Drive Results in your Practice via Continual Quality Improvement

Maximize the Results in your Practice using Continuous Quality Improvement

 

Continuous improvement

Continuous improvement

One of the biggest challenges to running a healthcare practice is to continually improve your business and prevent it from stagnating. A business that stagnates is one that is quickly surpassed by the competition and soon finds itself in dire straits. By using continuous quality improvement techniques you can ensure that your practice is continually moving forward and getting better at what it does. This will go a long way when it comes to getting more business and cultivating repeat customers.

 

Quality Assurance Concept

Quality Assurance Concept

Quality Assurance Programs

One of the ways you can make sure that your practice is continuing to meet quality standards is to take part in programs that measure and rate the quality of your business. These programs are dedicated to helping healthcare practices to be the best that they can by analyzing and rating various areas and criteria in relation to how they run their business and provide care to their clients. In many cases these programs will provide a guiding set of principles that will help a practice to keep their focus on the things that are most important when it comes to assuring total quality for their clients.

 

Marathon Runners

Marathon Runners

Keeping Up with Technology

An important aspect of continuous quality improvement is to make sure that your practice is keeping up with the latest technological advancements in your field. Nothing is worse than hearing that a competitor is generating more business because they bought a revolutionary new piece of equipment, and have begun marketing it aggressively. At the same time this should not consume you as a race to always have the next best thing. Instead value at your equipment on a regular basis and see exactly what needs to be replaced with more advanced technology.

Eliminate waste

Eliminate waste

Eliminating Waste

Streamlining your practice and eliminating waste in all areas is a great way to improve the quality of your services for your clients. Wast can be defined in a variety of ways: wasteful spending, wasteful use of time, wasteful use of resources, wasteful use of your staff’s time, and much more. By analyzing and cutting down on the amount of waste your practice produces you will create more opportunistic to use your resources more wisely which in turn will help your practice to accomplish more with less effort and less expenditures. This is a great way to reach higher levels of quality whirl at the same time improving the fundamental infrastructure of your practice.

 

Checklist

Checklist

Plan-Do-Check-Act

The founding principles of continuous quality improvement are based on the philosophy of “plan-do-check-act.” What this basically means is that each step of how your practice is run is thoroughly analyzed and continuously checked for weaknesses or signs that it could be improved in some way. This simple method of quantifying actions and their results is great for better understanding exactly how various tasks play out in the greater scheme of things in regards to how your practice serves your clients for all of their healthcare needs. In doing so, you are able to implement improvements to quality as the need arises.

 

Customer Focus

Customer Focus

Focus on the Customer

When it comes to continuous quality improvement many people tend to forget to focus on the customer and instead focus mainly on their business, using profit margins and other statistics as a sole means of measuring success. However, it should be remembered that statistics such as those do not always reflect the overall quality of your practice. Instead make sure that you take the time to get customer feedback and look into how receptive they are to your practice and how it operates. By focusing on the customer you’re able to better focus on the core of your practice.

 

Reward clients

Reward clients

Rewarding Value

In many cases a business will reward quantity, not quality and this mentality can undermine the long term stability of the business by inhibiting its ability to improve itself. These days this principal is even more important as potential customers are learning more and more about how the healthcare system works and are becoming more choosey about who they decide to do business with. Proving to potential customers that you are able to provide the value that they desire is incredibly important for any healthcare practice that seeks to maintain its profitability long term.

 

Avoidable errors

Avoidable errors

Quality, Cost, and Avoidable Errors

Recent studies have shown that in the US patients aren’t getting the basic healthcare service they need when they need them. Part of this is due to the high cost of healthcare while some of this is also due to avoidable medical errors. These are two areas that must be managed as a part of continuous quality improvement if a practice wants to remain viable in the coming years. By staying on top of these issues your practice will be better able to meet the challenges that will arise in regards to inflated prices and the number of errors that happen as a result of a “quantity over quality” mentality.

Thanks for reading this article. Please share any thoughts in the comments box below. For those managing a doctor’s office, and filing patient claims, JustCMS1500Forms.com is running a special on the Cms 1500 version 02/12 at the moment. Personally, I prefer to purchase CMS 1500 02/12 forms for my practice from a manufacture (like they are), instead of a re-seller who doesn’t guarantee their product. Even if you prefer using software to file your claims, they offer software for that as well.

Stay on the look-out for my next article!

Critical Tax Considerations of Transferring Employees Overseas

The Oversea Employee

The tax problems associated with sending employees overseas once existed only for a small number of businesses; namely, those companies which could afford to send their employees to distant shores. However, in recent years, the practice of sending employees abroad has proven to be increasingly practical. As a result, the importance of executives carefully studying the challenges involved with sending employees out of the country has never been greater. There are many business implications involved with international work assignments, taxes being one of the most important.

