Providence ex-COO offers cure for bad business

Providence ex-COO offers cure for bad business

As Southern Oregon's medical community grows, more physicians are joining existing medical groups or hanging out their own shingle.

While the region's aging population crowds waiting rooms and doctors see dozens of patients a week, it doesn't guarantee smooth-running fiscal operations. That's where Will Brake sees opportunity to improve medical office business practices and grow his own company.

Brake was with the Providence Medical Group in Medford the past 11 years and was its chief operations officer from 2002 until this fall. During that period, the hospital expanded from 16 doctors to 50 and from two clinics to 11. At 46, he was ready to launch his own firm. He founded Executive Practice Management with the knowledge that independent doctors and small physicians groups frequently let large amounts of revenue slip away.

His business territory ranges from Eugene and Bend to Brookings and Klamath Falls.

"There are 2,100 doctors in that vicinity, most in small practices — under 10 — and most of them need help," Brake says. "They don't run their business well, they aren't maximizing accounts receivable.

"Medical groups hire at the top end as far as education when it comes to doctors," Brake says. "But most of the rest of the staff, except for nurses, are entry-level folks, few with college degrees. They are expecting entry-level people to run their business and that's historically been the problem, which turns into an opportunity for me."

It doesn't take a lot of money to run a practice efficiently, but it takes good systems and the ability to chase down reimbursements, he says.

"If the insurance company says it won't pay, a lot of doctors don't go back and battle," Brake says. "They'll either eat it or write it off as a bad debt. If a person knows what they're doing, they can capture that revenue."

Another area where Brake says doctors and groups can cut costs is in supplies.

"Medical groups pay a lot of dollars for supplies," Brake says. "I'm amazed how often they haven't done competitive bidding — it's usually a foreign concept to them. When suppliers walk in they order items and no one talks to them; it's a gold mine for suppliers."

Aware of the obstacles facing small practices, Ashland Community Hospital Chief Executive Officer Mark Marchetti brought in Brake to offer a monthly breakfast-time medical practice management series.

"The health care environment is difficult for hospitals and physicians as well," Marchetti says. "Sometimes, physicians don't have the resources to deal with business issues. We hope to help make our local physicians to be successful because we certainly want physicians to remain in our community meeting the needs of people in the community."

From November through March, Brake is talking to doctors and their staffs about accounting, finances, accounts receivable and scheduling patients.

"They are eating this up," Brake says. "They're hungry for knowledge about how to better run their businesses."

Brake says he is just as inclined to help a startup as turning around a group that's been around 20 years. He began formulating his business plan eight months ago.

"This has always been in the back of my mind as something I wanted to eventually do," Brake says. "Then I started hearing more and more from doctors that wanted help."

One cure, he suggests, is better training for people handling insurance claims.

"The insurance companies, Medicare and Medicaid have created such a complex system that you really need to be a billing expert to manage accounts receivable well," Brake says. "Medical groups have a lot of turnover and when the entry-level person comes in, they can fall behind quickly."

Reach reporter Greg Stiles at 776-4463 or e-mail

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