Align multilocation clinics for better efficiency and higher profit margins

In the field of health care, you can’t simply hand out training manuals and expect every branch of your business to run seamlessly. Over time, you may find that some locations will begin to invent their own intake processes, training strategies and operations policies, not directly aligning with your core procedures. Over time, I’ve tested, tweaked and solidified a handful of practical strategies to keep each location aligned with our vision, in compliance and ultimately growing the bottom line. Now, I’d like to share the strategies that have helped unify our teams across multiple states — and can do the same for your practice.

Clear communication and regular meetings/training

No matter how comprehensive your policies are, they don’t mean much if they’re not consistently communicated. When you realize just how crucial direct, ongoing conversations are, make a point of scheduling frequent check-ins and cross-departmental sessions at every clinic you operate. These shouldn’t be just standard conference calls or email blasts. Organize in-person or video conference meetings designed to tackle specific areas of the business — patient care protocols, compliance updates, marketing strategies and more.

In these sessions, encourage open dialogue. I’ve found it’s vital to give local managers and staff members a platform to voice issues or share innovative ideas that arise from on-the-ground experiences. After all, each location has its unique challenges, and acknowledging them fosters an inclusive culture that values collaboration.

Regular training supplements these discussions. This goes beyond a stale PowerPoint presentation on standard operating procedures. Instead, try coordinating hands-on workshops and skill-building exercises where employees at all levels can learn best practices in patient interaction, data compliance or new technologies.

When your teams are given a recurring forum to learn, share feedback and exchange success stories, you cultivate a sense of unity and transparency. Suddenly, protocols become collective goals everyone is invested in achieving.

Balanced local clinic culture with companywide consistency

One of the biggest mistakes CEOs tend to make early on is assuming that once a new location starts using your brand name and wearing matching uniforms, everything will fall in line. The reality is that each branch comes with its own set of cultural norms — especially true if you’ve acquired a clinic that has been in operation for years. Ignoring these nuances can lead to resistance, confusion and, eventually, a fractured brand image.

Instead, learn to embrace these local cultures while carefully integrating them into your company’s overarching identity. Start by sharing your mission, vision and values in ways that resonate with the team’s existing strengths. If a particular site excels at patient outreach but struggles with internal communication, tailor your training and resources to shore up weaknesses without undercutting what they do well.

It also helps to have companywide events — whether virtual or in person — where staff from different locations can interact and learn from each other. In these settings, people discover shared values and objectives, bridging any gaps between “their way” and “our way.”

Uniformity across clinics for profitability and patient trust

When you’re running multiple clinics, consistent service delivery equates to profits. Patients and clients expect the same quality of care and professionalism regardless of which branch they visit. If they sense disorganization or experience a dip in service at a particular location, their trust in your entire brand can falter.

The same logic applies to your staff. High-performing employees want to work where standards are clear, collaboration is encouraged and advancement pathways are transparent. If each clinic is operating in a silo, talented staff members may jump to locations or companies that better align with their career expectations.

Moreover, uniformity enables predictable and measurable growth. When every site adheres to the same guidelines for patient intake, billing and follow-up, you can accurately measure key performance indicators across the board. These data are invaluable for strategic planning; if one clinic outperforms another, you can pinpoint best practices and replicate them systemwide, optimizing revenue generation.

Taken together, strong retention and predictable operations create a virtuous cycle of satisfied patients becoming loyal advocates who refer friends and family, while motivated employees drive efficiencies that keep costs in check. In my experience, it’s this alignment that sustains profitability over the long term, far more effectively than any one-off marketing campaign ever could.

This system, when implemented intentionally, can ensure that no matter where patients or employees engage with your company, they experience the same standards of excellence. And that, in my book, is the key to long-term growth.

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3 marketing metrics for medical practices

Most of the readers of this blog do not have a marketing background and may not have both an MD and an MBA. However, there are a few metrics that you should consider when using marketing techniques to attract new patients to your practice. I know that diving into the business side of your practice can feel intimidating, especially if you are like most physicians, including myself, who have never received any formal marketing training. It is not necessary to take on the job of a large-scale marketing department to understand the basics of medical marketing, but just measuring a few marketing metrics can go a long way in ensuring your practice's success. This blog will discuss the cost of acquiring a new patient using a marketing campaign, the patient acquisition cost, and the return on the investment from your marketing dollars. When you understand this concept, you can fine-tune your marketing efforts.

Let's begin with calculating your cost per lead (CPL). Your cost\lead is the cost to attract a new patient to your practice. The CPL describes the cost for someone to become a patient in your practice. For example, this would be the cost for a web surfer who reads a blog post on your website and enters their email to receive additional information. The cost may represent the potential patient who clicks a Google AdWord for your practice and comes in for a free consultation you are conducting on a weight loss program.

Knowing your CPL can help you make important decisions about where to spend your money to maximize the value of your marketing dollar. You can also see what isn't working and discontinue that marketing campaign.

In the past, healthcare marketing required a lot of guesswork to understand the value of your marketing efforts. You know how much you spent but measuring the patients who came to your practice directly from your marketing was murky, and you were marketing by the seat of your pants.

