AAPM. National Conference 2017 Benchmarking your Practice (Part 1)

Transcription

1 AAPM National Conference 2017 Benchmarking your Practice (Part 1)

2 About Cutcher & Neale Cutcher & Neale Overview Specialist Chartered Accountants 60+ years of services to Medical Professionals Industry Leaders & Contributors Preferred partner of the AMA (NSW) Trainers to GP & Specialist networks Dedicated Specialised Medical Services Division

3 Disclaimer The material contained in this seminar is in the nature of general comment only, and neither purports, nor is intended to be advice on any particular matter. Persons should not act or rely upon any information contained in or implied by this seminar without seeking appropriate professional advice which relates specifically to his/her particular circumstances. Cutcher & Neale expressly disclaim all and any liability to any person, whether a client of Cutcher & Neale or not, who acts or fails to act as a consequence of reliance upon the whole or any part of this presentation.

4 Know your Business Agenda - Understanding what drives Growth in a Practice - Understanding the Budgeting Process - Introduction to Key Performance Indicators KPI s - Bringing it all together Benchmarking your Practice

5 AAPM Understanding what drives growth in a Practice

6 Know your Business The Cutcher & Neale 4 Ways to Grow formula 1. Increase the number of Patients 2. Increase the number of times they return 3. Increase the average value of a consult 4. Increase the effectiveness of processes Consider the 4 ways to grow formula when reading Financial Reports

7 How s your practice Structured? Know your Business

8 Know your Business How s your practice structured? Doctor: Sole Trader Company Service Fee Practice/Business: Trust Company Partnership Rent Practice Rooms Profit Distribution Shareholder Unitholder Beneficiary SMSF Property Unit Trust Doctor/Spouse

9 Know your Business How does your practice operate? Generates Gross Medical Income Pays Service Fees Doctor Administration Computers Medical Supplies Reception Rent Salaries Practice/Business Tax Effective Distribution Distribute to Beneficiaries

10 Know Your Business Traditional financial reports are limited What are the key attributes in the financial reports that drive your practice s performance? What drives Income? What drives Expenses? What drives Cashflow?

11 Know Your Business Other Reports that drive good business more than income and expenses Comparative reports Gross Medical Billings report (per doctor) Item numbers per doctor C&N Consolidated KPI report

12 Know Your Business

13 Know Your Business

14 Know your Business Standard Financial Reports? - Profit & Loss Statement - Balance Sheet - Cashflow Statement (v P&L) Other Reports? - KPI Reports - Benchmarking reports - Gross Medical Billings/Service Fee income

15 Know your Business Effective Accounting Programs - Desktop versions - Cloud Based versions - Cutcher & Neale Xero Program You need more than basic bookkeeping to improve your business You need business intelligence information

16 Know Your Business Profit & Loss Income (Expenses) Net Profit/(Loss)

17 Know Your Business Profit & Loss / Statement of Financial Performance Income Expenses / Overheads Distinguish between Doctor & Practice Indicates the profitability of a practice Timeliness

18 Know Your Business Profit & Loss / Statement of Financial Performance Goods & Service Tax Cash v Accruals accounting Structure your chart of accounts P&L Analytics What does it cost to keep the doors open? Rooms how much does a consulting room cost? Doctors practice income v cost of services to the doctor Excess capacity is there scope for additional income?

19 Know Your Business Profit & Loss / Statement of Financial Performance A practice needs to be profitable to be viable What s the Business profit position?

20 Know Your Business Balance Sheet Assets (Liabilities) Net Assets

21 Know Your Business Balance Sheet / Statement of Financial Position Timeliness at least annually Goods & Services Tax (GST) Balance Sheet Analytics

22 Know Your Business Cashflow Statement Opening Cash Balance Cash Inflows (income, loans) Cash Outflows (expenses, loans) Closing Cash Balance

23 Know Your Business Cashflow Statement Profit & Loss statement says we re making a profit but we don t have any cash? Cashflow is not the same as your P&L Takes into account other Cash sources (loans) Ignores non-cash items (depreciation)

24 AAPM Understanding the budgeting process

25 Objectives How to prepare a (realistic) Budgets Using your budget to grow your practice - Income Growth Sensitivity Analysis - Costs Sensitivity Analysis How to Benchmarking your Practice - Simple KPI reporting

