Saturday, July 31, 2010

Performance Matters - Closing Thoughts

Performance Matters - not just some but all of the time!

Why? Because performance is how reputations are forged. It's how opportunity takes root. It's how growth is nurtured. It's how reward is is justified. It's how communities are served, how jobs are secured, how excellence is evolved, and how people are provoked to rise to their potential. ...Because we owe it to ourselves and those around us. When we perform well we create value and build trust. Why would one settle for less?

Performance is multidimensional and complexly integrated. Performance is a matter of purpose, promise, potential, persistence, and pride - the stuff that inspires the human spirit and attracts talent. 

The Performance Matters Matrix provides a potent framework for the replication of high performance practice cultures. This framework is relatively easy to understand and makes intuitive sense but is neither quick nor easy to implement. Building a high performance culture is a journey but it all begins with a very simple but intentional decision - I will do it. 

Replication is not expensive, in fact, it is value generating. What is required is a modest investment in leadership to bring out the best in people. One must also acknowledge that some people are quite satisfied with mediocre - they must be be pruned away to allow resources to nurture the performance culture to enable it to blossom. 

I hope this Performance Matters blog series has stimulated a sense possibility for you. Few will set out on the performance journey because most people are satisfied with mediocre.  But perhaps you will be one of them who do - if so, it will be a life changing journey professionally and personally.  It will touch your mind,body and spirit. It will touch those around you as well and they will thank you. If you would like to explore the possibilities, be in touch with me. 

Thank you for your interest in the Performance Matters Series! 

All The Best


(c) Copyright 2010
Performance Builders
Wednesday, July 28, 2010

Quotable - Truth Series

 "Primitive people, as they are, taught me a new philosophy of life, for their ignorance is nearer the truth than our prejudice". - Carl Lumholtz
Saturday, July 24, 2010

Performance Matters Matrix – Collecting

Collecting earned income for a business is like crossing the finish line in a race. Failure to finish is well, failure. Collected income is less about wealth creation than it is a validation of business strategy, operational systems, management decisions, professional judgment, regulatory compliance, and service value.  

The Collecting cell is located in the lower right corner of the Performance Matters Matrix. It is found at the intersection of financial value and results. Collecting contributes financial value in the most direct way possible; and builds trust by producing tangible evidence of the Practices relevance and financial  viability by providing compensation and return on investment to stakeholders – owners, employees, and vendors. Compensation is the last link of the value chain in all practices.

Collecting encompasses the receipt of cash payments such as co-pays and deductibles as well as deferred reimbursement paid privately or through third party payers. It includes the management of accounts receivable, resubmission of payment rejections, appealing rejections, working delinquent accounts, legal actions, write-offs, and related banking matters. Its work that takes place out-of-sight in the back office but always on the front burner of successful practices. It is a purely business function that is poorly understood by clinically trained managers with service-facing priorities.

The key metrics associated with collecting is Days in Accounts Receivable (Days in AR), also called Days of Services Outstanding (DSO) – i.e. how long on average it takes to collect what is owed. Aged Accounts Receivable provides a detailed profile as to the percentage of dollars owed over certain time periods – current (less than 30 days), 30-60 days,  60-90 days, 90-120 days, and 120+ days. It’s surprising how many practice owners overlook these vital metrics or are even unfamiliar with them.

Collecting involves optimizing several key processes: qualifying the practice to receive payment, verification and preauthorization of benefits, billing and collecting, reducing collecting related time and expense, continuous learning about ongoing reimbursement changes. Collecting is complex and ever evolving. It requires sophistication and accountability.

Collecting is a race that is run every day and the stakes are high – finish or be finished. Run well…

All The Best!


(c) copyright 2010
Performance Builders
Wednesday, July 21, 2010

Quotable - Truth Series

“The truth about “I can’t” is “I won’t.” - Anonymous
Friday, July 16, 2010

Performance Matters Matrix – Charging

Charging is the Achilles heel of most practices. In the mind of clinical professionals, compassion and service supersede all matters of business with the exception perhaps of their own compensation. The tendency for clinicians to undercharge is legendary. Tracking studies have found that 12- 15% undercharging is typical. When one realizes that the undercharged amount would go directly to the bottom line (profit) were it collected, the interest of management is tweaked.

Charging is located in the lower center of the Performance Matters Matrix. It’s value is obviously measured financially. It builds trust through the integrity that comes with the understanding of relatedness between promise and possibility and between money and mission. While mission is an organization’s appropriate focus and first priority, there is deep wisdom in the nonprofit humanitarian-aid  sector’s reminder of, “No money – no mission.” That reality is true for all organizations.

Charging is impacted by a host of variables such as: payer contracts, caps, discounts, and adjustments; care plans, charge capture, classification, coding, and posting; deductable / co-pay collections and cash management policies. Charging is a principle, a behavior and a discipline.

Charging encompasses matters of ethics, legality, fairness, integrity, accountability, and obligation. It determines the vitality, viability, and sustainability of an organization’s capacity to serve its community; it empowers an organization to  recruit, retain, train, and equip its staff.

