2019 Asset Management Year in Review and Look Ahead to 2020
What a difference a year makes. Last December, equity markets plunged almost into bear market territory driven by fears that the Federal Reserve and their rate hikes would throw the economy into a recession. Today, the Federal Reserve is buying more treasury bills than they ever bought in prior Quantitative Easing (QE) periods and have pushed the markets to new all-time highs[1]. QT, or “Quantitation Tightening” – increasing short term rates and a shrinking Federal Reserve balance sheet – is but a vague memory now. So, just as last year’s pessimism clearly was overdone, today’s optimism is likely outpacing the economic evidence that the economy is moving to higher growth.
A measure of that is the CNN Fear & Greed Index- below reaching the “Extreme Greed” level as we started trading for 2020 versus 1 Year Ago[2].
2019 was a stellar year for the equity and bond markets. Nearly every major asset class had significant outperformance versus the rate of inflation. That said, it is important to recognize 2019’s good returns were primarily driven by what investors are willing to pay for a dollar of company earnings (the “earnings multiple”), as annual earnings growth is likely to be only single digits when companies complete announcing their 2019 Fourth Quarter results this month. 2018’s disappointing equity market returns were the result of the exact opposite situation: 22% earnings growth but declining earnings multiples. You may recall from our January 2019 letter that almost no asset classes beat inflation in 2018. While such a dichotomy between the years is not unheard of, it was historically extreme as noted by Morgan Stanley[3].
Central Banks, including the Federal Reserve, can have a large impact on earnings multiples. According to economic theory, when money growth is faster than the growth of the economy, the excess money goes into financial assets driving even expensive stocks and bonds higher. Ever since the start of October when the Fed launched QE4 in response to the September stealth banking crisis, the Federal Reserve balance sheet rose 11 of 12 weeks starting October 9, and declined just 1 of 12, and magically, the S&P did just that as well[4].
We remain concerned that the New York Federal Reserve continues to inject reserves into the banking system to keep some short-term rates from rising. This system, the overnight repo market, is where the interest rates that central banks set meet the interest rates that real economic actors use. You may recall the unrest in September in the money markets, when short-term interest rates got out of the Federal Reserve’s control and briefly spiked to 9%[5]. This could signal that something’s potentially wrong with the financial system, especially as it relates to banks and liquidity.
During 2019, we counted over 50 Central Bank easing actions, and global short term rates declined about -0.6%[6]. The aggressiveness of the Central Banks has been a surprise to many with the Federal Reserve, in particular, adding almost $400 billion dollars to the markets in just four months! (Note dramatic upturn in the graph below[7].)
It is also remarkable how skewed the S&P 500’s 2019 return is toward a small handful of larger-cap firms and sectors. Apple (+88% return) and Microsoft (+57% return) accounted for almost one-fifth, and Information Technology was 50% of the S&P 500 index’s return. The largest source of stock buying was the companies themselves, with Information Technology buying back the most stock of any sector.
Companies buying back their own shares has been a major contributor to the rally since 2009. A Goldman Sachs analysis warns that they anticipate 2019 stock buybacks will drop 15% in 2019 to $710 billion and continue to drop in 2020. Corporate buybacks currently provide more demand for stocks than any other individual source, including households, mutual funds or exchange-traded funds. Buybacks as a percentage of trailing annual free cash flow has historically peaked near the highs of the market, i.e.: 2000, 2008, and 2016[8]. A slower pace of buybacks should not only drag on companies’ earnings per share, but also lead to increased market volatility as corporations provide less support to the equity markets.
The last time that we saw such dynamics in the market was the late 1990s, with “insurance” rate cuts, skewed returns and political risks. We remember what happened in 2000: a severe market downturn.
All of this is in the background of an investment market that wants to find a narrative to support driving asset prices higher. In December, the narrative was that the three biggest worries of 2019 have been solved during the week of December 9. On trade, the U.S. and China agreed to a “Phase One” deal and additional tariffs scheduled for December 15 were delayed. In the UK, Prime Minister Boris Johnson won a landslide victory, ensuring that “Brexit” would finally take place. Lastly, the Federal Reserve said that interest rates should remain steady through 2020. As we entered 2020, markets started off slow but now have begun to make some new highs. Given recent events in the Middle East, it feels like anything could happen.
Where does this leave the investment markets? One of the best indicators of the fair value of the stock market in the U.S. is the total market value relative to the total economy, or GDP. At this point, an argument could be made that the market is significantly overvalued, given that the total market value is almost 155% of the last reported GDP. The last time that this happened was the Dot Com Boom of the late 1990s.