Overseas Employees

Overseas Employees

Double Taxation

Many employers believe that tax exposure problems can be reduced or eliminated altogether if the employee spends less than 183 days in the host location. Although many tax treaties support this assumption, it is inaccurate. The Organization for Economic Cooperation and Development (OECD) has released a list of principles which state that the primary goal should be to avoid double taxation. The Model Tax Convention sponsored by OECD was designed to develop a common platform on which to solve problems that arise from double taxation causes.

Double Taxation

Double Taxation

Reducing Tax Exposure Problems

Here is a hypothetical problem. A company based in the U.S. owns stations in the nations of Nigeria, Venezuela and China. This company employs a person who is not a U.S. citizen at one of the subsidiaries. The worker receives monetary compensation through a split U.S. and local payroll. The worker’s income is paid into a bank account in a third country. By this process, the American headquarters is taking a deduction for the employee’s work without recharge of the cost made to the associate subsidiary.

In the above example, the American-based company could have a permanent establishment risk, according to OECD principles. Multiple tax treaties and domestic tax laws have tests to help an employer determine if he or she has a permanent establishment risk. The most common indicator of a risk is the presence of a foreign-employed individual who makes executive decisions for the local business.

Organization for Economic Cooperation and Development

Organization for Economic Cooperation and Development

In the hypothetical story, there is also the chance that the employee is not exercising compliance with the local tax laws. Using the split payroll structure, any locally-paid compensation is typically subject to partial withholding for income tax purposes. The employee will most likely not report foreign pay earning to the U.S. company.

In addition, the American company should most likely be withholding taxes on the foreign-earned pay as well American pay. Failure to do so can result in harsh penalties.

Working in Venezuela

The United States and Venezuela already have a tax treaty. While the principles of the OECD are generally not taken into account with regard to political climate, they do provide an easy starting point. Given the work environment, a permanent establishment risk is possible. As a result, tax issues will need to be resolved.

Working in China

In the case of a China-based subsidiary, a permanent establishment risk is easily created by the secondment of expatriate employees. As of 2009, Chinese authorities began treating secondment as a personal establishment risk on the part of the overseas employer. In June 2013, authorities released Circular 19 to help reduce conflict between local tax bureaus.

 

Expatriate Employees

Expatriate Employees

Based on the assumption that the American employer will bear all risks and responsibilities associated with outsourcing employees, Circular 19 regards the U.S. employer as the actual employer of the individual working out of the United States. If, however, the employee is stationed in China for more than 183 days of a calendar year, the U.S. employer will be regarded as having a permanent establishment risk and will be obligated to pay Chinese corporate taxes.

If the U.S.-employed individual were to work full time in China, he or she would be required to report all income to the Chinese officials. No time-apportionment claim would be allowed. An easy way for the US to solve the permanent establishment risk problem is for the U.S.-employed worker to enter into a contract with the Chinese entity. In this way, the worker would be considered a Chinese employee and taxes would be handled accordingly. For Social Security purposes, the employee would also keep his or her original contract with the United States.

Chinese Corporate Taxes

Chinese Corporate Taxes

Working in Nigeria

Because Nigeria has no tax treaty with the United States, tax issues must be handled differently than for Venezuela or China. The Nigerian Companies Income Tax Act states that corporate tax must be assessed on any profits that enter the country of Nigeria. In addition, foreign companies are required to pay corporate tax if they habitually operate in Nigeria through another agent. In short, Nigeria’s tax structure closely follows the guidelines of the OECD, even though there is no written treaty on which to base facts or arguments.

Non-Compliance Fees

Non-Compliance Fees

Avoiding Costly Non-compliance Fees

Relocating employees to another country can have significant impact on both the employer and the employee. While every country’s tax system operates differently, the OECD offers some continuity and has helped several employees avoid being hit with costly non-compliance fees. By ensuring compliance with the tax system of the country being outsourced to, employers can ensure that they are doing their best to make the world a better place.

Whether your employees and contractors are a few miles away, or a country away, typically you will have to file 1099 online forms for them, as well as send them printed copies of those forms for them to do their part.  If you’ve got the manpower to do all of that in-house, that’s great. However, smaller tax preparation practices like my own are usually bogged down with the menial tasks of filing the forms, then printing them out, addressing envelopes and then running to the post office to get them out on time.

Well, this year, I decided to look for a better way of doing all that legwork. I asked around and was referred to eFile4Biz.com.  I went to their site and found out that they let me efile 1099 forms very cost-effectively, and the fees included them doing the printing and mailing of the docs to the contractors and employees as well.  Signing up with them was a no-brainer for my small business.  Check out their video below and see if they’d be a stress-reliever for your tax preparation business as well.

Until next time!