These days, with all the latest technology at your fingertips, you can track your cost per lead. Accurate trackers can be enabled so you know if a patient is reaching out from an online ad, an email, a postcard, or a billboard. You can even track that person through your practice from the beginning to the end of their patient journey. In other words, you can know the exact patient value your marketing campaign brought in—no guesswork needed.

In the healthcare industry, the cost per lead ranges from $36 to $286\patient, with an average of $162 per lead. The average CPL for health and medical companies using Google AdWords is approximately $125\patient. These are broad averages over the whole industry. Still, they give an idea of what you may expect as you begin calculating the cost per lead for each new patient that enters your practice.

Calculation of the CPL

The CPL is a simple math equation.

The calculation consists of the campaign cost or marketing expenses divided by the number of patients who called the office for an appointment, which is the patient cost per lead. For example, if the practice spent $2000 on Google Ads over three months and received 500 calls from those ads, the cost per lead is $2000 divided by 500, or $4.00 for each patient lead.

Cost per acquisition (CPA)

However, not all initial callers will convert to paying patients. The 50 patients who made appointments can be plugged into the same equation: campaign costs divided by patients who became paying patients or $2000 divided by 50 equals $40, representing the patient acquisition cost (PAC). Now, each patient who entered the practice spends $800 over the patient's lifetime. In that case, that's an increase in income of $40,000, not shabby for $2000 in marketing expenses.

Return on the investment (ROI)

The return on the investment (ROI) is the income derived divided by the marketing expense X 100. For example, $40,000 divided by $2000 x 100 is 200% as a return on the initial investment.

ROI = income\marketing costs X 100

You can measure the effectiveness of your marketing efforts. The available data gives us the power to make informed decisions that will increase our practice if we have the knowledge and expertise to tap into it. You're missing valuable information if you don't consider your patient cost per lead when making marketing decisions.

Bottom Line: Understanding your patient's CPL, PAC, and ROI positions you to bring in new patients and grow your practice with the confidence of data-backed decisions. Leads from your marketing efforts are the lifeblood of growing your practice. Your marketing goal is to create a steady stream of new, loyal patients and add significant revenue to your bottom line. Knowing these three metrics provides you with objective data to make good marketing decisions.

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Value-based care is a team sport: How to optimize roles for better outcomes

As leaders of the care team, physicians rightfully take their role in driving patient outcomes very seriously. This is equally true when practices pursue value-based care. To succeed in these arrangements, physicians must continue to act as the “captain” of a patient’s care, however they also must leverage the skill sets of their full team to support early identification of conditions, care plan execution, and ongoing patient monitoring and treatment.

Leveraging the care team to their full potential can be a challenge. Many organizations place the entire responsibility for risk capture and patient management on physicians. Unfortunately, this not only overburdens even the most dedicated providers, it also results in missed diagnoses, insufficient documentation and risk capture, and suboptimal reimbursement.

Conversely, when every staff member works at the top of their license and shares responsibility for identifying, documenting, and managing patient conditions, it creates a collaborative, purpose-driven environment that enables reliable care management and promotes accurate risk capture and reimbursement. Practices that pursue this team-based approach also see greater staff satisfaction and retention because staff feel more connected to each other and fulfilled by their work.

Embracing a new model

It’s easy to say “work as a team” but to truly achieve the right level of collaboration, physician practices must rethink how they function. Approaching this in a methodical way can lead to lasting and sustainable success. Here are a few strategies to consider.

Conduct a role-based inventory.Before making changes, it is imperative to understand the work being done by each role. Taking the time to complete a thorough inventory will identify work that isn’t adding value and pinpoint who may have capacity to take on more responsibility. This review should span the entire care continuum, from appointment scheduling to patient checkout, and must include what happens in-between visits. During this review, practice leaders should think through what tasks could be handled differently for greater efficiency and effectiveness. For example, while a physician must diagnose a patient and develop the appropriate care plan, other qualified staff members can facilitate parts of the assessment and examination, calling out important information the physician should address when meeting with the patient. Similarly, the team member can collaborate with the provider and check on patients between visits to answer any questions, discuss concerns, and make sure a patient is following the care plan.

Involve physicians early on.Practice physicians must be at the table and engaged in any restructure or alignment activities from the outset. Provider insight is critical to these changes, especially the integration of evidence-based care. Physicians will also have key insights on what they should handle versus what may be supported by another team member. If providers don’t have confidence that things will get done well and in a timely fashion, they may try to manage everything on their own, which will stall a practice’s efforts towards greater collaboration and teamwork.

Depending on a practice’s size and current dynamics, it can be helpful to bring in an expert third party to facilitate an unbiased inventory and help identify areas that may be ideal for restructure. An outside resource can remain objective as they consider assorted perspectives and recommend the optimal structure based on the practice’s unique characteristics.

Accessibility is key. Accessibility is the greatest leading indicator of success in value-based care.Still, many practices struggle to help patients get the care they need when they need it. Using your staff to their full potential can assist with proactive risk identification, fostering a positive patient experience and enabling strong quality performance.

The move to quality starts at the front door. For example, when the patient arrives for an appointment, patient access staff can assess demographics, document preferred communication methods, assess social determinants of care, review insurance information, and check eligibility for payment programs the patient may not be aware of or is using. The team can also administer certain screenings, such as the PHQ-9 questionnaire, which assesses a patient's risk for mental health conditions like depression and anxiety.

