Managing Your Practice: Answers to your questions about...


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Dividing practice income

Q My partners and I can't agree on how to divide the income from our ob/gyn practice. Currently, we're splitting everything equally, but some of us see more patients than others. How can we apportion income to give our higher producers incentive without alienating clinicians whose practices are less busy?

A If all the partners care for roughly the same volume of patients, it's easy and fair to split the proceeds of the practice equally. But if the amount of work performed varies among the partners, equal apportionment may not be optimal. There are several possible approaches you can consider.

Arrangements that give individual physicians credit for the specific work that they do-whether in obstetrics, gynecology, or both-tend to increase a practice's overall productivity and profitability because they offer an incentive to do additional work. The right scenario for your particular group practice depends upon the partners' chemistry and their expectations for work volume and income.

Employee insurance

Q The premiums for our employees' health insurance keep increasing. Right now, we're paying 100% of the cost. Would it be reasonable to require our employees to start paying part of the premium?

A Many businesses require employees to pay a portion of their health insurance premiums. It helps ensure that employees enroll only for coverage they really need. If your employee's partner or spouse has health coverage, he or she may not need coverage through your practice, which could save you money.

It may be worthwhile for you to canvass the human resources departments of other employers in your area to find out if any of them have employees pay a portion of their health insurance premiums. It's also wise to set eligibility thresholds for benefits. At Mount Kisco Medical Group, an employee has to work at least 32 hours in a 5-day workweek and have been with us for at least 1 month in order to qualify for health benefits. Our employees contribute 25% of the cost of their health coverage.

Collecting copayments

Q Our practice's policy is to collect cash for copayments at the time of a visit. But patients often say they don't have enough money to pay. Should we start accepting credit cards for copayments?

A First, you're absolutely right to collect copayments at each visit because it often costs more to bill and collect after the fact than it's worth, and the copayments represent revenue you shouldn't lose. Accepting credit card payments from patients is also good policy. Even though your practice will pay a fee for each transaction, the benefits in terms of avoiding the expense of collection outweigh the cost of accepting credit cards. Money collected via credit card is available as soon as the transaction has cleared, increasing cash flow. Patients also appreciate the convenience of using "plastic."

The key with credit card payments is to shop for the lowest processing fees. Depending on what the fees are for different cards, you may decide to limit the number or type of cards you accept. Check with your county and state medical societies, and with AMGA (American Medical Group Association) and MGMA (Medical Group Management Association) to learn about discount programs for processing fees.

Have a Practice Management question you need answered? Send it to
and Dr. Hayworth will consider it for a future column.

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John Stanley, MD
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