Medical practice management 101: Budgeting
Creating a medical practice budget is one of the most important elements of running a profitable physician practice, doctor’s office, or physical therapy clinic. The medical practice budget provides physicians, office managers and administrators with a gauge from which financial performance can be measured and operational issues identified.
There are many ways to create a medical practice budget, however our firm often recommends use of a budgeting format which clearly distinguishes those revenues and expenses that are variable in nature (change from month to month) from those that are fixed (relatively consistent from month to month).
To create a medical practice budget which outlines revenues and expenses in this way is quite easy to perform, and the reporting that comes from this type of budget is of the most easily understood.
Starting with revenues, create a list of all sources of revenue for your medical practice. Use large categories to capture the largest sources of revenue, then gradually break down the large categories into smaller subsets of revenue.
For example, if your physical therapy clinic provides two main types of services – physical therapy and fitness classes – then these might make up your two main revenue categories for your medical practice budget.
You may wish to further break down the “physical therapy” category into subcategories such as “orthopedics,” “pediatrics,” and “women’s health.” Your fitness classes may also be broken down into subcategories such as “weight management,” “strength training,” and “flexibility.”
It is a good idea to capture your “adjustments to revenue” within your revenue section as it is normal to collect much less than is charged to insurance companies. These adjustments are captured in the revenue section of the medical practice budget, along with any refunds that are credited back to clients through the course of business.
Moving to the expenses category, start by breaking all of your expenses down into “variable” and “fixed” expense categories. A rule of thumb that is often used to determine which expenses are variable versus fixed is to consider all expenses that would diminish or cease upon closure of your medical practice for a period of a month or so. Expenses such as clinical staff (often paid based on production or hours worked), hourly office and administrative staff, most utilities, office supplies, and repairs/maintenance would likely diminish or cease, and are therefore examples of variable expenses in some medical practices.
Expenses that would remain unchanged if your medical office closed for a month or so are considered “fixed” and would likely include your fixed management salaries, lease payments, loan repayments, dues/subscriptions, and contractual advertising expenses.
The rules for breaking medical practice expenses into variable and fixed categories are not hard and fast, but are rather dependent upon the operations of the medical practice, as well as the reporting that is desired of those that will be managing the medical practice budget.
After all revenues and expenses are accounted for within the medical practice budget, all expenses are subtracted from all revenues to come up with a number known as “net income.” Net income reflects the profitability of the time period examined by the medical practice budget, accounting for all recorded revenues and expenses.
You can likely see that without a medical practice budget, the ability to truly understand where, why and how revenues and expenses are generated is nearly impossible. By creating a medical practice budget, sticking to it, and revising it annually, your medical practice will have much more chance of success and profitability, and is therefore highly recommended.
If you’re interested in starting or improving your own medical practice budget, please visit the Vantage Clinical Solutions website to download a free medical practice budgeting tool that can be used within your medical practice, doctor’s office, or physical therapy clinic.
Tannus Quatre is a private practice consultant and principal with Vantage Clinical Solutions, Inc., a nationwide healthcare consulting and management firm located in Bend, OR and Denver, CO. Tannus specializes in the areas of healthcare marketing, strategy, and finance, and can be reached through the Vantage Clinical Solutions website.