While some may argue that low interest rates and the amount of company sales overseas have impacted this ratio, on the face of it, the U.S. stock market would likely need to return about -3% per year in the next eight years to get back to the long term trend for the economy.
The corporate bond market has also benefited from declining interest rates over the last 18 months. As interest rates and bond yields have fallen in Europe and Japan into negative territory, investors there have bought more corporate bonds in the U.S[9]. As a result, the current market requires investors to increase risk in order to maintain the interest payments that they received in previous years. As of mid-December, the average junk bond (BB rated) yielded just 3.5%, an all-time low, including a credit premium or “spread” of just 1.64% more than risk-free Treasuries. A year before, the average high quality corporate bond (AA rated), such as those issued by Berkshire Hathaway, Apple and Exxon, was yielding 3.6%, more than the yield one now gets for bonds whose rating is some nine credit rating levels lower, in deep junk territory[10]. Meanwhile, cracks are starting to show in the lowest rated bonds[11].
Consequently, our objective in 2019 was to generate returns ahead of client financial plan targets by taking restrained risk in relation to client general risk preferences. We accomplished that by being:
- Slightly less invested in stocks and 25% less invested in bonds versus our benchmarks.
- Invested in shorter-term bonds to avoid the risk of rising interest rates.
- Diversified internationally and in alternatives investments like Gold.
- Underweight expensive corporate bonds and loans with deteriorating protections for investors like those mentioned above.
In 2020, the CIG team will continue to weigh the potential risks in the markets and plan for a wide range of scenarios, both positive and negative, while steadily reevaluating and managing the appropriate level of risk so that clients can achieve their financial plan goals. Specifically, our strategy remains consistent with prior years and will encompass:
- A core portfolio which focuses on stock and bond characteristics – Factors – that are a persistent source of investment return. We will attempt to limit the Momentum Factor in our portfolios. Momentum manifests itself in investors simply buying what has been making money (i.e., high growth names and consumer staples stocks) and selling what hasn’t (i.e., energy). The problem is that it leads to crowding into the same stocks. As soon as those stocks stop making money, these investors rush for the exits and the stocks fall significantly, which is what happened in the first two weeks of September.
- Meaningful diversification. After a 10-year equity bull market in the United States, the prudent approach for client portfolios is to have some investments in different geographies, fixed income and alternatives. We seek to deliver a nuanced, material understanding of diversification, which typically means carefully buying assets that have not appreciated and selling investors’ favorites. Diversification remains our best defense.
- A long-term approach. This methodology is particularly true in clients’ variable annuity and educational accounts, which generally do not have as extensive Factor or diversification exposure as the main portfolios.
- Tactical risk management. When the markets become, in our estimation, too volatile, we take risk management action in CIG’s Dynamic portfolios.
The bottom line is that we expect 2020’s market returns to be much lower than those of 2019 and less uniform. We continue to seek out “value-additive” investments to take advantage of market opportunities and be more contrarian and tactical to enhance portfolio returns in 2020. Markets are expensive and likely to get more expensive as a result of “easy money” from Central Banks. The risk of policymakers losing control is rising along with geopolitical risks. In this late cycle environment, CIG has taken a defensive stance and is prepared to take further action as the market direction dictates; we continue to focus on our clients’ risk-adjusted returns in support of their financial objectives and goals. In the words of Warren Buffet, the “Oracle of Omaha” and legendary investor, we will be “fearful when others are greedy and greedy when others are fearful.”
This report was prepared by CIG Asset Management and reflects the current opinion of the authors. It is based upon sources and data believed to be accurate and reliable. Opinions and forward-looking statements expressed are subject to change without notice. This information does not constitute a solicitation or an offer to buy or sell any security.
