Editor’s note: This concludes a two-part series on healthcare consultants. The first article appeared in the August issue of AAOS Now.

Part one of this article discussed reasons a practice should consider hiring a healthcare consultant. Although consultants can be expensive, they can add impartiality, fresh perspectives, unique experiences, and focused resources. Once the decision is made to bring in a consultant, the physician and management team must evaluate their options. This article outlines three important steps for choosing the right consultant and having a successful working relationship.

Clearly define the problem and scope of the engagement

Although it is legitimate to call on a consultant to perform a “well check” of a practice, that is rare. For a successful consulting project, the physicians and management team must be transparent about the real problems to be addressed. Misidentification of a true problem and its scale will result in a project that may be underpriced or assigned to staff with the wrong skill sets.

In some cases, the issue is not particularly controversial. The practice can define a specific problem, such as “our income has dropped by 10 percent,” but the scope of the engagement may be broad and require patient-flow studies, revenue-cycle examinations, and expense analyses for accurate assessments and recommendations. On the other hand, both the scope and skills for a project can be very specific. For example, a practice may want a chart review on a physician who received a coding warning letter from a payer.

Defining the problem and scope will also allow the practice to better select a consulting firm with the appropriate expertise. Some firms have strengths in operations or strategic planning. If a project is relatively narrow, such as conducting a coding review, performing a revenue-cycle analysis, or hiring and evaluating staff, a smaller, local firm will likely have the appropriate resources and a better understanding of the payer market or have more networking abilities and contacts for recruiting and completing informal reference checks. For a long-term project, such as interim administration or information technology (IT) implementation, a local option may be less expensive. For a project that is larger in scope, such as a major governance restructuring, IT evaluation, partnership with a major health system, compliance issues, or strategic planning, a regional or national firm can bring experience in multiple market models and the necessary data analytics.

Perform due diligence

An online search will generate an extensive array of healthcare consultants. The ones at the top of the list are going to be large firms that cater to hospitals with six figures to spend on consulting engagements. For physician practices with more limited budgets, attending national conferences such as AAOS or the American Alliance of Orthopaedic Executives meetings is a great way to meet various experts in the field. Ask other orthopaedic surgeons or practice administrators about consultants they have successfully used.

After creating a prospect list, the leadership team should meet with candidates in person. The practice should define the problem to presenters before meetings so consulting firms can provide practical information about the specific engagement, rather than just general PowerPoint presentations.

During the interview stage, the following questions should be considered:

• What is your experience relevant to this project? The firm should provide references on recent engagements. This may be difficult if the services needed involve a sensitive issue (e.g., the consultant won’t immediately disclose another client with a physician substance-abuse problem), but consultants can outline how an issue was handled in another practice.
• Who will be working on my project, and what are their experience and skill sets? Do they have detailed industry knowledge? With some consulting firms, senior partners meet with prospective clients, but consultants who will be assigned are not present. If this is the case, it will be difficult to truly gauge the personality and skills of the designated person or people you will work with, and you may want to request an additional interview.
• What is your view of the industry’s future? Although this seems like a complete divergence from the previous, specific questions, it is an important measure of the firm’s commitment to keeping up with the environment, trends, and thought leadership in the industry.

Determine cultural fit

A leadership team needs to trust its consultant’s knowledge and communication skills. When a consultant delivers a difficult message, the leadership team needs to own the results and recommendations for change. If a consultant will be interviewing physicians or staff, working in the office, or communicating with other important partners, the practice must be sure that the consultant can accurately reflect the goals and values of the organization. A consultant might be the most knowledgeable in the industry, but if he or she cannot effectively work with the practice, the engagement will be worthless.

Lisa Warren, MBA/MSHA, CPC, is CEO of Andrews Sports Medicine and Orthopaedic Center in Birmingham, Ala.