Chiropractic Business Tips – Riskiest Investment is a 401K
13 Reasons Why Your 401(k) Is Your Riskiest “Investment” by Garrett B. Gunderson As a financial advocate to business owners, I’ve worked with hundreds of professionals, most of whom diligently save in a 401(k). But when I teach them the following concepts, they’re eager for alternatives. Consider these 13 dangers of 401(k)s: 1. No Cash Flow The theory is that the money compounds, but this really means it stagnates. Most people will not choose to utilize these funds even when a compelling opportunity will make them far more money than the 401(k) would, even accounting for the penalties. Numerous legitimate opportunities are passed by as people stay “in it for the long haul.” 2. Lack of Liquidity The money is tied up with penalties attached for early withdrawal—unless you know how to safely navigate specific, obscure IRS codes for penalty-free withdrawals. 3. Market Dependency The performance of the funds is dependent upon uncontrollable market factors. Therefore, your retirement plans are based on unknowable projections. Do you want to live your ideal life only if the market cooperates? 4. Lack of Knowledge How much do you really know about your 401(k)? Do you know the funds in which you’re invested? Do you know the details of the companies inside those funds? Do you know the fund manager’s philosophy, history, and performance? How can you expect to gain a return from something you know so little about? And how can this be called investing? It’s not investing—it’s gambling. 5. Administrative Fees The funds are subject to various (and usually hidden) administrative fees in addition to expense ratios and 12-b1 fees—a fact ignored by most contributors and advisors. 6. Under-Utilization Because of Tax Deferral If you don’t like paying taxes today, why would you want to pay them any more in the future? The tax deferral aspect, which is touted as a great boon, is actually a primary factor contributing to under-utilization. Most retirees let the money sit for fear of triggering tax consequences. 7. Higher Tax Brackets Upon Withdrawal It’s ironic that people project healthy returns on their qualified plan while also projecting they’ll be in a lower tax bracket at retirement. If you have achieved any measure of success, you should actually be in a higher tax bracket at retirement, although most advisors assume the opposite. Do you think taxes will be higher or lower in the future? Deferring your taxes results in a far greater tax burden than would be incurred using different products and strategies. 8. Estate Taxes 401(k)s are sitting ducks for estate taxes. Much 401(k) money is never utilized because contributors don’t make withdrawals in fear of paying taxes. Yet when the money is passed on to the next generation, there is not only a likely income tax, but also an estate tax. 9. No Exit Strategy Getting into a 401(k) seems simple enough. But how are you going to get out of it? Do you understand the penalties and tax consequences? 10. Subject to Government Control and Change Your 401(k) does not even technically belong to you. Read the fine print and you will find “FBO” (For Benefit Of). It’s technically owned by the government, but provided for your benefit. It’s essentially a tax code. Judging by history, 401(k)s are in great jeopardy. What will keep them from changing the rules and taking your hard-earned money? 11. Disinvesting Suppose you’ve retired and begin taking interest payments from your 401(k). You project you can withdraw 6 percent a year, based on an average annual return of 8 percent. But what happens to your principal when the market is volatile? If in one year your fund is down 10 percent, you’re tapping into your principal to take your interest withdrawal. At that point, you have only two choices: start withdrawing principal leave the money alone until your account is up again. 12. No Holistic Plan I’ve witnessed many people whose finances are in shambles, yet they diligently contribute to their 401(k). It’s like a person trying to take care of a scraped knee when their wrist is slit. They urgently need a macroeconomic plan that identifies, prioritizes, and manages all pieces of their financial puzzle, with all pieces coordinated and working together. 13. Neglect of Stewardship 401(k)s cause contributors to abdicate their responsibility. They think they can just throw enough money at the “experts” and somehow they’ll end up thirty years later with lots of money. And when things don’t turn out that way they blame others. Interestingly, traditional media is finally realizing what I’ve been warning investors about for more than 10 years. For example, see the 60 Minute special, “Retirement Dreams Disappear With 401(k)s” and the Time Magazine article, “Why It’s Time to Retire the 401(k).” Saving for retirement is wise and prudent, but there are other investment philosophies, products, and strategies that would meet your financial objectives much more quickly and safely than a 401(k). Ok, so if a 401(k) isn’t the best option, what is? See how sustainable wealth can be created with investing and get a check-up on how you are currently applying it to your life. Go to www.freedomfasttrack.com/cfw and take our Financial Health Assessment at no charge and learn about our Curriculum for Wealth to get a deeper dive and more answers.
