Things to consider when bringing on a mid-level provider

June 28, 2013

There are things to consider when bringing on a mid-level provider, first be clear on what you are trying to achieve. Is it increased revenue, better life style, or more face time with patients?  With some planning each of the above can be accomplished.

If increasing revenue is your goal, bringing in a mid-level provider can be a very good way to accomplish this.  Revenue will be increased but, more importantly, so will profit margins.  The primary reason for this is that you are seeing more patients or offering more services without a significant increase in overhead.   The direct costs of bringing in a mid-level are items such as salary, benefits, payroll taxes, and liability insurance.  Fixed costs items such as space, utilities, marketing, business insurance, and professional fees remain the same.  Direct costs usually run in the $100,000 range.  The revenue generated will run in the $250,000 range.  The actual numbers will depend on the experience of the person hired, their productivity, and the location of the practice.  If the practice has limited space, consider extending the hours of the practice.  For example, services could be provided evenings and weekends.  Many patients would embrace these hours.

In the case of specialists, mid-levels can be deployed to maximize the amount of time a specialist can spend performing procedures.  Procedures are usually done in an ASC, OR, or a procedure room.  While the physician is performing these procedures, exam rooms in the office are often underutilized.   A mid-level can see patients and utilize these rooms.  Additionally, specialists generate far more revenue from procedures as compared to office visits.  If the mid-level can perform more of the office visits, this will free up the physician to perform more procedures.  There is a clear economic benefit to doing this.  Additionally, most specialists enjoy performing procedures as compared to office visits.

Beyond the potential financial benefits, there are other advantages of having a mid-level.  Providers in the practice could lighten their load and either improve their lifestyle or spend more time with current patients.

If you decide to bring in a mid-level provider, be sure to prepare for a successful launch.  You will need to consider a marketing plan to let the community know that you have a new member of your team and that you have extended hours, if you decide to go that route.  You may need a line of credit or some working capital to allow for a ramp-up period.  This is the period when you are paying the salary and any additional expenses associated with bringing on the new mid-level while they are building their patient load.  They will not start off with a full panel, so in the beginning you will be paying more than you are taking in on the new service.  Be sure to plan for the fact that even for patients seen, payments from insurers won’t begin arriving for 30-60 days.  Credentialing is another consideration.  Your new provider must be credentialed for claims to be paid.

With proper planning, adding a mid-level provider can provide genuine benefits to your practice.  Just be clear on what you are trying to accomplish.