Year-End Planning Best Practices for Healthcare
The Work That Follows a Healthcare Practice into January
By the time November arrives, many healthcare practice leaders are already discussing next year’s goals. Plans for another provider, an additional location, or a new service line compete for attention with holiday schedules and the pressure to finish the year well. Those conversations are necessary, but they can move ahead without much examination of the daily operations that will have to support the expansion.
Inside the practice, the unfinished work continues to accumulate. Referrals wait for follow-up, incomplete encounters delay billing, and employees maintain their own tracking systems to keep patients moving. These issues can become familiar enough that they stop attracting leadership’s attention, even as staff spend considerable time working around them.
A financial close helps establish how the business performed. An operational closeout helps explain why it performed that way—and what needs attention before the practice takes on more.
What unfinished work reveals
One useful starting point is the work that remains open at the end of each week. A referral awaiting scheduling, an authorization missing supporting information, and an encounter awaiting documentation may belong to different departments, but each represents a process that has stopped moving.
A year-end review should establish the size and age of those backlogs, along with who is responsible for the next action. The more revealing discussion, however, concerns how the work became stalled. A referral backlog may reflect limited appointment availability, unclear follow-up expectations, or an intake process that requires staff to repeatedly chase missing information. Each cause calls for a different response.
Simply asking employees to clear their lists can produce a temporary improvement while leaving the underlying problem intact. Leadership needs enough visibility to distinguish an unusual disruption from a recurring failure in the workflow. That distinction determines whether the practice needs a short-term recovery effort or a change in how work is assigned and completed.
The operational story behind the financial results
Year-end financial reports can show whether collections increased without showing the effort required to collect them. A practice may finish with acceptable revenue while employees spend hours correcting registration errors, tracking down documentation, or resubmitting claims.
Bringing billing and operations into the same conversation helps uncover that hidden workload. Rather than reviewing accounts receivable only as an aggregate balance, leaders can examine where payment slows and which issues return most often. When the same denial category appears repeatedly, the discussion should include the upstream process that may be contributing to it.
The front office belongs in this review. Information gathered during intake and registration affects the work that follows, and employees handling those steps may be able to explain problems that appear much later in the revenue cycle. A shared review gives the practice a better chance of correcting the source instead of repeatedly paying for the cleanup.
How the practice actually works
Written procedures offer only a partial view of daily operations. In many practices, experienced employees have developed informal systems that help them navigate gaps in the official process. Those adaptations may keep the day moving, but they can also make the organization dependent on knowledge that has never been shared.
Walking through a few high-friction workflows with the employees who perform them can reveal where that dependence exists. Following a referral from arrival to the first appointment, for example, may uncover an unofficial spreadsheet, an unclear handoff, or a decision that always waits for one particular person.
The purpose of this exercise is to understand what staff need to complete the work reliably. An updated procedure should reflect a process the team can realistically follow, with clear ownership and usable instructions. It should also allow someone else to step in during an absence without having to reconstruct the workflow from emails and memory.
The commitments that renew quietly
Vendor agreements and software subscriptions deserve similar scrutiny. A tool purchased to solve an earlier problem may no longer fit the practice, while overlapping systems can create extra work for employees who must maintain information in multiple places.
A consolidated review of recurring expenses should include usage, renewal dates, notice requirements, and the person responsible for each relationship. Leadership should also ask whether the service is delivering the expected value and what would be involved in changing it.
Price alone provides an incomplete comparison. A lower-cost service may require substantial staff follow-up, while a more expensive option may reduce administrative work. Understanding that tradeoff requires input from the employees using the service, alongside a review of the agreement and its cost.
Holiday coverage as an operational test
Reduced holiday staffing can expose weaknesses that are less visible when the full team is available. A routine question may become a prolonged delay if only one employee knows the answer or has access to the necessary system.
Coverage planning should therefore extend beyond approving time off. Teams need clear responsibility for patient calls, scheduling changes, and time-sensitive work, along with an established route for clinical escalations. Employees providing coverage should have the access and instructions required to carry out their assigned responsibilities.
Mobile practices may also need to account for travel capacity and service-area coverage, while clinic-based practices should align appointment schedules and patient communications with reduced hours. Leadership availability matters in both settings: staff need to know who can make a decision when their usual contact is away.
Turning the review into a realistic first quarter
An operational review loses value if it produces a long improvement list without decisions about capacity or responsibility. The first-quarter plan should concentrate on a small number of problems that materially affect the practice, with an accountable owner and a clear way to assess progress.
Specific goals make those expectations easier to manage. A broad instruction to “improve intake” leaves considerable room for interpretation. A goal to reduce referrals waiting more than three business days for an initial scheduling attempt gives the team a defined issue to address and a measure to review.
These findings should also inform growth decisions. Adding volume to a process that already struggles can increase the backlog and the burden on staff. Understanding current capacity allows leadership to identify what must improve before expansion and what resources the growth plan will require.
At Kindling Consulting, we help healthcare practices examine these operational challenges and translate them into workable changes. The employees closest to the work often have valuable insight into where progress stalls; leadership’s role is to turn that insight into decisions, ownership, and follow-through.
Year-end offers a useful point to do that work. Before the calendar fills with new initiatives, practice leaders have an opportunity to address the problems their teams have been carrying—and give next year’s plans a stronger foundation.
-Nikki Johnston, COO, Kindling Consulting
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