Chiropractic EHR software | Improve patient retention with Care Plans
Does paying your monthly overhead stress you out because your chiropractic clinic is plagued by patient no-shows? It is impossible to predict your clinic’s cash flow when your patients are non-compliant with your prescribed care plans. Needless to say, patients who miss their appointments won’t get better. Inconsistent patient flow also hinders practice growth and profitability. But your clinic’s cash flow can take an even bigger hit when you have to return payments for unfinished care plans. Not to mention the possible compliance issues resulting from this. You can figure out how much your chiropractic clinic might be losing due to unfinished care plans when you replace the assumptions below with your own numbers and complete the calculations. For example: Assumptions: 1 visit = $30 1 care plan = 30 visits Average number of no-shows per care plan: 15 Calculations: Potential income and losses from unfinished care plans per patient: Potential income from 1 care plan: 30 visits x $30 = $900 Potential loss from no-shows per care plan: 15 visits x $30 = $450 Conclusion: You risk losing half of your income when patients don’t finish their care plans! Just how can you identify patients who don’t understand the need for multiple visits to achieve their health goals? First of all, you need to know what the entire care plan looks like in order to track multiple visits. All patients go through a traditional treatment step-down ladder, such as four visits per week for the first four weeks, then three visits per week for the next three weeks. Such unique nuances on many patient schedules are difficult to track manually, and this difficulty grows dramatically with each added chiropractic care plan. Tracking the respective discounts given for each care plan is nearly impossible without a tool. Thousands of care plans are created for new patients every month, to schedule multiple appointments and then track all payments and visits in your Genesis EHR software. When patients don’t show up for their appointments you can receive automated notifications in form of tickets on your Genesis chiropractic software workbench. When patients don’t have a future appointment scheduled or when they cancel their existing appointments you can receive alerts via tickets. That way you can assign your staff the task of scheduling the next appointment. Another useful tool for helping your patients stay on track with their care plans are appointment reminders sent via phone, text, or email. Genesis chiropractic software has integrated several apps which serve this purpose. To set up chiropractic care plan when your patients come into your clinic, simply go to the Genesis Scheduler and click on the “More” tab to open the wizard. You can also create a full care plan from the patient account. Make sure you turn on the settings in your Genesis chiropractic software for Patient Relationship Management and Reminders. Read more about Genesis Chiropractic Software Care Plans. Learn more about increasing your chiropractic practice revenue.
Improve chiropractic clinic profitability by increasing PVA
What is PVA and how do you use it? An increasing number of chiropractors have been experiencing anxiety about the future success of their practice. Their concerns span a gamut of issues– from lack of patient feedback about their patient relationships to lack of control of practice management processes to unpredictability of patient flow and cash flow to low profitability. Shrinking practice profitability is a result of five forces that conspire for a “perfect storm:” Rising costs of doing business, from rent to payroll to insurance Shrinking insurance reimbursements Increasingly stringent regulations and growing frequency of audits Delays and underpayments of insurance claims Patient flow fluctuations 3 steps to gain control over your practice’s profitability: Regaining your peace of mind and taking control back into your hands requires a methodical approach consisting of three steps. Measure your case profitability and set a goal for it: Profitability or case profit margin is a ratio of case fees collected minus case costs, divided by case fees collected. Case fees collected is the money spent by the patient in your office over the lifetime of that patient. Measure your patient visit average (PVA): The sad thing about profitability is that there is no way to control it directly. But the good news is that it grows in step with your Patient Visit Average (PVA). In other words, you can control your case profitability indirectly by controlling your PVA. Increase your PVA: Figure out ways to have your patients commit to more than one visit and keep implementing new ideas until your practice’s profitability meets your goals. How to determine case fees collected? The case-fees-collected statistic can be calculated by dividing total collections by the number of cases. This approach has a major shortcoming because it requires the chiropractor to wait until all cases have terminated. For a reliable approximation of the same number without waiting for termination of every patient, follow the two-step approach below: 1. Calculate all collections for a given time period. 