The world of "Medical America" is constantly changing. Practices merge, they break apart, and new lines of business are added, then evaluated for profitability. Practices grow and new physicians need to be recruited. Reimbursements decline and an HMO contract needs to be renegotiated. While all this happens, daily operations must continue, patients must be seen and prescriptions must be filled.

I can help with any of the following tasks related to practice reorganization or expansion of services:

• Performance of cost/benefit analysis for expansion (or reduction) of services. A large multi-site reproductive care clinic was contemplating offering primary care services at several locations. I assisted with the initial cost/benefit analysis, the implementation of the new service and analysis of the profitability of this service after it had been operational for several years.

• Recruitment of physicians, mid-level providers and support staff. I've assisted practices ranging in size from solo practices to multi-site in the process of recruiting physicians, PAs, NPs and support staff.

• Leasing, renovation, or purchase of new or expanded facilities & equipment. As a practice administrator and as a consultant I have managed the negotiation of new leases, financing arrangements, and purchase of equipment for new or expanding practices.

• Operational realignment following practice mergers. Every business -- no matter how small-- has a "culture" associated with it. When practices merge, there is an almost inevitable "culture clash" which is virtually always ignored. And it almost always bites back with decreased employee satisfaction, increased turnover, and decreased operational efficiency. I can help you anticipate where "culture clash" may occur and smooth out the bumps before they become too costly.

• Negotiation and implementation new HMO, PPO, or managed Medi-Cal contracts. Look before you leap -- or sign! It pays to be careful about the terms of HMO, PPO and managed Medi-Cal contracts before you sign them. I can assist you in evaluating contracts, negotiating contracts, and analyzing the impact of discontinuing your participation in selected contracts.

Whether you are concerned about why revenues are decreasing or simply want to know that you are being paid everything you are due, I can provide analysis of your reimbursement picture and recommendations about how to make it brighter.