Beginning in the Fall of 2022 and with a grant from the New York Community Trust, Primary Care Development Corporation (PCDC) led a Financial Management Collaborative to support eleven small, New York metro area independent provider practices to improve their financial literacy (knowledge and confidence on the drivers of their financial position) and business operations. The need for this program grew from repeat conversations with private practices that were not eligible for COVID-19 small business grants or loans because they could not furnish the necessary financial documents to demonstrate lost revenue.
The program included virtual group trainings, 1:1 technical assistance support, and supported a class of ‘fellows’ – designated from each practice – to support physician-owners in tracking monthly financial information, conducting prospective budgeting and financial forecasting, and pursuing timely opportunities to increase revenue.
By June 2023, nine of the eleven practices had implemented and were actively using monthly financial tracking tools, compared to only three of the eleven practices (27%) at the start of the initiative. PCDC coaching provided support to ensure practice fellows and leadership could accurately read and interpret financial and revenue cycle reports, including those available in their EMR or provided by third-party accountants and billing vendors. At the start of the initiative, only five practices (45%) reviewed revenue cycle metrics every month. By the end of the project, eight practices (73%) reviewed revenue cycle metrics monthly, allowing them to identify and remedy missed revenues.
Camkids Pediatrics – one of the eleven participating practices – is a neighborhood clinic that provides quality healthcare to the residents of Queen’s Cambria Heights neighborhood. In August 2023, PCDC sat down with Arielle Dupiton, Camkids Pediatrics’ Executive Director, to discuss their experience working with PCDC. The following interview has been edited for clarity and context.
When we first heard about PCDC’s Financial Management Collaborative, I was a little nervous because it was a six-month course. I didn’t really know what it entailed; I had no background in finance, so I was curious to see what we were going to learn. To my surprise, it was more than we could have asked for, especially because it was [made available by the Community Trust].
Camkids has been around for over two decades, and we had Dr. Dupiton running everything from finance to business—to every aspect of the practice. We never really had anyone dive into our financials besides our accountant, who is a general accountant. We wanted to see what we were doing right, what we were doing wrong, things we could improve upon—on the finance level.
It was excellent! It was more than we could have asked for, and we would have loved to extend our partnership with PCDC because six months wasn’t enough. It was great because we had group meetings followed by breakout meetings with coaches Rachel House and Maia Morse. During those breakout sessions, we would dive into our finances—they could see our exact numbers in our account. We explained to the team what was being paid toward bills and vaccines, and they helped us understand those expenses.
Our accountant was giving a report every month, but we really didn’t understand what was going into that report. The PCDC team helped us to break down [those numbers] and see where we could save—things that we could cut back on, things that were needed. Throughout the course, we made some changes—we created a budget that’s updated monthly, and now we have a clearer view of how to move forward managing our financials.
It was definitely beneficial to understand the numbers and to see where our money was going. We knew that we brought in a certain amount of revenue and had a certain amount of expenses. But it’s not just enough to know just a general number—you have to know specifics when you’re running a business. Now we’re more mindful of that—figuring out how many additional patients we can bring in order to cover our expenses, or what expenses have we been paying for that we can eliminate. For example, we can switch to a less expensive vendor for certain services.
The healthcare reimbursement aspect was beneficial to our practice because it helped us to understand the different components, including billing and coding. If PCDC wants to offer part two of this course, we’re all in for that!
I would tell them to go for it! Even if they think that they have their financials in order, it doesn’t hurt….It always helps to get a second opinion, and they may learn things that they didn’t know before. Times are always changing; technology is always changing, so there’s always something to learn.