[1] Yahoo Finance
[2] https://money.cnn.com/data/fear-and-greed/ as of 1/2/20 at 9:45AM
[3] “On the Markets,” Morgan Stanley, January 2020
[4] “Market Your Calendar: Next Week The Fed’s Liquidity Drain Begins,” ZeroHedge.com, January 2020
[5] https://www.chicagofed.org/publications/chicago-fed-letter/2019/423
[6] Cornerstone Macro, November 3, 2019
[7] https://fred.stlouisfed.org/series/WALCL
[8] Goldman Sachs 10/21/2019
[9] “Even Goldman Bristles As Junk Bond Rally Smashers All Records,” Zerohedge.com, December 2019
[10] Bloomberg Opinion and Bloomberg Barclays
[11] “Eye on the Market,” J.P. Morgan
New Year Resolutions for Better Financial Health
As we approach the new year, it is a good idea to examine and review a financial health checklist and make changes as necessary. Here is a list of some of the items the CIG Capital Advisors Wealth Management team recommends you review as part of your resolution for better financial health in the new year and to help establish good personal finance habits in the years to come:
- Review and update beneficiaries. Confirm who is designated as your beneficiaries on your retirement accounts. For many people, naming beneficiaries happens one time, when they set up the account or policy. However, life changes (birth, marriage, divorce, death) are inevitable, and when these changes occur, you, or your family, may find that the designated beneficiary on your retirement account is not who you think it should be now.When it comes to planning for wealth transfers, it’s extremely important to review your beneficiaries periodically, especially if you have had children, divorced, or remarried since you first established your retirement account. This also applies if you had previously named a charity or trust as your beneficiary upon account setup and that organization no longer exists.
- Review and/or prepare for Required Minimum Distributions (RMDs) If you’re 70½ or older, you’re required by the IRS to take RMDs from certain retirement accounts by December 31—or face a penalty equal to 50% of the sum you failed to withdraw. If you turned 70½ this year, you have until April 1, 2020, to take your first RMD, albeit with potential consequences. Additionally, if you will be turning 70½ soon, now is the time to review your distribution strategy.
- Retirement Plan Contribution Increase. The contribution limit for employees who participate in 401(k), 403(b), most 457 plans, and the federal government’s Thrift Savings Plan, is increased from $19,000 to $19,500 for tax year 2020. Consider reviewing and changing your contribution limits if appropriate.
- Review Living Wills and Trusts. Most often people wait to do their estate planning and draft a Will until they absolutely have to, which is often after they have children, get married, buy a house, start a significant business or have a spouse or family member convince them of its importance. If nothing sudden or significant has happened such as the birth of a child, divorce, marriage, death of a family member, change in jobs, or change in your balance sheet or assets, then a good benchmark for reviewing your estate plan is once every five years. Otherwise, it’s a healthy habit to do a general review once a year.
- Revisit Tax Withholding. Changes in dependents, income and marital status can all affect your tax bill. Use the IRS’s withholding calculator to ensure you’re withholding enough—but not too much.
- Check your credit reports. Under the Fair Credit Reporting Act, each of the national credit-reporting agencies is required to provide you with a free copy of your credit report, upon request, once every 12 months. Get yours at annualcreditreport.com.
- Review your insurance needs. Make sure your loved ones and the things you’ve worked so hard for are protected. Ensure that there are no gaps in your home, auto, business insurance coverage.
Resolve to get take care of your financial health in the new year. To get assistance with a complete, holistic review of your financial plan, contact a CIG Capital Advisor to schedule a brief introductory call today.
CIG Asset Management Update December 2019: When Others are Greedy
November was a “risk-on” month, with the CNN Fear & Greed Index(1) reaching the “Extreme Greed” level. With the Federal Reserve buying more treasury bills than they ever bought in prior Quantitative Easing (QE) periods(2), a variety of U.S. equity indices did very well last month. The S&P 500 Index(3) returned 3.4% while riskier small company stocks, as measured by the Russell 2000 Index(3), were up 4.0%. The VIX Index(3) (The CBOE Volatility Index® which measures U.S. equity market volatility) posted a low for the year of 11.5 on November 26 as complacency in the market set in.
Given the lack of additional Central Bank stimulus, developed market foreign stocks in the MSCI EAFE Net(4) Index produced a more modest return of +1.1% while Emerging Markets as measured by the MSCI Emerging Markets Net(4), lost -0.1%. Investors also did not appear to be interested in bonds, as The Barclays U.S. Aggregate Total Return Bond Index(5) decreased by -0.1%. Surprisingly, market participants did not bid up the price of high yield issues, a traditional “risk-on” asset, with The Barclays High Yield Index(5) only gaining +0.3%.
Warren Buffet, the “Oracle of Omaha” and legendary investor, once said to be “fearful when others are greedy and greedy when others are fearful.”(6) With that in mind, the most important aspect of client relationships, beyond the investment expertise that we offer, is to ensure when these times arise and risk appetites are high, that we work together to restrain any exuberant investment behaviors. The same is true when risk appetites are low and we need to moderate our fearful investment behaviors (e.g., early 2009).
