Schedule a Consultation
Practice Now briefs

Clear thinking to drive practice improvements.

Practical perspective on the clinical, financial, and operational problems that shape how a practice performs, written for the owners, operators, clinicians, and investors living them.

Browse by topic

Featured

More briefs

Two physicians in white coats review a tablet together at a nurses' station in a bright medical practice.
Physician performance

Physician Productivity Gaps: It's the Day, Not the Doctor

When physicians on the same schedule get very different results, the reason is rarely effort or skill. It's how their day is built, and that's fixable.

Read brief →
A maternal-fetal medicine specialist talks with a new mother holding her newborn, while the father and their young daughter sit beside her in a medical practice exam room.
Case study · Maternal-fetal medicine

MFM Practice Case Study: From Referrals to Owning Care

A maternal-fetal medicine practice stopped advising on high-risk pregnancies and started owning them.

Read case study →
A physician in a white coat sits on a wooden three-legged stool while talking with a patient in a sunlit medical practice exam room.
Revenue & billing

Medical Practice Overhead: Is Your Cost Mix Balanced?

Every practice stands on three legs: physicians, staff and billing. When one carries more than it should, the whole thing wobbles, and your margin slides off.

Read brief →
A billing lead points to an unpaid-claims spreadsheet on her monitor while a practice manager listens at her desk.
Revenue & billing

A/R Over 90 Days: Why Aging Claims Lose Value

The longer a claim sits unpaid, the less of it you'll ever collect, and the more it costs to chase. The money you collect fastest is the money you keep.

Read brief →
A practice leader on the phone takes notes at her desk, with monitors showing a rate comparison by billing code and a payer negotiation plan.
Payer contracts

How to Negotiate Reimbursement Rates With Insurers

Your rates with insurers aren't set in stone. Getting them raised takes real work, but a better rate pays you on every visit, every year.

Read brief →
A physician and a colleague review a patient's chart at the nurses' station while a smiling partner wheels a pregnant patient through the practice.
Clinical quality

Closing the Referral Loop When Specialists Share Care

When a specialist and a referring physician share a high-risk patient, the gap between their offices is where things go wrong. Here's how to close it.

Read brief →
A physician and a nurse review a printed protocol together at a laptop in a bright medical practice workroom.
Clinical quality

How to Reduce Clinical Variation and Make Protocols Stick

Most practices have protocols. They live in a binder, and care still varies from provider to provider. Here's why standards don't stick, and what makes them stick.

Read brief →
A front-desk staffer on the phone fills out paperwork while patients wait at the counter and an older patient waits in the lobby.
Operations & technology

AI Revenue Cycle Management: Automate Paperwork, Not Care

AI is good at repetitive, rules-based work. Care decisions belong with clinicians. The value is in drawing a clear line between the two.

Read brief →
A physician leader talks through notes with a circle of physicians in white coats in a bright medical practice hallway.
Physician performance

The Physician Barometer: Fair Physician Performance Feedback

The Physician Barometer: no report card, no long list. Just the three changes that would make the biggest difference for you, chosen with you.

Read brief →
A physician in a white coat talks with a pregnant patient seated on an exam table, with an ultrasound monitor behind them.
Revenue & billing

Global OB Billing Ends in 2027: What Practices Should Do

On January 1, 2027, the single bill for a whole pregnancy goes away. Here's where the money can slip, and what to fix first.

Read brief →
A billing specialist at her desk reviews an unpaid claims report next to a laptop chart showing collections falling as claims age.
Revenue & billing

Revenue Cycle Management Problems Your Biller Can't Fix

Why the root cause is usually upstream of billing, and why a good billing vendor can't fix it alone.

Read brief →
Two physicians in white coats talk as they walk down the hallway of a bright medical practice, past a waiting area and an open exam room.
Leadership & growth

Medical Practice Profit Margin: Why Revenue Isn't Enough

A healthy top line can hide a struggling operation. Here's how to tell the difference before something breaks.

Read brief →
A woman and a man in business attire sit across a table in a medical practice office during a positive hiring interview.
Leadership & growth

Before You Hire a COO, Read This

One senior hire or a few new staff can't fix a practice that has no structure underneath them. Build the foundation first, and your next hire has something to run.

Read brief →
A practice leader maps a denial fix on a whiteboard, with next steps and goals, while a nurse, a staff member and a physician look on.
Operations & technology

How to Make Practice Improvements Stick

Most practice fixes work for a few months, then slide back. Here's why gains fade, and the four things that make them stick.

Read brief →
A thick spiral-bound consulting report with a coffee ring on its cover sits untouched on a desk while a practice manager works at her computer and a nurse walks past.
Leadership & growth

Why Practice Improvement Fades After Consultants Leave

Most consulting ends with a report, and the practice stays the same. Here's what real improvement takes, and the one question to ask any firm before you hire them.

Read brief →
A practice manager reads through a report at the front desk while a nurse and a physician lean in to review it with her.
Operations & technology

What the First 90 Days Ask of Your Team

Most improvement projects stall because they land on a team that's already full. Here's what the first 90 days actually ask of your people, and why the first changes are chosen to give them time back.

Read brief →
A practice owner on a ski vacation takes a work call at his laptop while his wife and child enjoy the snowy mountain view from the balcony.
Operations & technology

How to Build a Medical Practice That Runs Without You

If the practice stalls when you step away, the problem usually isn't your people. It's that the practice runs on you instead of on systems.

Read brief →
A practice leader walks physicians, nurses and an administrator through a screen comparing the network's outcomes with the market average.
Payer contracts

Negotiate Better Payer Contracts With Outcomes Data

If your patients do better than the market but you can't show it, insurers pay you like an average practice, on every visit, every year. Outcomes data is how you show it.

Read brief →

Get new briefs by email

One short, practical brief on a periodic basis. No spam.

Is your practice running you?

We examine, diagnose, and prescribe, and then we do the work. In 90 days you can have an Assessment, an actionable plan, and early results.