After the patient’s appointment, staff can help schedule follow-up visits or get information about referrals, helping the patient navigate the next steps for additional care. Throughout these interactions, staff can get to know and develop a rapport with patients, increasing the likelihood that patients will reach out to the practice when they have a problem instead of waiting until the issue becomes an emergency that requires a hospital stay.

Care adherence is a team effort.Medical assistants serve as a liaison between patients and physicians. For instance, instead of physicians having to answer 15 patient messages during their lunch break, medical assistants can triage patient questions, answering those that are administrative and surfacing to the physician those questions that warrant the doctor’s attention. Medical assistants can also ensure that patients have the information they need before departure, facilitate patient education, provide medical supplies, and answer basic questions patients may have. They can also proactively reach out to high-risk patients between visits to check how things are going. During these interactions, medical assistants can ask patients whether they are taking their medications, check for side effects, provide education, and answer questions. This can help improve care plan adherence and avoid acute situations while building patient trust.

Standardizing workflows is foundational to optimal outcomes. If you don’t have a standard way to do a task, don’t expect a standard outcome. Practices should establish clear care processes and pathways to ensure that risk identification and care management tasks are performed by the right person at the right time. This is especially important for managing chronic conditions, such as diabetes, hypertension, congestive heart failure and COPD. For these conditions, practices should have systematic and standardized care pathways which outline team actions to facilitate strong condition management and clinical outcomes.

Document the new approach. We’ve all heard the phrase, “if it isn’t documented, it isn’t done.”This has never been more true than as practices optimize and standardize tasks and workflows. As practices develop new ways of working, they should document each step to ensure that everyone in the practice has a clear understanding of what they are supposed to handle, why it’s an essential function, when it should happen, and how it connects to everyone else’s work. If practices don’t document the new workflow, standard performance often doesn’t happen, allowing tasks to fall through the cracks and causing frustration for patients and staff—not to mention increasing risk.

Educate patients about the new model.Some patients may feel uneasy relying on staff members other than physicians to meet their needs. Clearly and intentionally communicating the purpose and value of each role—and how these functions seamlessly work together to ensure high-quality patient care—is crucial to help patients feel confident they’ll receive timely, knowledgeable assistance regardless of who they interact with at the practice.

When collaboration happens by design, practices see better outcomes

By approaching value-based care as a team sport, practices lay the foundation for better performance. This degree of collaboration doesn’t happen by accident. Physician practices must design roles and processes intentionally, ensuring everyone works at the top of their license and follows choreographed, evidence-based care pathways. Taking the time to methodically approach the work at hand will help the practice identify risk and manage care more effectively while fostering an environment where everyone is focused on achieving the same goals.

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Three-step annual review process to keep your medical practice on mission

Medical group owners know that conducting an annual review of their practice is not only imperative to running a successful business, but key to identifying both operational gaps and clinical care issues. It’s also one of the most impactful actions you can take to remain focused on your practice’s core purpose—the reason you became a private practice owner in the first place.

Because a comprehensive annual review involves looking at your most critical KPIs and evaluating them against previous performance, many practice owners fail to dig into the data that can significantly impact their business. Instead, they simply do what they’ve always done to ensure everything is on the up and up.

But, when done correctly, an annual review can uncover hidden opportunities that greatly improve your patient satisfaction, clinical outcomes, and revenue cycle management strategies. The good news is that it doesn’t have to be a complex, drawn out process. In fact, it only takes three steps to conduct an effective annual review to help you stay focused on fulfilling your practice’s core purpose.

Step #1: Measure your practice’s performance against previous KPIs and other metrics

The first step to conducting an annual review starts with the data. A strong focus on a small number of business-critical KPIs that directly impact your practice’s core purpose is optimal for managing and directing a thriving practice. Annual earnings is an obvious KPI, but it also helps to evaluate metrics like patient satisfaction and appointment trends, clinical outcomes, and, if you have multiple providers on staff, physician billing trends.

The goal is to assess current practice performance against the previous year’s results. Have they improved? Is there work to be done in some areas? Underperformance in any area is an opportunity to figure out where the roadblocks are so that you can course-correct whatever may be throttling your practice’s success.

After gaining a solid grasp of your practice’s KPIs, it is also beneficial to compare your results to industry standard benchmarks. It’s important to know how your practice is doing compared to the others in your field so that you are not operating your business in a vacuum. Comparing your performance to other practices also offers insights on the KPIs you track and whether or not they are the right metrics to measure your practice’s success.

Step #2: Analyze trends that show how the data is shifting over time

Once you have a snapshot of your practice’s annual performance, the next step is to analyze operational, financial, and clinical trends so that you can determine how the data is shifting over time. Your metrics should show you which way the data is moving and how fast. Does it vary month-to-month? Do you see spikes or downfalls during certain times of the year? Are there irregularities that may be signaling problem areas? Are there anomalies in your data that require more attention?

The trends in your data are crucial indicators of your practice’s momentum as a business. It’s the closest thing you have to a crystal ball, helping you better understand what is likely to happen six months, or even a year, from now.

Taking the time to analyze how your most important KPIs may be shifting from year to year offers insights on upcoming opportunities, while also shedding light on potential challenges ahead.