Consequently, the objective right now is to generate returns ahead of client financial plan targets by taking restrained risk in relation to client general risk preferences (i.e., growth models may look more balanced while still attempting to generate double-digit returns). In consideration of the massive QE mentioned above and trade war uncertainty, along with weakening global growth, CIG transitioned to “a later cycle approach” in portfolios during the last quarterly rebalance in furtherance of that goal. Overall, equity holdings were decreased, quality increased and fixed income increased slightly.
On the other hand, given the substantial QE (which one can wonder its rationale), the growth of the money supply has accelerated at a more rapid pace than last year. According to theory, when money growth is faster than the growth of the economy, the excess money goes into financial assets driving even expensive stocks and bonds higher. In addition, according to DataTrek, U.S. stocks rarely reverse course in a dramatic fashion after a year like 2019, but they also don’t usually do quite as well as the long run averages. The one exception was when the Federal Reserve tightened in 1937 and the S&P 500 Index delivered a -35% return(7).
We continue to weigh the potential risks in the markets and plan for a wide range of scenarios, both positive and negative, with the goal of consistently reevaluating and managing the appropriate level of risk so that clients can achieve their financial plan goals. It means delivering a nuanced, material understanding of diversification, which typically means carefully buying assets that have not appreciated and selling investors’ favorites. Diversification remains our best defense and recently healthcare stocks, a lesser performer in 2019, were increased in the portfolios. This increase in equities highlights our continued flexibility and our devotion to offering a fundamental value proposition to clients who seek long-term out-performance.
This report was prepared by CIG Asset Management and reflects the current opinion of the authors. It is based upon sources and data believed to be accurate and reliable. Opinions and forward-looking statements expressed are subject to change without notice. This information does not constitute a solicitation or an offer to buy or sell any security.
SOURCES:
- https://money.cnn.com/data/fear-and-greed/
- Market Commentary by Art Cashin, UBS Financial Services, November 13, 2019
- Calculated from data obtained from Yahoo Finance, as of 12/11/19
- MSCI, as 12/11/19
- NEPC, as of 12/11/19
- https://www.investopedia.com/articles/investing/012116/warren-buffett-be-fearful-when-others-are-greedy.asp
- From DataTrek in Market Commentary by Art Cashin, UBS Financial Services, October 16, 2019
Selling Your Practice? Important Issues To Consider
Lay the Groundwork
Start by taking a critical look at your practice’s current financial condition. Identify areas of weakness. For example, does your medical practice experience poor collections or weak cash flow? How do your staffing levels compare to those of similar practices? Issues such as these can reduce the appeal of your practice. It’s to your benefit to deal with them well before you put your practice on the market.
You’ll want to have a realistic appraisal of your practice’s potential worth before you put it up for sale. Tangible assets, such as medical equipment, computers, and furniture, are relatively easy to value, though they generally make up only a small part of a medical practice’s total value. Goodwill is an intangible asset that can be difficult to value. But there are methods that can be used to establish a reasonable estimate.
Identify Potential Buyers
You may receive an unsolicited offer. If you don’t, consider reaching out locally or contacting a broker who specializes in selling medical practices. An experienced broker can identify and contact qualified potential buyers.
The speed with which a sale may occur may largely depend on the deal you’re seeking. Do you want a buy-out that will let you continue to practice as an employee? In that case, looking for a group practice, hospital, or other corporate buyer may be the best route. If the sale goes through to one of these entities, you will be able to continue to work in medicine without the responsibilities of ownership.
If retirement is your goal, you may opt for a gradual buy-in by a physician who will take over your practice. Typically, this arrangement requires you to employ the prospective buyer and, under the terms of the deal, after a trial period of a year or two, offer a partnership with a documented exit arrangement for you. This arrangement could be in the form of a severance package.
Review All Offers Carefully
If you receive an offer, your focus should be on the would-be buyer’s financial condition and the payment terms if you plan on retiring. If you plan to continue working at the practice with the individual or entity who may buy it, you should carefully review all ramifications, including transfer expenses and malpractice terms involved in the sale.
Apart from satisfying yourself about the financial and legal issues involved in the sale, you should also feel that you will be able to fit into the potential buyer’s organization and that your advice and input will be welcomed. Remember, whatever way your medical practice’s sale is structured, there will be tax implications.
The business advisory team at CIG Capital Advisors can help you evaluate potential medical practice sale offers and determine the terms which might make it the right deal for you. Schedule a complimentary consultation with one of our business advisory professionals today.