2. Divide that figure by the total number of new patients for the same time period. For instance, if Dr. Joe treated 20 new patients last month and collected $10,000, then his case-fees-collected last month were $500. In other words, the average patient last month spent $1,000 before terminating care. How to determine case costs? You can use the same approach to calculate your case costs: 1. Compile total overhead for the same time period used to calculate case fees collected. 2. Divide your total overhead by the total number of new patients for the same time period. For instance, if Dr. Joe treated 20 new patients last month and his total overhead during the same month was $10,000, then his case-costs last month was $500. In other words, the care of average patient last month cost Dr. Joe $500. What does Profitability mean? If your fee to cost ratio is greater than one then you have a profitable practice. Otherwise, you are losing money. Common sense dictates that a profitable practice that takes care of its owner manages a 3:1 ratio of fees to costs, or about 67% profit margin. A common fallacy among many practice owners is the belief that increasing the number of new patients positively impacts profitability. But this may not necessarily be true since increasing the number of patients also increases the overhead, potentially decreasing profitability even further and defeating the purpose of increasing the number of patients. How to compute Patient Visit Average? PVA is a measure of your retention, or your ability to retain patients. In other words, it is a relationship quality indicator. The higher the PVA, the better is your relationship with your patients. As in an earlier calculation, the Patient Visit Average statistic can be calculated by dividing total visits by the number of patients. This approach has the same shortcoming as above because it requires to wait until all patients have terminated. For a reliable approximation of the same number without waiting for termination of every patient,simply divide your total visits for a given time period by the total number of new patients for the same time period. For instance, if Dr. Joe had 300 patient visits last month, including 20 new patients, then his PVA would be 15. In other words, the average new patient returns 15 times to see Dr. Joe. 5 steps for improving your PVA The way to increase PVA is to create a lifetime-maintenance practice. Maintenance patients have a greater understanding and appreciation of what chiropractic has to offer. Create customized treatment plans: Give your patients a customized plan that is tailored to their specific problems at the end of their first session. Block schedule the entire plan in advance: Help your patients understand that you are offering them a complete treatment plan – not a session by session experience. Train your team: Practice “role play,” including specific verbiage and intonation. Without practicing in advance, you leave it to your staff to come up with the right things to say on the spot. Every mistake they make can keep a new patient from coming back and even more importantly – prevent them from benefiting from your treatment plan. Set goals and display results: What you can measure, you can manage and on the same side of the coin what you measure will improve. Go the extra mile: Send thank you letters for referrals. Acknowledge special events like anniversaries, graduations, weddings, or funerals. Thank your patients for being on time, complying with your treatment plan, and meeting payment deadlines.
Compliant Care Plans with Cash Practice
Did you know Billing Precision has integrated with Cash Practice? What does this mean to you? It means with the Cash Plan Calculator® System you can create 100% customized care plans for individuals, family plans and plans with insurance! Having customized, professional, affordable and complaint care plans is the key ingredient to patient retention. What You Need to Know About Care Plans By Cash Practice: Are you giving any of your practice members discounts on their plans? Are you confident the care plan is legal? Are you relying on what your friend down the street is doing? Most Chiropractors are creating care plans in a NON-COMPLIANT fashion which puts their practice and it’s members in jeopardy. We’ve teamed up with some of the industry’s noted experts in the field of compliance and discounting to ensure our Cash Plan Calculator® is providing Chiropractic offices with a trustworthy source for financial plans. Don’t gamble on what you think is right – join Cash Practice today and gain piece of mind! Having clients commit to an outlined program of care, with affordable financial options has many benefits: Better compliance on following care plan recommendations. Clients easily transition on the the next phase of care. Increased collections. Decreased dependence on insurance money. More time to focus on patient education, marketing, etc. Consistent cash flow coming into the practice. Client retention!! Imagine a Practice Full of Clients who Pay, Stay & Refer! Become a member of Cash Practice® today! Yours in health, Billing Precision & Cash Practice®