Strategic Advisory

• Reporting of costs and profits by DRG, ICD-9, service lines, and payors.
• A framework for predicting future profitability based on changes in productivity, prices, reimbursement rates, and patient volumes.
• The ability to assess the right level of resource capacity needed for various protocols, service levels, and patient volumes.

Master site and facility planning is a core competency of Wipfli. Our staff has been involved in a significant number of planning projects in a wide range of provider settings. As a result, our approach to master planning is comprehensive and time-tested and yields superlative results for our clients.

Upon completion of a master site and facility plan, Wipfli is able to provide detailed functional and space program design that is ultimately used by architects to design hospital facilities. The Program is a narrative description of the major functions, operating concepts, and staffing, space, and design needs for each department or area within the new facility. The narrative includes a thorough description of services provided, workload analyses, and important inter- and intradepartmental requirements and adjacencies.

In undertaking a master planning effort, we incorporate five key steps:

• Market assessment - Source of patients, market share, population trends, service volumes, use-rate trends, technology and utilization shifts
• Strategies - Physician partnership, medical office building development, centers of excellence, ambulatory delivery strategy, regional network development
• Projected service volume - Inpatient volumes and ancillary service volumes
• Physical facility requirements - By every major department and service area, space deficiencies and requirements, departmental relationships and adjacencies
• Master facility plan - Building expansion plan options, building renovation plan operations, site development options cost guidelines

Wipfli also conducts a functional evaluation of existing facilities to accommodate the service needs identified in the strategic plan. We prioritize the facility issues by department based on major functional deficiencies. We recommended alternatives for expanding or renovating facilities in order to solve major strategic and/or operational issues. The latter includes developing high-level cost guidelines and project phasing for the master plan solution.

Our experience in both managing and consulting with medical groups and integrated delivery systems throughout the country has shown that truly successful physician compensation plans move beyond merely dividing up a pool of money in some mechanical fashion to recognizing and rewarding desired performance. While developing workable mechanics and understanding market dynamics are important, the truly successful plans provide strong linkages between organizational goals and physician compensation to ensure the long-term sustainability of the practice. Moreover, they aren’t disproportionately driven by surveys, which reflect the blended performance of many practices and not the achievable performance of our client’s practice. Accordingly, an overarching goal of any physician compensation plan must be to operate within the framework of the organization’s business plan and to ensure physicians demonstrate the requisite attitudes and behaviors that will ultimately help drive the success of the practice.

Studies show that while the average primary care physician controls about $3.2 million in health care services, he or she generates only approximately $550,000 per year within the four walls of his or her practice. Given the ongoing erosion of provider reimbursement and increases in overhead, we have experienced an increasing desire by our clients to identify prospective new and expanded service opportunities to improve their bottom lines without increasing pressures on providers to be more productive. In addition, many new service initiatives provide excellent collaboration opportunities with the providers’ local hospital/health system.

Wipfli supports this process by taking a very practical, step-by-step approach that, when concluded, provides the client with clear and achievable service options, along with precise work plans for implementation.

1. We help build a “context” for the client by determining your current service “yield” (i.e., mix, volume, payer mix, referral patterns) and identifying other revenue opportunities within your service mix.

2. We educate the stakeholders:

• We provide alternative structures to house a prospective new service (e.g., joint venture)
• We identify potential legal and tax issues involved (e.g., Stark, anti-kickback, intermediate sanctions)

3. We conduct patterned interviews with key stakeholders to determine their “appetite” (e.g., financial risk, market implications) for expanding their practice's services.

4. We present a set of prospective services for the client’s consideration, including financial projections. The client decides which service(s) to implement.

5. We develop a detailed implementation plan for the client’s use.  

As competitive pressures continue to force health care organizations to seek economies of scale, increase productivity, and/or expand into new markets or services, many utilize mergers, acquisitions, and/or joint ventures as vehicles to achieve such objectives. To be successful, such efforts generally require:

• A detailed review of the market and competitive landscapes.
• An analysis of the practice’s current service mix and any “gaps” that may provide a strategic opportunity.
• Involvement of senior management to forge “the deal.”
• Construction of an integration/implementation management plan and team (some or all of whom were part of “the deal”) that move swiftly.
• Development of early warning “signals” that identify behaviors or potential obstacles that may sidetrack the strategy (e.g., culture, management personalities, insufficient resources dedicated to integration, poor communication plan).