Charitable trusts and the difference between a charitable lead trust and a charitable remainder trust
For many of us, philanthropy can provide great personal satisfaction. However, when properly planned for, charitable giving can provide financial benefits both today (as an income tax deduction and/or capital gains tax shelter) and in the future (when the amount of taxes your estate may owe when you die can be reduced).
There are many ways to give to charity. A common vehicle for many families is a charitable trust, where a charity is named as the sole beneficiary. You may name a non-charitable beneficiary as well, splitting the beneficial interest (this is referred to as making a partial charitable gift). The most common types of trusts used to make partial gifts to charity are the charitable lead trust and the charitable remainder trust.
What is a charitable lead trust?
A charitable lead trust pays income to a charity for a certain period of years, and then the trust principal passes back to you, your family members, or other heirs. The trust is known as a charitable lead trust because the charity gets the first, or lead, interest. A charitable lead trust can be an excellent estate planning vehicle if you own assets that you expect will substantially appreciate in value. If created properly, a charitable lead trust allows you to keep an asset in the family and still enjoy some tax benefits.
SOURCE: Broadridge Investor Communication Solutions, Inc. Copyright 2017
What is a charitable remainder trust?
A charitable remainder trust is the mirror image of the charitable lead trust. Trust income is payable to you, your family members, or other heirs for a period of years, then the principal goes to your favorite charity. A charitable remainder trust can be beneficial because it provides you with a stream of current income — a desirable feature if there won’t be enough income from other sources.
SOURCE: Broadridge Investor Communication Solutions, Inc. Copyright 2017
Note: There are expenses and fees associated with the creation of a trust. Please speak to your financial and/or tax professional to understand the cost and tax implications of your particular giving situation.
CIG Asset Management Update November 2019: Optimism versus economic data: Has the market already priced in most of the good news?
U.S. equity markets reached new all-time highs at the end of October. The S&P 500 Index increased 2.0%.(1) Foreign stock markets continued their recent outperformance over U.S. equities as international stocks, measured by MSCI EAFE Net(2), advanced 3.6% last month and the MSCI Emerging Markets Net(2) was up 4.2%.
The Federal Reserve, as expected, cut short term interest rates by 0.25%. Longer term U.S. rates increased by 0.08 – 0.11%.(1) The Barclays U.S. Aggregate Total Return Bond Index (3) increased by +0.3%. German government bond yields became less negative, moving up 16 basis points to -0.41% and Japanese government yields moved up 8 basis points to -0.13%.(1)
There were plenty of reasons to become more optimistic in October. Negative bond yields worldwide became less negative, especially in Germany and Japan.(1) The September unemployment rate was 3.5%(4), the lowest in 50 years. Nearly 74% of the 341 S&P 500 companies that reported earnings during the month beat lowered estimates.(5) Markets traded higher at the end of the month on hopes that the trade war would de-escalate as the U.S. and China announced a partial trade deal at the White House on October 21st. A deal was not actually signed, details were lacking, and both sides said talks would continue. Europe was relieved that it did not have to worry at this time about a “no deal” Brexit after a deal was reached to extend the original October 31 Brexit deadline to January 31, 2020. The Federal Reserve injected more liquidity into the banking system and said it would start purchasing $60 billion in treasury bills monthly and increase daily repo operations to $120 billion per day from $75 billion.
However, an abundance of data shows that the economy continues to slow. The September ISM Manufacturing purchasing managers’ index came in at 47.8%(6), the lowest level since June 2009. A number below 50% indicates a contraction in manufacturing. ISM Non-Manufacturing Index came in at 52.6, down from August at 56.4 and a 3 year low.(7) The Bureau of Labor Statistics (BLS) reported August Job Openings Levels: Total Nonfarm (JOLTS), decreased to 7.051 million, the lowest number of openings since March 2018.(8) Corporate earnings results are down -0.6% on 4.9% higher revenues than one year ago.(5) Companies buying back their own shares has been a major contributor to the rally since 2009. Goldman Sachs analysis warns that they anticipate 2019 stock buybacks will drop 15% in 2019 to $710 billion and continue to drop in 2020. Corporate buybacks currently provide more demand for stocks than any other individual source, including households, mutual funds or exchange traded funds. Buybacks as a percentage of trailing annual free cash flow has historically peaked near the highs of the market, i.e.: 2000, 2008, and 2016.(9) Lastly, the Federal Reserve is still looking at how to fix short term funding market strains, according to Chairman Jerome Powell at his post FOMC rate cut press conference on October 30. “One thing that was surprising about the episode was that liquidity didn’t seem to flow as one might have expected”, said Powell.
