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| Many of the functions pertain to the role of a COO and CFO. Practices need support in all administrative and planning disciplines, but even large ones often cannot justify internalizing them. They seek relationships with management/consulting firms who provide the necessary technical expertise. Outsourcing critical executive functions provides access to a higher level of sophistication at annual costs lower than internalization. |
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| James Kieffer |
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Benchmarking
Identification and trending of critical financial and statistical information is a distinguishing service. The Proforma Financial Group benchmarking methodology facilitates measurement against proprietary and public domain universes; supporting design of business plans that encompass changes in entity structure, professional staffing, third party reimbursement, referral patterns, managed care contracting and capital equipment acquisition.
The challenge lies both in gathering information and presenting it in a way the client can understand.
Entity Governance
All practices, regardless of size or legal structure, require leadership, transitional logistics for members, contractual relationships with related organizations, and clinical coverage guidelines.
Medical Schools do not teach physicians about the business of medicine.
Analysis of Accounts Receivable Systems: Performance
Radiologists are the single largest submitter of physician-based insurance claims in the United States. Account volume is both large and complex. The trend has been toward outsourcing to specialized service bureaus, compelled by payer demands for documentation. Practices need outside reviews of their vendors' performance to assure that their interests are protected.
Most oversight is through benchmarking techniques. Random audits of statistically significant account populations are the best way to measure a vendor's efficiency and operational processes.
Managed Care Planning
Managed care initiatives can change the method and extent of payment for clinical services; often implying assumption of utilization risk. Practices retain Proforma to negotiate with payers or other provider systems, where it's knowledge of market value for clinical services benefits the client.
Practices negotiate from a position of strength when they understand how payers seek to transfer risk. Proforma's role is to help a client understand the underwriting process that payers use to compile contract fees.
Personal Financial Planning
A separate but interrelated discipline, personal planning builds upon knowing the income and benefit structure that was created within the legal entity used by the practitioners. Most planning requires forecasting that draws upon knowledge of how a physician is compensated and invests for future lifestyle needs.
ProForma Financial Group's specialized Personal Planning Services consider both how income is currently produced and how it is used to deal with future needs, including basic estate planning techniques.
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