Step #3: Determine if your practice is fulfilling its core purpose … and what actions may be needed to get back on track

Once you have identified which KPIs best reflect your practice’s core purpose and evaluated your practice’s performance for the year, then analyzed your practice’s business-critical trends, it’s time to take a step back and look at the big picture. Does the data support what you want to achieve as a health care provider? In other words, are you truly fulfilling your practice’s core purpose?

As a medical group owner, it is easy to get overwhelmed by daily operations. Caring for patients, supporting your staff, managing the business—it’s a lot to handle. A successful annual review will make clear if the time and resources you are investing in your practice are paying off. It also will give you the insights you need to address the bigger questions: Are you fulfilled professionally? Are you happy with your work-life balance? Is your practice meeting its foundational goals?

A successful annual review will provide answers to these questions, while also offering insights on what actions need to be taken to align your outcomes with your practice’s core purpose. Once you have a clear view of the data, it is much easier to make necessary adjustments that have a major impact on your practice’s success.

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The ABCs of medical practice transactions

Medical practice acquisitions represent a challenging and risky strategic decision. In its most simplest form, there are three main legal structures for acquiring a medical practice: asset purchase, stock purchase, or merger. All three of these structures are essentially different types of acquisitions. A merger is a type of acquisition that has a particular legal meaning.

The decision to buy, sell, or merge a medical practice is more complicated than ever, and physician owners must have a clear understanding of the legal structure of the potential transaction. Here are some of the advantages, disadvantages, and considerations for these legal structures.

Asset purchase

In an asset purchase, the buyer purchases specific assets of the target practice that are listed within the transaction documents. Buyers may prefer an asset purchase because they can avoid buying unneeded or unwanted assets and liabilities. Generally, no liabilities are assumed unless specifically transferred under the transaction documents. Because the liabilities remain within the selling practice, buyers can eliminate or reduce the risk of assuming unknown liabilities. Further, buyers typically receive better tax treatment when purchasing assets as opposed to stock. Buyers may also be able to reduce their taxable gain or increase their loss when they later sell or dispose of the assets.

The main risk to buyers in an asset purchase transaction is that a buyer may fail to purchase all of the assets it needs to effectively run the practice. There are also various aspects of an asset sale that can be time-consuming and drive up transaction costs, such as listing specific assets and determining their value. For some assets, third-party consent may be required before the assets can be transferred to the buyer. The manner in which title of an asset is passed to the buyer will vary depending on each kind of asset. Finally, there is always the risk that the seller could retain sufficient assets to continue as a competing going concern. This risk is usually mitigated by requiring that the seller enters into a covenant not to compete with the buyer.

Sellers generally disfavor asset transactions because the seller is left with potential liabilities without significant assets it could otherwise use to satisfy those liabilities. Also, the tax treatment of an asset sale is generally less favorable to sellers than a stock sale. The practice and its shareholders can each potentially incur taxable income, which could result in double-taxation of the sale proceeds. Entities that have pass-through taxation such as partnerships, LLCs and S corporations can avoid the problem of double taxation and thus may be more likely to accept an asset purchase structure. Of course, you should definitely speak with an accountant on your particular situation.

Stock purchase

In a stock purchase, the buyer purchases the stock of the target practice directly from the target's shareholders. The practice remains an existing going concern after the purchase, and its business, assets, and liabilities are all unaffected by the transaction. A stock purchase may be preferred if the buyer wishes to continue operating the target practice after the purchase. Further, absent unusual circumstances, consent from third parties is not needed to approve the transaction. However, the buyer may be exposed to unknown risks by buying the entire practice, assets, and liabilities. Buyers can reduce their risk by holding back some of the purchase price in escrow to satisfy any liabilities that arise after closing.

Obtaining approval for a stock purchase can be problematic if the target has a large number of shareholders. Unless there are agreements in place before finalizing a deal, buyers cannot force shareholders to sell. Thus, a holdout shareholder could refuse to sell to the buyer. This result can be very undesirable for buyers and could ultimately cause the deal to fall apart.

Buyers may have less preferential tax treatment in a stock purchase. However, in certain circumstances, buyers can elect to treat the stock purchase as an asset purchase, thus securing a desirable tax treatment.

Merger

In a merger, two separate legal entities become one surviving entity. Under state law, the assets and liabilities of each are then owned by the new surviving legal entity. There are several structures that mergers can take. The simplest is a forward merger, whereby the selling practice merges into the purchasing practice, and the purchasing practice survives the merger. Sometimes, buyers will wish to keep the target practice as a separate legal entity for liability reasons, so the buyer will instead merge the target into a wholly-owned subsidiary corporation of the buyer, called a forward triangular merger. When complete, the subsidiary survives the merger, holding all of the assets and liabilities of the target practice. Both a forward and a forward triangular merger generally require consent from third parties, as the target practice ceases to exist after the merger and all of its assets are owned by the surviving entity. A reverse triangular merger is similar to a forward triangular merger, except that the target practice is the surviving entity, instead of the wholly-owned subsidiary of the buyer. A health care transactional attorney will advise the best approach based on your particular situation.

How a merger is taxed depends on its structure. Generally, forward and forward triangle mergers are taxed as asset purchases while reverse triangular mergers are taxed as stock purchases.

