That is a question often asked medical practices, especially primary care. As we learn more about preventive health care and being proactive in our wellness initiatives, it is appropriate to have regular checkups. This same thought process should apply to medical practices and other health care entities. We call it an operational assessment. It can also be termed a diagnostic analysis of all non-clinical operations.

The Practices that most often turn to such reviews are those who clearly have problems, whether in personnel, billing, compliance, or other areas. However, the really good practices also appreciate the fact that on occasion they need a wellness checkup, i.e., an operational assessment.

This review should encompass all areas of non-clinical operations to include personnel management, compliance, compensation (including physicians and other providers), front-office processes, managed care, financial management and assessment, and billing and collections issues.

Following is a list of areas that need to be analyzed in an operational assessment. The operational checkup or assessment should include areas of strategic analysis, which should involve the entire practice, including its providers (both partners and otherwise), in a thorough analysis of where the practice is going and where it is currently. The next list identifies areas to be reviewed in the strategic portion of this assessment.

Who should do the assessment? Many practices have the talent within their own organizations to do much of this. However, most will want to engage an outside consultant with an unbiased outlook and a different perspective to complete their review. Those involved in the day to day operations of the practice are already busy with their own workload, and it's harder to spot problems when you live with them everyday.

How often should this be done? For maximum results and efficiency, our recommendation is to complete a review at least every other year. Some practices may need to focus on specific areas, such as compliance, including procedural coding, one year alternating with other areas of operations, such as billing, etc., in following years. These areas of consideration and evaluation should be based on the specific needs of the practice.

Even if you think your practice is 100% healthy, there are probably some areas that a good wellness checkup could identify where improvements are needed. For more information concerning how to complete the operational assessment, contact Max Reiboldt, Managing Partner/CEO of The Coker Group at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 800 345-5829.

Operational Assessment

Organizational Structure
Responsibilities of Physician
Responsibilities of Staff
Reporting Guidelines

Interprofessional Relationships
Hospital
Physicians
Mid-level providers

Facility
Layout and Design
Adaptation for Expansion

Administrative Systems
Bookkeeping
Appointment Scheduling
Medical Record/Report Filing
Insurance Processing
Office Inventory
Office Equipment
Mail Processing
Public Relations

Financial Management
Accounts Receivable
Billing Procedures
Collection Procedures
Evaluate Reliability/Efficiency of Computer System

Cash Management
Internal Controls
Fraud and Embezzlement

Information Systems
Operating system
Practice management reporting
Electronic medical records

Medical/Regulatory Issues
Medical Record Documentation
Patient Follow-up
Adherence to Government Regulations
OSHA and ADA
HIPAA

Legal Issues
Confidentiality
Ethical and Legal Standards

Personnel Management
Personnel and Payroll Records
Work Schedules
Job Descriptions
Employee Benefits
Policies and Procedures
Protocols Adherence

Marketing
Evaluation and Recommendation for Internal and External Marketing Strategies

Longer-term Strategic Planning Initiatives

Interviews with Physicians and Appropriate Staff

Strategic Assessment

Strategic Analysis
Near term
Longer term

Relational Analysis
Physicians
Mid-level providers
Administration

Communications Analysis

Organizational Hierarchy Review
Physician leadership
Committees
Administration

Collaborative Initiatives Review

Governance and Leadership Review

Clinic Model/Analysis

Facilities
Space planning

Divestiture versus Continued Operations as a Part of the Practice

Opportunities to Reduce the Practice Subsidies to Physician Practices

Max Reiboldt, CPA is Managing Partner/CEO at The Coker Group
Reproduced by permission from The Coker Group, CokerConnection, (Roswell, GA: The Coker Group, 2003), Vol. 3, No. 12, December 2003 by The Coker Group.