In summary, while the U.S. economy is enjoying its longest expansion in American history, we believe that much of the good news very well may be priced into equity markets. The Federal Reserve began injecting massive amounts of liquidity into the banking system and still does not know why there are short term funding issues. Global economic growth continues to slow. We believe the markets have effectively priced in a U.S.-China trade deal despite its tenuous and elusive nature. We are continuing our defensive posture that we adopted when we recently transitioned to “a later cycle approach” in portfolios during the quarterly rebalance. We still have exposure to equity markets should they continue to move higher but will look to shift, if conditions warrant.
This report was prepared by CIG Asset Management and reflects the current opinion of the authors. It is based upon sources and data believed to be accurate and reliable. Opinions and forward-looking statements expressed are subject to change without notice. This information does not constitute a solicitation or an offer to buy or sell any security.SOURCES:
1. Calculated from data obtained from Yahoo Finance, as of 11/07/2019
2. Data obtained from MSCI, as of 11/07/2019
3. Calculated from data obtained from Bloomberg, as of 11/08/2019
4. Bureau of Labor Statistics 10/04/2019
5. Zacks, 11/01/2019
6. Institute for Supply Management 10/01/2019
7. Institute for Supply Management 10/03/2019
8. Bureau of Labor Statistics 10/09/2019
9. Goldman Sachs 10/21/2019
Optimizing Your Medical Practice’s Income
Enhancing revenue and controlling expenses should be the primary financial focus of every medical practice.
Improving operational efficiencies can help bring a practice closer to achieving these financial goals. Here are some ways you can maximize your practice’s revenue stream and reduce costs without sacrificing patient care:
Keep Coding Current
Coding errors are all too common. Simple errors end up costing medical practices money as well as time to rectify mistakes. Delays or denied claims translate into reduced reimbursements, which, in turn, affect cash flow.
To minimize coding errors, you need to identify the cause of the problem. Typically, miscodes are due to undercoding to avoid penalty risk, using outdated data, or leaving coding decisions to inexperienced support staff. Periodic assessments of your practice’s coding accuracy can help uncover problem areas. These assessments could include a review of your practice’s forms and a comparison of billing codes with the actual services that were provided.
Maintaining updated coding manuals and software, keeping a code reference summary handy in exam rooms, and using online coding resources can help your practice attain a more accurate coding rate. So too will making notes during each patient visit. Be sure to have your staff attend refresher courses to help them stay current with coding practices.
Improve Employee Productivity
Eliminating inefficiencies and boosting employee productivity directly benefit your practice’s bottom line. Try these approaches to improving the productivity of your practice:
o Define productivity goals and offer incentives to your staff for reaching those goals.
o Delegate administrative functions so that physicians spend the greater part of their day seeing patients.
o Maximize physician and medical assistant billable time by planning patient flow carefully.
Better Control of Staff Time
Are your overtime expenses increasing from quarter to quarter? While some overtime is unavoidable, a consistent rise in overtime hours deserves some scrutiny. Review the payroll records of your non-exempt employees to determine who worked overtime and why. Was your practice fully staffed and simply busy or was it short one or more employees on the days when the overtime occurred? If overtime was necessary because you were short-staffed, see if this was due to vacations or some other controllable situation. It may be time to revise your practice’s policy on vacation time if scheduled time off was the cause of the overtime.
Update Fee Schedules
If your practice hasn’t raised fees in some time, you may want to consider appropriate increases. Just be aware that some patients may be resistant to fee increases and could switch to another provider. In addition, take a look at the reimbursement rates of all the plans you participate in. Run the numbers to determine whether it makes financial sense to continue accepting patients from some of the plans that reimburse poorly.
Buy Smarter
Medical and office supplies make up a portion of a practice’s expenses. Yet, some practices rarely shop around for more competitive prices. You can control expenses by becoming a smarter shopper. Pick some of your practice’s “high-volume” items and find out how much other vendors are charging. Use that information to negotiate lower prices with your current suppliers, consolidate orders with fewer vendors, or switch to new suppliers to save money.
Eliminating inefficiencies and boosting employee productivity directly benefit your practice’s bottom line. The business advisory professionals at CIG Capital Advisors can work with you to identify areas in your medical practice where streamlining operations may help optimize your practice’s bottom line.
