Primary Care Group Not Financially Viable

Primary care group with fifteen providers located in rural market was struggling with provider production below expectations thereby straining the viability of the group.
Health Intersect conducted a thorough practice assessment to identify the issues impacting the group’s performance.

Key Findings


  • Getting patients into the practice was difficult, the practice had partially adopted an EMR (half paper, half EMR) making more work for everyone,
  • Workspace for the providers and support staff was inadequate,
  • Staff work assignments did little to support  rapid, efficient patient treatment,
  • Providers had to designate one day per week as a non-patient day to catch up on EMR charting – delaying patient referrals and impacting follow up. 
  • Nurse’s area was chaotic, and sounds traveled to patient care areas. 
  • The principles of a Patient Centered Medical Home (PCMH) were not in place.


  • Point of service collections were weak, lacking a comprehensive insurance verification process prior to the visit
  • Costs exceeded production
  • Provider compensation did not match production
  • Practice growth/access was stifled
  • Managed care contracts were old and much lower than community rates
  • On-site billing was lacking robust follow-up


1. Using the principles of a PCMH, staff were re-assigned into teams that would support the providers, handle the patients at the practice and those at home calling in, enhancing quality of patient care with outreach to patient and disease follow up. 
2. A small facility renovation was recommended that would provide for co-location of providers and their support staff in a quieter, confidential area – improving their ability to work together. 
3. Policies, procedures, and scripts were provided for immediate implementation of comprehensive insurance verification; and daily, weekly, and monthly monitoring of point of service collections. 
4. A re-implementation of the EMR was scheduled after the workspace renovation and the purchase of tablets/computers & monitors that fit the style of practice.


The co-location of providers and staff, reimplementation of the EMR, and purchase of needed monitors and tablets meant that each provider’s production would be increased by 8 contact hours per week – a huge gain in productivity that would reduce the practice deficit by 85%. Any future improvement in billing or contracting would only add to the positive position financial position of the practice.