Advisory Insights
Thinking & Frameworks
Insights from our advisory work with independent practices. Real challenges, practical solutions, and the thinking behind our approach to operational excellence.
Case Study: Margin Recovery in a Multi-Location Ophthalmology Practice
How a 9-provider ophthalmology group recovered operating margin from 21% to 26.4% through a 90-day plan addressing revenue cycle, access, and operations.
The Empty Chair at 2pm: What Your No-Show Rate Is Actually Costing You
Patient no-shows are a system problem, not a patient problem. Better reminder workflows, waitlist management, and calibrated overbooking can recapture $150K–$400K+ in lost revenue.
The Contract Nobody Read: How Payer Fee Schedules Silently Drain Independent Practices
Most practices have not reviewed their payer contracts in years. Below-market reimbursement rates can quietly cost $100K–$300K+ annually. The practices that negotiate get paid more.
The 50% You Don't See: Why Your IT Spend Is Quietly Eating Your Margin
Most practices cannot itemize their IT costs. Redundant systems, unused licenses, and uncontested vendor pricing quietly erode 3–5% of operating margin.
The Silent Cost of Patient Frustration
Patients rarely storm out—they drift away quietly. A pediatric clinic recaptured $120K annually by fixing its phone system after measuring a 20% call abandonment rate.
MGMA Benchmarks vs. Hands-On Margin Recovery: Which Actually Moves the Needle?
Benchmarking data tells you where you stand. It does not tell you how to move. Here is why most practices need an execution partner, not another report.
How to Reduce Overhead in a Medical Practice Without Cutting Staff
Most overhead problems are not headcount problems. They are workflow, vendor, and utilization problems. Here is how to find the real savings without losing your team.
What a Fractional COO Actually Does for a Healthcare Group
Most practice owners know they need operational leadership but cannot justify a full-time executive hire. A fractional COO fills the gap at a fraction of the cost.
What Lean Actually Looks Like in a Physician Practice (And What It Does Not)
Lean transformation in healthcare gets oversold and underdelivered. Here is what it looks like when it works, what kills it, and why the practices that stick with it end up in a different category than the ones that tried it once.
The Physician Who Is Also the CEO, COO, and HR Department
Most independent practice owners are running the clinical side and the operational side simultaneously. That arrangement has a cost that rarely shows up on the P&L but shows up everywhere else.
Nobody Teaches You How to Run a Practice. Here Is What That Costs.
Medical school, residency, and fellowship prepare physicians to deliver excellent care. None of it prepares them to manage a business. Here is what that gap costs and what closing it looks like.
Year One After Selling to PE: What the Physicians Actually Say
The pitch is compelling. The multiple is real. But year one inside a PE-backed platform is a different experience than the one described in the letter of intent. Here is what physicians report when they are willing to be honest about it.
Year Two After the Sale: When the Honeymoon Ends and the Reckoning Begins
Year one has a certain momentum to it. The check cleared, the team is still intact, and the new platform is still making promises. Year two is when physicians find out what they actually agreed to.
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