In terms of required corporate approvals, mergers generally require approval only of the seller's board of directors and a majority of its shareholders (absent other requirements in its charter documents). This lower threshold is particularly appealing when a target practice has multiple shareholders. However, shareholders who vote against the merger will generally have appraisal rights under state law. Appraisal rights, or Dissenters' Rights, enable dissenting shareholders to petition a court to obtain the fair market value of their shares. This can complicate transactions and increase the buyer's costs.

Clearly, medical practice transactions can be complicated. Consequently, it is imperative that physicians have an experienced and competent team consisting of a consultant, accountant, and attorney who help you review all of your options and choose the one that ensures your practice’s continued success.

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The shifting landscape in medical practice staffing

Medical practices have always had to balance patient care needs with the realities of business operations. Yet since the start of the COVID-19 pandemic, that balance has grown more precarious. Today, staffing is one of the most pressing challenges faced by practice administrators and physicians. At Physicians Practice, we recently surveyed our audience of medical professionals to gauge the state of staffing, pay, and benefits in 2025. The findings in our 2025 Physicians Practice Staffing & Salary Survey provide a window into where practices are succeeding — and where they continue to struggle — in building and retaining high-functioning teams.

Understaffing persists, even as some practices grow

The most glaring statistic from our survey is that 41% of respondents consider themselves understaffed today—up significantly from 27% who reported understaffing five years ago. Paradoxically, 44% of respondents say they have hired more staff in the past five years, indicating that even a hiring push can fail to keep pace with patient demand and administrative complexity. Meanwhile, 53% feel they are adequately staffed, and only 6% say they are overstaffed.

In looking ahead, the majority (60%) expect their staffing levels to remain the same in 2025, while a third (34%) anticipate bringing on additional employees. This suggests a steady, cautious approach: Practices want to ensure they can handle patient volumes without overstretching budgets or risking layoffs down the line.

Finding qualified people: The single biggest hurdle

When asked about the biggest staffing challenges, an overwhelming 76% of respondents cited finding qualified staff. Although the labor market’s tightness is less acute than in previous years, a significant shortage of skilled professionals continues—particularly in positions requiring specialized clinical or administrative knowledge. Other top concerns include:Increased workload/dual roles(37%),
High staff turnover(20%), and
Lack of professionalism(22%).

These issues echo many of the soft-skill concerns we hear anecdotally from practice managers: how to balance the need for reliable, congenial team players with the reality that some roles (like billers/coders or medical assistants) are in especially high demand.

Despite widely voiced concerns over reimbursement shortfalls, 69% of practices gave staff raises in 2024. Among the 31% that did not, the most frequently cited reason was decreasing reimbursements by payers and patients, highlighting just how central revenue pressures are in dictating compensation decisions. Check out the full report for more detail on what our survey respondents pay specific positions.

Benefits: Stability and modest improvements

Our survey reveals a generally stable benefit structure:

• Paid time off (sick days, vacation, personal days) is nearly universal at 92%.
• Health insurance is offered by 78% of respondents, followed by retirement plans at 70%, dental at 62%, and vision at 57%.
• Only 10% have added benefits in the past year, while 75% report no changes.

Practices clearly recognize that competitive benefits can be a differentiator in recruitment and retention. Offering robust PTO, some level of health coverage, and retirement options can help stabilize staffing, even if salaries are not at the very top of the local market range.

Words of wisdom from the field

One unique facet of this year’s survey was the open-ended advice administrators and physicians shared. Their suggestions revolve around several common themes. Here's what they had to say, in their own words:Invest in people: 

• “Train, train, train new employees,” and “Treat your staff well (financially) and they will be loyal.”
• Act quickly on poor fits: “Don’t delay in getting rid of poor performers,” and “If someone is not a good fit or brings negativity, don’t wait to remove them.”
• Foster a team culture: “Lead by example, not intimidation,” and “Build that team and continue perfecting it every day.”
• Stay flexible: “Give more flexibility, especially to mothers,” and “Be sure the staff is satisfied.”
• Plan for the future: “Start getting ready for AI,” “Control overhead by limiting staffing to adequate numbers,” and “We can’t cover our costs by just seeing patients.”

Looking ahead: Balancing costs and care

As we head deeper into 2025, the tension between adequate staffing, compensation, and practice profitability remains at the forefront. With a majority of practices still relying on traditional fee-for-service reimbursement (and only 21% blending it with value-based care), controlling overhead is challenging. Some practitioners see concierge or direct pay models as key to solving the financial puzzle, but these are far from universal solutions.

In the face of these complexities, the survey data affirms a few universal truths:

• Practices that offer competitive pay and meaningful benefits see stronger retention.
• A positive workplace culture—where team members are trained, respected, and recognized—remains the single most powerful antidote to staffing shortages.
• Leaders must be agile, ready to adjust staff levels, explore new reimbursement models, and embrace emerging technologies (like AI and digital health solutions).

The feedback from our survey participants is clear: Finding and keeping the right people is critical, yet there is no one-size-fits-all recipe for success. As you look to refine your own practice’s staffing approach, consider investing in quality talent, staying open to new operational models, and fostering an environment that genuinely values employees. By doing so, you can position your practice not just to survive, but to thrive in a rapidly changing medical practice landscape.

