Healthcare is evolving on a daily basis.

Whether it is regulatory requirements, decreased reimbursement, or even changes in technology requirements, it is hard to stay ahead. I am often asked what “number” is most important in evaluating an anesthesia practice. The truth is that there is not one silver bullet or number to look at. You have to find the two or three metrics that matter the most to your practice and make them your everything. Here are some of the metrics that I look at regularly to evaluate the anesthesia practices I manage.

Staff Utilization

In my last post, I shared some of the things that I routinely look at to ensure efficient utilization. However, there are even more ways to look at how you are utilizing your staff.

  • How can you maximize each team member’s productivity while also not hurting morale and culture?
  • How do you connect human capital expense with revenue and production?
  • How would your team respond if you asked them to increase revenue and production by 10-20%?

The key is to match what each person is working on with higher ROI work along with minimizing waste and down time. If staff is going to have to produce more and work harder, is it more per hour that you are looking for or longer hours? I have chosen the former and am optimizing my team’s time with work that produces more for the company’s bottom line while not taking away from their non-work hours, which has only become more valuable to people nowadays. I also trust that my team is creative and talented enough to find solutions to help improve our company’s revenue and production per FTE not only when they are asked to do so, but on a continuous basis.

Staff Turnover

  • How long have your staff been with you?
  • Why do they leave when they do?
  • Do you know what your staff’s priorities are with respect to compensation, benefits, and rewards and recognitions? What is most important for you to compete on?
  • How do you recognize your high performers?

Small business healthcare relies on relationships, consistency, service, and personable and frequent touches with clients. If you are losing too many staff members and must routinely recruit, onboard and orient new staff, can you trust that you will be able to retain “stickiness” with your clients? It is critical that you create the proper culture and a supportive environment for your staff. Find creative ways to recognize your high-performing staff and stop focusing on the non-performers. Help those that do not meet performance requirements or are toxic to your culture find alternatives so that they can be successful and you can improve morale. With limited dollars to spend in this environment, the organizations that will survive are those that can balance financial rewards with creative recognition programs, and genuine expressions of gratitude.

Client Retention

  • How long have your clients been with you?
  • Why do they leave when they do?
  • Are you adapting to their needs to prolong those relationships?

I think the length of service relationships is key given the switching costs. This industry likes changes less than almost any other so if you listen to your clients’ needs and continue to improve and expand your services, you will hopefully have lifelong clients. When your client base is stable, you can focus more on growth and responding to industry changes more easily.


  • What is your client and specialty concentration?
  • What is your payer mix and how is it impacting your reimbursement?
  • Are higher deductibles and increased patient cost-sharing impacting realization? If so, what protocols are you putting in place to increase pre-collections?
  • How is market consolidation (e.g., payers, networks, physician groups) impacting your ability to grow and maintain current reimbursement levels?
  • What is hurting the competition that has not impacted you yet?

The key with reimbursement is identifying how many potential holes you need to fill or how many possible threats you need to battle. Minimizing financial risk by being proactive can better allow you to control your future. You must offensively plan, prepare, and execute. Hoping for a cyclical return or assuming the volatility in the market will decrease, will impact your ability to remain a player in your market.

I hope that the information that I shared above is useful to you as you continue to evaluate and expand your anesthesia practice. You will live or die by them, so you might as well make them your core focus. Remember that what is working today or has worked in the past will not work in the future. Good luck, I know you will get there!