The third statistic is based upon a formula that we’ve worked out that compares several month’s collections to several month’s worth of services, with a time factor built in depending upon the type of practice, how much insurance is used and some other factors.

There are a variety of stats we help our Silkin Management Group clients with so that they can easily and properly manage their practice. The information above gives you more data about one area. I hope it is helpful.

If you are interested in any management help with your practice or business, feel free to contact us at info@silkinmanagementgroup.com or visit our website: silkinmanagementgroup.com

Best regards,
Dave McKevitt
Consultant
Silkin Management Group

I can’t emphasize enough how important statistical monitoring is to the management of a practice. As clearly elucidated in yesterday’s blog, without proper metrics, you can’t really see what is going on throughout the business side of a practice.

The first question you might ask yourself is how one determines what the correct monitoring statistic is for an area or job position. The answer to that is something more basic, and that is determining what the actual product is that should be produced by that position or area.

In sales this is usually easy to see. For example, the product of a car salesman is a sold car and his statistic would simply be the number of cars sold.

That one is easy. But what about a receptionist in a health care office? What’s her product? And what statistic measures that?

Here are some ideas you can use for this position in terms of product and statistic for a receptionist:

• Product: A patient who arrives at the agreed upon time
• Statistic: Percent of patients kept to schedule
• Product: Sufficiently full appointment book to keep the office at or above its needed production target.
• Statistic: Percent of the appointment book filled

I hope this example gives you an idea on how this basic management tool works. If you want to properly manage your practice, you must be able to easily see the productivity in any area or job position and not operate on “feel” or “how it seems”.

Please note: this does not mean that you take the important human element out of your practice. I’ve heard people say that watching statistics takes the “humanity” out of a practice. These are not mutually exclusive activities! The “human element” is more important than anything else as it is people, working together as a team in a mutually created enjoyable work place that makes a practice a fun, pleasant and productive place to work. But, at the same time, you must also be able to logically see how the productivity of each area and job position of a practice is doing or you won’t be able to manage the practice as a whole and take care of your staff.

Letting a staff member flounder around, not really knowing how they are doing, is not a fair way to treat any staff member. Neither is letting a poorly producing staff member attack in subtle or not so subtle ways a good producing staff member. Having a proper statistical monitoring system in place takes helps your staff know how they are doing and protects the good producers. That makes a happy and productive place to work.

At Silkin Management Group, we have researched and worked out nearly every product and statistic in a health care practice and, where we haven’t, we know exactly how to figure them out. If you are interested in more information about how to do this, contact us at info@silkinmanagementgroup.com or visit our website at silkinmanagementgroup.com. View our other blog at practicemanagementblog.com

Eric Korb
Technical Director

Here’s a tip that you can use and that I pass along to all of the clients I consult with at Silkin: do a simple survey with all new patients that come in to find out what brought them to your practice. This can be done as part of their new patient intake forms or verbally done by the receptionist or any other designated staff member.

At Silkin Management Group, we have a variety of pre-prepared surveys for our clients to use, but here are some areas to find out about that you can use to create your own survey.

• If you were referred, who referred you and what did they say that interested you in our office?
• If you responded to an ad, which one did you see? What about it attracted you?
• If you responded to our website, how did you locate it and what about it interested you?

There are many more areas you can check and that we teach our clients at Silkin Management Group to look into, but if you check the above areas you’ll be off to a good start.

Also, you should review the surveys and compare them with any time coincident rise or dip in new patient numbers and you might find something may have changed about your marketing efforts and you can then either reinforce it or fix it.

I hope this advice helps anyone reading this blog site. It has helped many of my clients I’ve consulted over the years at Silkin.

If you’d like to find out more about Silkin Management Group,

Visit our website at:
silkinmanagementgroup.com

You can also email us at:
info@silkinmanagementgroup.com

Read our other blog at: practicemanagementblog.com

Gary Crawshaw
Consultant
Silkin Management Group

The most timely issue of our day seems to be the various pieces of legislation being worked on regarding health care reform. In fact several of Silkin Management Group’s blog sites have articles on them about this important matter than affects all of us, whether Silkin clients or not.

In a blog article posted on November 10, written by Larry Silver, Silkin Management Group’s president, (the article can be found here: Health Care Bill and Small Business, he conjectured that most lawmakers had “never run a business themselves…” nor had to deal with all the issues that go along with running a business, especially during lean times.

Interestingly enough, I ran across the following New York Times article that supported his conjecture: Entrepreneurs in Congress Say No to Health Care Reform.

This article points out that only 11 members of Congress, whether Republican or Democrat, were recent business owners/entrepreneurs. 8 of them voted against the House bill, and only 3 voted for it. I think that lends further credence to what Mr. Silver was discussing about our legislators having little or no reality on what it takes to run a small business and how the proposed legislation could adversely affect these businesses. I think the facts that less than 10% of our legislators are business owners and 73% of the legislators who are business owners voted against the House bill, despite party affiliation, makes a strong statement paralleling the opinion outlined in Mr. Silver’s blog.

Anyone who is a business owner should take action and express your viewpoint and concern to your Congressperson and Senators so that they get some reality from business owners on this as well.

I invite your feedback on any of this through our comments link below this blog.
Also feel free to visit our website: silkinmanagementgroup.com
or email us at: info@silkinmanagementgroup.com

Bill Hickey, Management Consultant for Silkin Management Group.

Visit our other blog at practicemanagementblog.com

Hiring the right people is a key activity that we help our Silkin clients with. We have many proven successful actions on recruiting, screening and hiring. Knowing how to do this properly is a very important management tool to have as it cuts down on employee turnover and increases efficiency in any office.

I ran across the following article Ready to hire? You have many employee options which I thought was a great summation and clarification of the three key types of personnel you can have: regular full time staff, part time staff and independent contractors. Each has its own rules and regulations, advantages and disadvantages. This article provides valuable information to anyone interested (whether you are a Silkin Management Group client or not) in the relevant differences between these personnel classifications I hope you find it helpful and useful.

If you’d like help with any employee situation, especially how to hire the right people, feel free to contact us!

Gary Crawshaw
Consultant
Silkin Management Group

Email:
Website: www.silkinmanagementgroup.com

Visit our other blogsite at:
practicemanagementblog.com