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The case for value-based care in women’s health: A win-win in improving maternal care

Over the past several years, providers and technology-focused physician enablement organizations across the country have been working together to initiate the transition from traditional fee-for-service models to value-based care (VBC) arrangements. They have been adopting analytics tools and service solutions to help improve health outcomes, provide more cost-effective care and close gaps in care, all of which drive efficiency for doctors, their patients and payers.

Primary care specialties have benefited significantly in VBC, improving clinical outcomes dramatically and receiving healthy financial rewards for thorough execution. However, despite the immense benefits VBC has demonstrated in other specialties, the transition from fee-for-service has largely been nonexistent in women’s health to this point. Obstetrician-gynecologist (OB-GYN) practices face a lack of standardized women’s health measures across the health care system and in Medicare. The absence of uniform measures has created varying levels of reimbursement and costs, ultimately presenting challenges to implementing VBC in a comprehensive way. Commercial payers likewise have been slow to develop thoughtful VBC contracts specific to women’s health. It is an area of medicine mired in partisan semantics designed by policy makers on both sides to ensure forward progress is all but impossible.

Women’s health and VBC

Women’s health is organically rooted in the principles of VBC — results-driven care that is critical for the health and well-being of women and the mother-child dyad. As outside factors influence women’s health policy making more and more, empowering OB-GYN practices across the country in their transition to VBC is more important than ever to ensure that expectant mothers are receiving the best care possible and that women experiencing gynecologic conditions have access to the most up-to-date care, especially for our most vulnerable patients, for whom care options are limited.

By accessing a robust catalog of women’s health technology solutions, OB-GYNs not only are better equipped to successfully care for patients in VBC models but can also utilize innovative solutions to navigate the unique, complex needs of women’s health care more effectively. Solutions like remote monitoring and telehealth services connect providers and patients at critical points when an office visit may not be necessary or isn’t possible. Pregnancy tracking and education apps can keep patients informed on what to expect and allow providers to share gestational age-specific information in real time. Virtual fertility, lactation and nutrition resources allow access to more specialized types of care that have historically been less accessible to minority groups and Medicaid patients. Electronic health records (EHRs) designed for success in VBC also tend to have deeply integrated best practice guidance to help providers manage the ever-increasing body of knowledge in women’s health.

Closing the gap on maternal health care for at-risk populations

Over the last 25 years, the U.S. maternal mortality rate has been steadily rising, with an increase of 144% from 1999 to 2021. Continued disparities in access to quality maternal health care have contributed to this increase. As care gaps continue to put expectant mothers at risk of life-threatening complications, OB-GYNs and care centers must implement quality improvement plans and initiatives that close those gaps, particularly for our nation’s most vulnerable communities. VBC in prenatal care holds the promise of equipping OB-GYNs with technology solutions that help them provide more timely, effective care at all points of a pregnancy and also of empowering patients with the knowledge they need to feel confident in the care they’re receiving.

Improving care coordination and driving better outcomes in VBC by integrating into a practice an EHR that leverages not only innovative technology but provider-oriented (and even provider-developed and -led!) workflows and decision support has dramatically increased the quality of care in primary care specialties. These strategies can similarly help OB-GYNs improve how they monitor a patient’s health throughout pregnancy and efficiently provide care at key moments. By effectively collecting patient information early in pregnancy and monitoring through a robust EHR designed and augmented with them and their patient population in mind, OB-GYNs can more easily identify patient risks that could complicate pregnancy and receive alerts that prompt planning and intervention at key points of care to address their patients’ needs and satisfy VBC standards comprehensively.

Further, patient-facing platforms through smartphone apps inform expectant mothers of health concerns or care needs throughout their pregnancy. By seamlessly integrating with EHRs, these platforms can help patients directly access educational resources and safety alerts, empowering them to play an integral role in their health and their baby’s, while improving their health literacy to better understand and participate in the care they need.

Ensuring the benefits of value-based care for expectant mothers everywhere

A key feature driving the success of VBC programs in other specialties is a relentless focus on access. Ensuring all expectant mothers across the country can access an OB-GYN regardless of where they live is a crucial next step. The most significant gaps in maternal care often occur in rural communities, where patients may live far from their OB-GYN and lack access to private or public transportation.

Without sufficient means to reach their doctor, expectant mothers may not only feel higher levels of burden or stress in receiving the care they need but may also be at greater risk of socioeconomic challenges that create pregnancy-related health emergencies.

While most expectant mothers in rural communities would prefer to see their OB-GYN in person, virtual visit platforms can serve as a complementary option that allows doctors to check in with their patients remotely and improve access. Through virtual platforms, rural maternal patients can feel confident they have a better understanding of their health needs throughout their pregnancy and make in-person meetings more meaningful and insightful based on virtual interactions with their doctors.

Additionally, telehealth services can help expectant mothers reach certified nurse practitioners, physician assistants or other care support staff who can triage immediate questions that don’t necessarily require a doctor’s input or can help a patient schedule a follow-up appointment with a doctor if needed. A natural extension of virtual care options from OB-GYNs, these services not only expand access to more immediate maternal care for patients regardless of where they live but can also reduce unnecessary emergency room visits and overall health care costs.