26 Financial Budgeting - Steps Step 1 Identify Step 2 Prepare the Budgets - Time Budget Step 3 Prepare the Budget - Overhead Budget Step 4 KPI Reporting

27 Step 1 - Identify Identify Reporting System What are our collection tools for measuring and determining? - Accounting system Xero, MYOB, Quickbooks - Practice Management system Best Practice, Genie, MedicalDirector

28 Step 1 Identify Identify your practice structure Practice/Business Generates Gross Medical Income Pays Service Fees Doctor Administration Computers Medical Supplies Reception Rent Salaries Tax Effective Distribution Distribute to Beneficiaries

29 Step 2 Prepare the Budgets Restructure your existing Chart of Accounts Classify expenses into key categories - Direct costs - Administration - Employment costs - Premises & equipment

30 Know Your Business

31 Step 2 & 3 Prepare the Budgets Time / Revenue Budget - Function of Time and - the Cost of Time Overhead Budget - Cost of the running the practice - expenses

32 Financial Budgeting Budgeting (Time Revenue) - Doctor Budgeted Days Non Working Days Available Working Days Hours /Day Total Budgeted Hours Budgeted Average Consultations Time Budgeted Consults Budgeted Average Consult Fee Budgeted Doctor Medical Fees

33 Financial Budgeting Budgeting (Time Revenue) - Doctor

34 Financial Budgeting Budgets Practice Revenue & Overheads Budgeted Doctor Medical Fees Service Fee Methodology Service Fee / Practice Income Other Budgeted Income Total Budgeted Practice Income Budgeted Overheads Expenses Adjust for Changes Total Budgeted Expenses Budgeted Profit

35 Financial Budgeting Budgets Practice Revenue & Overheads

36 Step 4 - Key Performance Indicators Performance Reporting Reporting Actual v Budget Analysis Actual Doctor Gross Fees v Budgeted Doctor Gross Fees Actual Service Fees v Budgeted Service Fees Actual Practice Other Income v Budgeted Other Income Actual Practice Expenses v Budgeted Practice Expenses Actual Profit/(Loss) v Budgeted Profit/(Loss)

37 Attributes of financially successful practices Higher average fee / consult Less spend on non wage overheads / Doctor Understand the value of a consulting room sublet rooms Leveraged Doctor time - effective practice & support staff Good business systems & processes - effective patient scheduling Multiple Doctors in one surgery Understand Practice Capacity helps max income & improve

38 Budgeting and the 4 Ways to Grow The Cutcher & Neale 4 Ways to Grow formula 1. Increase the number of Patients 2. Increase the number of times they return 3. Increase the average value of a consult 4. Increase the effectiveness of processes Apply this to your Budgeting Process

39 Introduction to KPI s

40 Practice KPIs KPI Workshop: - What s a KPI - Identify KPI s - Using KPI s to drive change Using KPI s in your Budget Setting KPI s and reporting

41 What are KPIs Key Performance Indicators are quantifiable financial and non financial measurements that reflect the critical success factors of an organisation Success as measured against an organisations objectives or strategies

42 What are KPIs Doctor Example: Blood pressure Cholesterol Heart Rate BMI Key indicators of good health

43 What are KPIs Different strategies to achieve overall vision So different KPIs to measure the success of different strategies

44 Success with KPIs Success with KPIs: Need to Key Relevant specific to the organisation Not too many but enough Best viewed over a period and not in isolation (trend analysis)

45 KPI Starting Point Analysis in key areas: - Patient - Processes - People & Resources - Financial

46 Key Performance Indicators (KPIs) Other Key Performance Indicators (KPIs) Full Time Equivalent Analysis (FTE) No. of FTE Doctors & No. consulting rooms Admin staff to Doctor ratio & Nurse to Doctor ratio Consult Analysis Average Fee per Consultation Average consultation time Profitability Analysis Gross income per Doctor Expenses as a % of Gross Income Capacity Analysis Average consult hours performed Practice operating capacity

47 Bringing it all together Benchmarking your Practice

48 Bringing it together Key Performance Questions Link strategy to KPIs What is the best data available KPIs Lead or Lag indicator Trends versus point in time

49 COST OF A CONSULT SAMPLE FINANCIALS Doctor Staff Overheads Profit 9% 7% 15% 69%

50 Australian Medical Benchmarks

51 Australian Medical Benchmarks Sample KPI Report (Monthly)

52 Thoughts, Comments & Observations Shane Morgan