What Makes a Midwifery Practice Successful? Key Insights and Strategies

As a midwife, you play an essential role in the health system, caring for pregnant women during some of the most vulnerable times in their lives. Many midwives aspire to build and run successful private practices, but achieving this goal requires both clinical excellence and business acumen. Before starting your practice, explore the following practical advice for running a successful midwife practice so you can focus on what you do best: delivering exceptional care to your patients.

Managing Your Finances

Proper financial management is the cornerstone of any midwifery practice's success. Begin by breaking down your monthly expenditures, including rent, utilities, salaries, medical supplies, and other overhead costs. Regularly monitor cash flow to ensure you’re operating within budget. Using healthcare-specific accounting software can streamline your financial management processes.

To support your financial health:

·         Build a Budget: Create a detailed budget and adhere to it to avoid unnecessary expenses. Consult with others in the field to better understand the hidden costs one might not typically consider.

·         Establish an Emergency Fund: Prepare for unexpected expenses, such as equipment repairs, legal fees, staff turnover and per diem independent contractors by maintaining a financial cushion.

·         Seek Expert Guidance: Consult a financial advisor specializing in healthcare practices for strategies to maximize revenue and minimize costs.

Strong financial management allows you to invest in high-quality equipment and maintain a comfortable, safe, and welcoming office environment for your patients.

Investing in the Right Equipment

High-quality medical equipment is fundamental for providing excellent care. Conduct thorough research, compare prices, and consider purchasing pre-owned equipment from reputable sources or medical practices upgrading their inventory. from other medical practices who are upgrading or closing their offices. Investing in reliable tools that meet current standards and regulations, such as dopplers, ultrasound machines, birthing stools, and neonatal resuscitation equipment need not always be cost prohibitive. Quality equipment ensures patient safety and enhances your professional credibility. Consider buying supplies in bulk with other similar midwifery offices. Investing cooperatively can have unexpected rewards.

To maximize the benefits of your equipment:

·         Training: Ensure you and your staff are trained to use and maintain all medical devices properly.

·         Maintenance: Regularly inspect and service your equipment to keep it functioning optimally.

·         Upgrades: Periodically evaluate your equipment to determine if upgrades or replacements are necessary.

A well-equipped and well-trained practice can provide better care and build trust with patients.

Implementing an EHR System

Efficient record-keeping is vital for any midwifery practice. Implementing an electronic health records (EHR) system can streamline tasks like documenting patient information, tracking medical histories, and managing appointments. For midwifery practices, EHR systems can also improve communication with expecting families, monitor prenatal milestones effectively, and support collaborative care with other healthcare providers, ensuring tailored and holistic patient care. An effective EHR system can also facilitate seamless communication with other healthcare providers to ensure continuity of care.

When selecting an EHR system:

·         Test Drive Several Platforms: While it can be time-consuming, testing various platforms is crucial for finding one that aligns best with your workflow. Every system will have "sharp edges", but only you can decide which sharp edges you're willing to live with.

·         Hire a Consultant: Consider hiring someone to vet multiple systems for you based on your criteria. They can whittle down the list and bring you in for the tours with sales representatives only after the list has been narrowed down.

·         User-Friendly Design: Choose a system that is intuitive and easy to navigate.

·         Customization: Look for features like customizable templates tailored to midwifery practices.

·         Compliance: Ensure the system complies with privacy and security regulations to protect patient data.

·         Integration: Opt for a system that integrates with other medical software for a smoother workflow.

·         Exit Strategy: Not all systems work out for an organization. Explore how you can switch platforms if necessary, by evaluating key criteria such as data exportability, ease of integration with existing workflows, customer support availability, and overall cost. Consider platforms that offer detailed exit strategies to ensure a smooth transition if needed. How difficult is it to export medical records? Is it even possible? Do they offer an export package? If so, what does it include and how much does it cost? Review the software contract and draft an exit strategy that is built in when you onboard.

An efficient EHR system enhances organization and allows you to focus more on patient care.

Understanding Insurance and Billing

Navigating the complexities of insurance is essential for making your services accessible to a broader range of patients. Start by researching the insurance plans most commonly used by your target demographic and consider which ones you would like to contract with in network, and which you'd prefer to stay out of network with. Some payers do not offer contractual rates that a practice can sustain. In such cases, remaining out-of-network with those payers may be a practical choice, allowing balance billing for the difference between the billed rate and the insurance carrier's allowed rate.

Key steps include:

·         Hire a Specialist: Consider employing a medical billing specialist or outsourcing to a professional service to minimize errors and delays. You may plan to hire an in-house biller, but by hiring an outside consultant, they can advise you on best practices, explore billing practices from a larger national perspective and help you to institute safeguards to avoid audits

·         Credentialing and Contracting: Determine which insurance payors, Government payors, Medicaid and their managed care organizations you'd like to contract with and get the process going immediately. This can take between 3-18 months to complete. A professional to manage this for you and to assist with contract negotiations is crucial.

·         Documentation: Build out your SOP* standard operating processes* manual that covers every task for the organization. Specifically with charting which leads to billing. Set clear expectations for when charting is to be completed, charges submitted to the biller and for the biller to file them with the insurance carrier.

·         Follow Up and Follow Through: With set expectations in writing and understood, be sure to follow up on how things are going and assist with remediation or training as needed. Claims that are filed will need to be followed up externally and often will require additional follow-through in the form of reconsideration requests or appeals. Track every encounter along the way.

Efficient handling of insurance and billing processes will help maintain a steady cash flow and ensure patient satisfaction.

Building a Qualified Team

The success of your midwifery practice depends heavily on your team. Hire qualified administrative staff, medical assistants, and other support personnel to ensure smooth operations.

To build and retain a strong team:

·         Focus on Qualifications: Employ professionals with the necessary skills and experience.

·         Invest in Training: Provide ongoing training and professional development opportunities to keep your team’s skills sharp.

·         Time Off Policy: Often times, with a new practice, staff will be covering many shifts and regardless of how busy it is, or how short staffed you are, everyone needs time off to rest and recover. Ensure that you encourage, and in some cases, mandate that staff take their PTO. This is tricky for medical professionals because of scheduling back up. We call this "scheduling jiujitsu".  Consult with peers in your field to identify effective solutions to this challenge. Explore options. Remember that extra coverage and paying for PTO hits the budget twice. First to cover the person taking time off, and second to cover their shift. Build this into your operating budget, not the emergency fund.

·         Foster a Positive Environment: Create a collaborative and supportive workplace culture. Encourage open communication and provide opportunities for growth to retain top talent.

A motivated and skilled team enhances patient care and contributes to the long-term success of your practice.

Running a successful midwifery practice requires a blend of clinical expertise and business savvy. By mastering financial management, investing in high-quality equipment, leveraging technology, understanding insurance, and building a qualified team, you can create a thriving practice that delivers exceptional care. The key to success lies in continuous learning and adaptation to meet the evolving needs of your patients and the healthcare industry.

For additional resources and tools to support your journey, check out www.marniecabezas.com , where we provide everything, you need to excel in your practice.