Conclusion: A better way forward for maternal health

VBC has the potential to play a critical role in improving the state of women’s health in America by supporting OB-GYNs in enhancing their focus on patient outcomes and rewarding them for high-quality care. There is a significant opportunity to improve the care not only of the maternal-fetal dyad but of women experiencing other gynecologic conditions like endometriosis, fibroids, menopausal syndromes, pelvic pain and more. The technology developed at scale by OB-GYN and other aggregators is designed with these benefits in mind.

In maternal health, success in VBC involves participation from the OB-GYN and the patient and requires thoughtful, forward-thinking plan development from payers. By equipping providers and patients with technology solutions to help them better understand the care journey, patients and doctors can forge stronger bonds that boost engagement and optimize health outcomes for expectant mothers and their children, no matter the circumstances.

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5 tax strategies to help physicians achieve financial independence

Physicians spend many years training for the opportunity to earn higher-than-average incomes. Although the time investment is intense, the returns on that investment are real. According to the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics, the average annual wage for all occupations in the United States in 2023 was $65,470, while family medicine physicians earned $240,790 on average.

However, higher wages typically also mean paying more in taxes. Physicians tend to focus on expensive and often ineffective strategies to get into a lower tax bracket, either now or in the future. But there’s more than money to consider when setting such strategies. Physicians should first focus on what is important to them and then determine the most tax-efficient strategies to achieve those goals. When properly executed, such plans can help physicians pay less in taxes today, in the future, or in both instances.

Roth IRAs

One of the most often missed opportunities for tax-free growth is through funding Roth individual retirement accounts (IRAs). A Roth IRA provides tax-free growth. Due to income limitations on funding a Roth IRA, many physicians mistakenly think that they cannot fund one. However, there is an alternative way to accomplish tax-free growth using this vehicle. Regardless of income, physicians can make a nondeductible contribution to an IRA based on annual contribution limits. Then, if they do not have an IRA account balance at the end of the year, they can convert those same dollars into a Roth IRA, with zero tax liability. If they do have an IRA account, they can often transfer the IRA balance into their current employer-sponsored plan to zero out their IRA account. This strategy can potentially be carried out each year.

Real estate

Physicians are often interested in diversifying their investment portfolio into real estate because of potential tax savings. These investments typically involve leveraging current dollars for a down payment to purchase a property, then renting the property to cover the costs of ownership while building equity and future cash flow. This strategy becomes much more effective if the physician’s spouse is a real estate professional. A real estate professional must meet specific requirements established by the IRS. When this is in place, the revenue generated via rented real estate becomes active income, which may allow for losses to offset other active income, including physician-earned income.

Charitable giving

Charitable giving is another common avenue for employing favorable tax strategies while also supporting community needs. There are several important details to keep in mind to most efficiently accomplish this goal. Instead of simply writing a check to a favorite charity, physicians should consider gifting appreciated stock to a donor-advised fund (DAF) or, for those who are over age 70 1/2, making qualified charitable distributions (QCDs) from an IRA. These moves not only can provide an annual tax benefit but may also yield long-term tax benefits.

Using appreciated stock to give to a DAF or directly to charity may reduce the capital gains taxes paid in the future while benefiting the chosen charity. At the same time, appreciated stock in a taxable account will receive a step-up in basis at the time of the taxpayer’s death. Assets in an IRA will see income taxes paid on those dollars at the time of distribution unless they go directly to a charity. For those aged 70 1/2 or older with IRA balances, QCDs may be beneficial to minimize long-term tax impacts for beneficiaries. Taxpayers can use a QCD as part of or all of their required minimum distribution up to $108,000 in 2025 to reduce their taxable income.

Health savings accounts

Another powerful tax-efficient strategy is investing in a health savings account (HSA). To qualify for an HSA, one must participate in a high-deductible health insurance plan. HSAs provide a triple tax benefit: contributions are tax-deductible, the earnings grow tax-free, and distributions may be tax-free if used for qualified expenses. The true power of this strategy comes into play when using these dollars as an investment for medical expenses later in life, rather than using them to pay for current medical expenses each year. There is no requirement to use these dollars each year, and the money can be invested, just as any other investment account, and grow tax-deferred. Because most people see health care spending increase as they age, pulling these dollars out tax-free for qualifying health care expenses after retirement is a significant savings strategy.

Tax-loss harvesting

Physicians often incur large taxable gains during their lifetimes as a result of capital gains taxes on growing investment portfolios, mutual fund payout capital distributions, or the sale of real estate or their businesses. One way to offset those taxable gains is through tax-loss harvesting. While no one invests to lose money, occasionally there are times when an investment leads to a loss, even if temporary. If this investment is in a taxable account, it could be sold to lock in the capital loss for tax purposes, then immediately reinvested in something else that would perform similarly or better. Be mindful of the IRS wash sale rule to avoid negating the tax benefit. By doing this, the portfolio would then have capital losses that can be carried forward indefinitely to offset capital gains in the future.

Developing a holistic, long-term strategy

Any one or all of these five strategies can be used by physicians to help reduce tax consequences now or in the future. These strategies are most impactful when they are part of a well-designed financial plan with specific goals that align with the physician’s intent. Implementing a few tactics to save on taxes in the current year may be a win in the short term, but a truly holistic and long-term strategy is a far more effective use of time and resources — and can ultimately save more today and tomorrow.