Undercharging handicaps a professional community from carrying out its corporate social responsibilities for accessibility, affordability,  service, excellence, and advocacy. In that context, a professional community also has responsibilities for holding third party payers accountable for policy and decisions  that harm patients. Such responsibilities are compromised with undercharging. While regulators and watchdog agencies make isolated cases of fraudulent overcharging front page headlines, there is little if any recognition given to dedicated professionals who’s lack of business savvy and infrastructure undercharge billions of dollars annually in the US.

If cash flow is the life-blood of an organization (and it is) then charging is the life supporting heart that pumps it. Charging excellence is a competency of all top quartile practices. Statistically that means that charging excellence is not a competency of 75% of all practices!

With systems in place for charging excellence the stage is set for collecting…

All The Best!


(c) copyright 2010
Wednesday, July 14, 2010

Quotable - Truth Series

“Do not follow people. Follow truth.” - Alan Cohen
Friday, July 9, 2010

Performance Matters Matrix – Scheduling

Productivity and profitability issues are always scheduling issues at their core. Scheduling creates value and builds trust by optimally aligning resource allocation with service needs and opportunities. When resources are managed effectively performance commitments are enabled.

The scheduling cell is located in the lower left corner of the Matrix. It controls the creation of financial value and builds trust by demonstrating concern and respect  for others by communicating shared expectations. Scheduling manages a Practices most important resources – time and competency. Schedulers are arguably the most significant non-clinical  people in a Practice yet their important time and attention is continually eroded by the constant disruption of passing font-desk  urgencies. Scheduling is a priority of the highest level.

Nothing gets delivered, charged or collected unless it first gets scheduled. That reality is reminiscent of an old baseball story… Three umpires are talking over drinks after a tournament. The rooky ump says, “Yup, I call-em the way I see-em.” The veteran ump says, “Well, I call-em the way they are!” The old-timer ump says, “Boys, they ain’t nothin till I call-em…” And so it is with scheduling.

Scheduling is complicated with vacations, sickness, time-off, transportation, emergencies, forgetfulness, thoughtlessness, and weather. There are considerations of treatment plans, staff training and competencies, facility / equipment capacity and internal, regulatory requirements, and external communications. Then there are matters of people’s idiosyncrasies, perceptions, priorities, attitudes, and willingness to accommodate. In a word, “COMPLICATED”. The measure of value is told by scheduling density, attendance rates, no-shows and cancellation metrics.

Top quartile business performance is never found where scheduling issues persist. While technology can facilitate scheduling, it, like clinical services, is primarily a matter of competency, creativity, and commitment.

With scheduling excellence comes the opportunity for charging optimization...

All The Best!


(c) copyright 2010
Wednesday, July 7, 2010

Quotable - Truth Series

“The truth will set you free, but first it will annoy you big-time.”  - Anonymous
Sunday, July 4, 2010

Performance Matters Matrix – Communications

Communications that are relevant, respectful, accurate, transparent, and timely are critical to building ones reputation on Trust and Value. Without such communications one may create affluence in the short term but not earn influence in the long term.

Communications occurs in the Performance Matters Matrix at the intersection of Relational Value and Results. Within the health services sector it is important that Communication be strategically used to establish realistic expectations, shape brag-about experiences, and celebrate superior results by providing evidence that the provider did what they said they would do.

Communication is about the telling of stories in the past, present, and future tense – what will happen, what is happening, and what did happen. Such stories are best told by those that who benefited as recipients of the Service. Through their telling authenticity, truth, and emotion are conveyed.

The provision of professional Services should always include a play-by-play Communication of the experience to assure that context and events will be interpreted and understood from a value adding perspective. The Service experience also provides an opportunity to coach the Service recipient in the telling of their evolving story and to provide them the opportunity to practice telling it.

Upon leaving the Service venue, the Service recipients become ultimate marketing agents for the Service provider by telling their stories of achievement and success. Each story becomes living and enduring evidence of valuable results.

Communication is a pass fail phenomena. Each story either builds or erodes the provider’s reputation there is no such thing as neutral. Never doubt that each story is told at least once! Stories that are not repeated are a lost opportunities.

On the stage of professional performances, each and every performance is evaluated, interpreted and talked about. There is just one chance to get it right. When "just right" doesn’t happen, there is again just one chance for recovery to make it right. Often stories of the recovery can be even more compelling – they are often the seeds of legend.

It is important to remember that in the Service sector, there is no such thing as casual conversation or a private performance. Every conversation whether spoken, written, or acted out creates a conscious or subconscious impression that influences value perception and results recognition.

When Communication is done well, it is followed by practice growth and the need to Schedule…

All the Best!


(c) Copyright 2010
Thursday, July 1, 2010

Quotable - Truth Series

“We can not approach truth from who we are. We think too small. We are confined and confining in our beliefs.” - Margret Wheatley