Developing an Action Plan for Your Business

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The beginning of a new year brings with it the feeling of a fresh start. What will we do with this opportunity? Will we follow through on our good intentions or end the year asking, "What exactly did we accomplish?" Did we further market share, profit, or our impact on patient lives? Do we have a measurement to tell us if we did? I challenge O&P practice owners and managers to name five things they purposefully set out to accomplish in 2016 and then succeeded in doing.

Unfortunately, when talking to people in the industry, I have found many of us cannot meet that simple challenge. The problem is we do not plan for success. It sounds great in theory, and we know we should do it, but we don't. Who has the time? With the consolidation of practices in O&P, those that remain are busy. And that may be an understatement. We are so wrapped up in the day-to-day routines of seeing patients and responding to audit requests, among a host of other things, that we ignore many other factors related to the foundational success of our businesses. This cannot continue if we still want to be in business in five years, or even just one more year.

retro alarm clock

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Change is happening fast, and O&P as we have known it is quickly becoming a thing of the past. What used to take years to affect our industry is now having an impact in months. A decision by the Centers for Medicare & Medicaid Services (CMS) to change audit procedures or implement prior authorization requirements can change a practice's business outlook overnight.

Other developments in the O&P sector include the advent of Accountable Care Organizations (ACOs), which were not even part of our vocabulary a few years ago. Yet now these well-staffed, well-managed, and well-funded structures loom over our industry as the new potential gateway to patients. Additionally, who would have predicted that the decades-old fee-for-service payment model used by Medicare could be replaced? In some health services, it already has. While value-based outcome payments have not hit O&P yet, we would be foolish to ignore the possibility that such a reimbursement model, or another alternative, could soon be the standard.

The landscape in which we find ourselves competing for clients has changed. In the past, O&P practices largely looked to other O&P practices as the main source of competition, although there have always been some physician groups that have tried to keep work in-house. We now may find ourselves competing with those O&P practices, not to see the patient, but for the opportunity to be part of the ACO that is directing that patient's care.

The aforementioned factors should present a compelling case for why reviewing your business and developing an action plan is essential. Many of us do not have the resources to weather a major financial storm. Every patient, every relationship is vital. We cannot afford to lose anything that can be prevented. Therefore, we need to take action now. The goal is to review our businesses from top to bottom (it's not as hard as you might think), set attainable goals, and execute them.

This is the first in a series of articles that will guide you through developing a business review model, or action plan, which has been patterned on an O&P practice. Once your action plan is complete, you will have a tool that will guide your efforts and focus your energies. The model can be revised or enhanced as your situation changes. You can make the model deep and comprehensive, or begin with a more general version with just a few action points.

The model can be developed through these four steps:

  1. Defining your purpose
  2. Deconstructing your business
  3. Developing the picture
  4. Distributing the work

Step 1: Defining your purpose. What is the reason your business exists? Perhaps you already have a mission statement or something similar. But what I am referring to may require self-reflection that goes deeper than a published mission statement or marketing slogan. If you attempt to build off of a partially untrue foundation, the house may not be constructed the way you want. For example, you may say, "I am in business to restore lives and help people live life to the fullest." But is that only partially why you are in business? Or is it really, "Our goal is to make money and this is the means to do that." That isn't a wrong answer; just understand decisions made down the road will always come back to your foundation.

So let's move on. We decide that we truly are in business to restore lives. Now we have our purpose.

From here we continue to develop our sample plan by going to Step 2: Deconstructing your business.

graphic of wheel of questions

We do this by simply asking logical questions that flow from one aspect of the business to the next. The answers to the questions form the building blocks in the model. Each business will be different. One may have 12 blocks, another 20.

We will develop the shell and then come back and add color in Step 3: Developing the picture. Keep in mind, your business can and probably will look different from this example-and it should, as this is a review, from start to finish, of your unique business.

Using the foundation-the purpose we determined in Step 1-"I'm in business to restore lives," answer the questions that logically follow: If that is the case, thenů.

We will begin with a blank diagram ready for you to fill in the specifics of your business by asking and answering questions-lots of questions.

  1. What product or products will I offer? Product: This becomes building block number one. The following answers represent the subsequent building blocks.
  2. Now that I have a product, how will it be delivered to the public? People
  3. Where will these people work? Place
  4. How will the public know about my place, my product, and my service? Promotion
  5. Who does this promotion need to target? Prescribers
  6. What do I want the prescribers to generate? Patients
  7. How will I meet the needs of the patients? Procurement
  8. What if it is a custom device? Production
  9. Now that I have a device, how will I deliver it? Procedure
  10. The device has been delivered, so how will I be paid? Process billing
  11. How is billing collected? Payment processing
  12. Is this operation going to last? Profit
  13. What about the future? Planning

modern alarm clock

Courtesy of Shutterstock Inc..

Each business is unique and not everyone will categorize his or her business using the letter P. Use what works for you; the important thing is to go through the exercise. If you don't take the time to review your business in a simple, straightforward manner such as this, important, foundational keys to success will be missed. You cast the vision for your business, and no one knows your business better than you do. While you may be able to do some of these things yourself, you need a change agent on your staff- someone who can implement your ideas and get things accomplished. (We will talk more about that in Step 4.) The next article in this series will move to Step 3 of the process, developing the picture, which we will accomplish by adding color and depth to the building blocks we have identified as foundational for the business.

Chris Field, MBA, has worked for Boas Surgical, based in Bethlehem, Pennsylvania, for over 15 years. He serves as the treasurer of the Pennsylvania Orthotic and Prosthetic Society and was named the CFO of the Year by the Lehigh Valley Business Journal in 2014.

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