After investing immense time and energy to reach their career goals in medicine, physicians may consider developing tax strategies that help make the most of the financial rewards they have worked so hard to achieve.

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Teenage mentors and smartwatches help rural seniors bridge digital health divide

In an effort to bridge the digital divide in older, under-resourced communities, researchers from Florida Atlantic University’s (FAU’s) Christine E. Lynn College of Nursing have implemented a pilot study that pairs high school students with older adults to promote the adoption of wearable health technology. The study, conducted in the rural “Glades” region of South-Central Florida, aimed to assess how technology-assisted health monitoring can support aging in place.

Many older residents in this rural community struggle with digital literacy, limiting their ability to use digital health-tracking devices like Fitbits and smartwatches. The study sought to change that, introducing an intergenerational program in which students helped older adults navigate the technology, while local faith-based educators provided additional support.

The research, published in the journal Educational Gerontology, used an ecological momentary assessment (EMA) to send participants smartwatch-based health surveys four times per day. The participants responded to questions about their social interactions, physical activity and cognitive engagement. Paper-based assessments were also administered to evaluate cognition, health literacy and technology competence.

The study found that 91% of older adults engaged with smartwatch prompts, with an overall response rate of 77.8%. Surprisingly, factors like age, education, rural living and technology self-efficacy did not have a significant impact on response rates.

Notably, social engagement was strongly linked to higher levels of physical and mental activity, reinforcing the importance of social connections in cognitive health.

Lisa Ann Kirk Wiese, PhD, MSN, RN, GERO-BC, PHNA-BC, CNE, FGSA, FAAN, senior author, with members of the faith-based community team who worked with the students.

“Our study created a win-win situation for everyone involved: older adults gained new skills in using wearable technology to monitor their health, while high school students had the opportunity to learn processes for conducting meaningful research and develop valuable skills,” said Lisa Ann Kirk Wiese, PhD, MSN, RN, GERO-BC, PHNA-BC, CNE, FGSA, FAAN, senior author of the study and an associate professor at the Christine E. Lynn College of Nursing.

High school students — ages 15 to 19 — played a critical role in onboarding participants, offering guidance on smartwatch use, prompt responses and device maintenance. The students expressed appreciation for the opportunity to assist with the research, noting that the experience bolstered their resumes and future research-related career aspirations.

“High school students don’t just teach older adults about mobile health — they also gain invaluable skills and insights themselves,” Wiese said. “Through these meaningful interactions, students discover how technology can improve health monitoring and care, while being inspired to pursue careers in aging, health care and gerontechnology. These experiences not only prepare them for future careers but also foster a deep appreciation for the power of digital health in their own lives.”

The initiative was part of a larger effort by FAU’s nurse-led research team, which has collaborated with community stakeholders to enhance care for older adults in the region over the past decade.

The project’s success highlights the potential for similar programs to improve digital health usage and literacy in other rural areas of the country. As mobile health technology continues to evolve, these collaborations could play a vital role in ensuring equitable access to digital health tools for aging populations.

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23andMe: How to delete your genetic data

23andME, the owner of “the world’s largest proprietary database of health and genetic information” filed for bankruptcy on March 23.

This has left consumers what will happen to their personal genetic data. The company announced it will use the voluntary, court-supervised process “to maximize stakeholder value” through a sale, and that “any buyer will be required to comply with applicable law with respect to treatment of customer data.”

“Your data remains protected,” said a March 23 “Open Letter to 23andMe Customers.”

But what if you want to delete your data before the 23andMe sale? Here’s a brief guide on how to do that:

1. Sign in to your 23andMe account
Go to 23andMe.com and enter your username and password. Access your personal dashboard, where you can review your genetic reports and account information.

2. Navigate to account settings
Once logged in, look for your profile picture or name in the top right corner. Select the dropdown menu and click “Settings.” This will take you to your account management page.

3. Locate privacy and data options
In the “Settings” section, find the headings related to “Privacy” or “Account.” Look for wording such as “Delete Account,” “Close Account” or “Manage Personal Information.”

4. Review data deletion policies
Before proceeding, carefully read 23andMe’s policies on data deletion. The company typically outlines:What data will be removed: Genetic information, personal profile details and health reports.
What data may remain: Aggregated data used for research (usually stripped of personal identifiers).
Time frame: The length of time the company needs to fully remove your data.

5. Initiate the deletion request
Select the option that confirms your request to delete or close your account. 23andMe may ask you to re-enter your password or provide a security code to verify your identity.

6. Confirm closure and data removal
After submitting your request, watch for a confirmation email from 23andMe. Keep any reference numbers or confirmations in case you need to follow up.

7. (Optional) Request destruction of physical samples
If you previously sent a saliva sample for DNA analysis, you may need to submit a separate request for sample destruction. Check the 23andMe help center or contact customer service for instructions on how to confirm that your physical sample is destroyed, if that is your preference.

8. Contact customer service if needed
For additional assistance or questions about your request, contact 23andMe’s customer support. You can typically do this through the website’s contact form, or by using any phone or email information provided in your account or the company’s Help Center.

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