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New Learning Opportunities Available for County Societies

New Learning Opportunities Available for County Societies

The Medical Association is partnering with Warren Averett in 2019 to provide several topics that you can use to host events that will interest the physician members in your county, at no cost to you. Each talk lasts about 30 minutes and several can be combined for a 60-minute talk.

MACRA/MIPS Refresher. MACRA is now in year three and the law is still changing. This presentation will cover the new areas to address, and what is in the pipeline for years to come.

What Does the New Federal Tax Law Mean to Physicians?  The new tax law affects all taxpayers, but this presentation will center around how the law affects physicians and the items that need to be addressed to minimize your personal tax.

Customer Service in the Medical Practice. Medical practice patients have increasing expectations about their medical care and plenty of options for where to obtain care. The practices where excellence in care is delivered can be selective about which patients to accept and which problem patients to release. The secret to getting highest ratings from patients is often not found in the quality of care you provide. We will share what gets you a 5-star rating and how you can put the processes in place to make raving fans out of your patients and referral sources.

How Can You Increase Employee Morale? Unemployment is at an all-time low, other practices and local employers are bidding at higher pay rates to get your top talent, and younger employees change jobs with greater frequency than older staff. Unless you are willing to pay at the highest wage rate in town, you must cultivate a culture where high morale prevails among your staff. What are the ways other practices are retaining good staff by encouraging fun and a family atmosphere in the workplace?

To book a speaker for your next event, contact Meghan Martin at mmartin@alamedical.org or call (334) 954-2500. CME credit is not provided for these opportunities.  

Posted in: Education

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Plan While You Still Can

Plan While You Still Can

In our work with hundreds of medical practices, and in our Firm’s medical practice manager roundtable meetings, a common issue among medical practitioners is the uncertainty about the economic future of their medical practices.

Reimbursement levels may drop, many patients may choose medical coverage offered by a state-sponsored exchange, and the burden of changing technology is felt in many areas of practice. Since so many aspects of a medical practice are beyond the control of physicians, it is essential that doctors, in a private practice, exercise intentional control over the areas where they still can. This strategic planning is less daunting than many think, and can produce a more dynamic practice than you have experienced in years.

The process of strategic planning begins with an honest assessment of your practice’s current situation. Each physician’s candid opinions must be sought and considered in the development of an agenda for the group meeting. Since candor, among even the most collegial doctors in a given practice may be difficult to elicit, consider having an outside facilitator conduct these interviews. Based on the content of each doctor’s concerns, build an agenda for the planning meeting. It is recommended that these meetings be held at a neutral site outside the office but can be held in the practice conference room as long as no physician is permitted to exert his or her authority by sitting in their “power” chair or heavy‐handedly controlling the agenda.

Prior to the actual retreat, the administrator and facilitator must assemble background information and construct schedules necessary to answer as many fact‐based questions as possible. The goal of these schedules is to lessen the likelihood that a decision is postponed for want of additional data or a projection of the impact of the decision. Physicians are among the worst at group decision making. Some are so accommodating of their partners that they permit everyone to have “veto power” over any issue. Others let one member of the group require that the matter be tabled until every conceivable question can be addressed. Some groups apply their appropriately cautious medical decision-making processes to business decisions, which are not nearly as lethal or consequential. Whatever the reason, these result in what we refer to as Decision Deficit Disorder in medical practices. This too is a reason to have an outside facilitator.

With an agenda built on the issues of concern to all members of the group and background material developed for each point, the meeting is a time to make strategic decisions and assign tactical responsibilities. Select one of the easier matters for first on the agenda to establish a quick tempo, gain a positive perspective and promote participation by the entire group. If painful issues must be addressed, these should be handled privately unless that avenue has been tried and failed.

A sufficient content would be five to seven decisions, depending on the magnitude of the topics. We have been involved in planning processes where more than ten issues were resolved but a recent strategic process resolved five matters. In that instance, the group decided where to open a satellite office, determined to recruit two new physicians, renewed their commitment to reach out to referring physicians, decided to hire a marketing director for the practice and affirmed a plan to make their clinic days more accessible to patients. This proves that major things can happen when doctors focus on their own business needs.

 

Article contributed by Sae Evans, Maddox Casey and Jim Stroud, Members, Warren Averett Healthcare Consulting Group. Warren Averett is an official partner with the Medical Association.

Posted in: Leadership

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How is Tax Reform Impacting Physician Practices?

How is Tax Reform Impacting Physician Practices?

The biggest U.S. tax reform since 1986 consists of major tax law changes that will affect everyone. The most significant change for corporations is a move from the graduated corporate tax rate structure to a flat rate. Although President Trump was originally fighting for the corporate rate to be reduced to 15 percent, lawmakers settled by reducing the rate from 35 percent to 21 percent. Other aspects of the tax law are more complex, and many businesses are wondering how this new law will affect their particular industries.

Let’s dive a little deeper into how tax reform is affecting physician practices.

A significant amount of attention has been focused on the 20 percent pass-through income deduction (also known as the qualified business income “QBI” deduction). Unfortunately, physician practices are specifically excluded from QBI deduction eligibility. However, an exception is made for physicians with taxable income under $415,000 for joint filers and $207,500 for single filers. Physicians with taxable income below these thresholds may be eligible for the 20 percent QBI deduction. The QBI deduction calculation is complex and should be considered in conjunction with physician group compensation models and reasonable compensation guidelines.

Entertainment expenses need to be evaluated and minimized. Under the new law, deductions for business-related entertainment expenses are disallowed. Meal expenses incurred while traveling on business will remain 50 percent deductible. The 50 percent disallowance will now also apply to meals provided at an on-premises cafeteria or otherwise on the employer’s premises for the convenience of the employer. After 2025, the cost of meals provided through an on-premises cafeteria or otherwise on the employer’s premises will be nondeductible.

Physicians should also take into account the tax reform changes for individuals by evaluating their personal mortgage interest structure to maximize the interest deduction. This can be achieved by turning a home equity line of credit (HELOC) into a traditional mortgage, if applicable. The home mortgage interest deduction has been modified to reduce the limit on acquisition indebtedness to $750,000 for married filing jointly (MFJ), down from $1,000,000 under previous law. However, if the acquisition indebtedness occurred before Dec. 15, 2017, the limit remains $1,000,000.

Finally, tax reform limits the Federal tax deduction for state and local taxes to $10,000, beginning in 2018. Many physicians will far exceed the $10,000 state and local tax deduction cap. The limitation on state and local tax deduction encompasses both income taxes, sales tax and property taxes. Physicians can potentially minimize tax liabilities by strategically planning the payment of their individual state taxes and utilizing any state scholarship granting organizations, such as an Alabama Scholarship Granting Organization (SGO) or Georgia Student Scholarship Organization (SSO). These programs allow taxpayers to receive a state tax credit in return for an eligible contribution. This contribution qualifies as a charitable contribution on a federal return. This turns a state tax payment into a charitable deduction for federal purposes, increasing itemized deductions.

 

Article contributed by Warren Averett CPAs and AdvisorsWarren Averett CPAs and Advisors is an official Gold Partner with the Medical Association.

Posted in: MVP

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