Strategic Planning--Now More than Ever

By Gerard J. Kassouf, CPA


Healthcare practices focus on providing quality care to the patients they serve, utilizing the resources, techniques and expertise available.

Today's practices face many complex challenges including value and cost-based reimbursement changes, facilities, equipment, practice management and electronic health systems, social media and marketing and the overall costs of efficient operations. In addition, many smaller practices fail to consider succession planning or an exit strategy as part of their long-term view.

Whether you practice medicine alone, in a private medical practice or in an employed group setting, as Yogi Berra--The New York Yankee legend who played or coached in 14 World Series--said: "You've got to be very careful if you don't know where you are going, because you might not get there."

Practices large and small benefit from strategic planning, utilizing tried and true techniques used by the business community to assess and develop the future of the organization. A strategic plan begins with a desire to assess your current practice, knowing that it will change. Change is critical for success, no matter how successful you feel your practice is.

Be open-minded.

Be fluid.

A strategic planning meeting cannot be a one and done luncheon. It can be as much as a multi-year process, with the group leaders taking time to assess the rapid changes in health care that affect your practice, determining how your practice will prepare, respond and continually adjust to the changing forces. To gain the most from strategic planning, developing a forum for an open and honest discussion of the current practice and external forces is crucial.

The assessment of the practice begins with the services performed; the number, age, capability and needs of the providers and the support team; patients served and their needs; along with the practice location; and equipment used or needed.

In addition to these internal issues, your practice must also recognize the external forces that affect you--government regulations and changing medical environment, payor reimbursement, and the changing dynamics to group medical practices to name a few.

Your practice's strategic plan will begin with the development of three critical statements: Mission; Vision; and Values. The words of these statements will define your practice and set the stage for the future.

The Mission statement provides a description of why your practice exists. The Vision statement provides goals for the future. The Value statement presents the firm's core beliefs.

A beginning point for the assessment of your practice is the SWOT analysis, which stands for Strengths, Weaknesses, Opportunities and Threats. Strength and weaknesses are issues that are internal to the practice. Strengths are noteworthy things that you do well or that are unique to your practice. Weaknesses are things within the practice that can be improved upon. Opportunities include things like a new satellite office or new ancillary services, while threats focus on outside issues that negatively affect your practice.

Designate a facilitator, either someone within your practice who has the skill and time to keep the project on course, or consider utilizing an outside facilitator, preferably someone with healthcare experience.

While someone inside the group has a historical prospective of the group, a skilled outside facilitator will meet to discuss the project, review practice key performance indicators and help you formulate the agenda.

Outside facilitators usually meet with each provider to confidentially assess each one's goals for the practice. Based on their knowledge, outside facilitators can interject concerns addressed in private that might not be addressed between the group otherwise.

Meetings should develop into a plan for the future. Consider an agenda that addresses practice services and quality, finances and debt, growth and new practice sites, patient engagement and satisfaction, and employee engagement and satisfaction.

The plan should include SMART goals--those that are Specific, Measurable, Achievable, Relevant and Time-bound.

It is critical to keep the plan alive after the planning sessions. Develop a written summary of the plan and objectives. List the issues addressed and the solutions discussed. Assign agreed-upon tasks to specific individuals and determine time lines for completion.

Focusing on the business side of your practice should generate new opportunities and growth for your practice. Many large groups were once small groups, and many small groups continue because they added providers to care for the patients of those retiring.

It is never too soon to begin looking at the future of your practice.


Gerard J. Kassouf, CPA is a director of Kassouf & Co., P. C. an accounting and health care advisory firm serving clients nationally.