Beyond Billing: Why Optimizing the Patient Journey Matters More

In our February newsletter featuring Jerry Durham, we explored how therapy practices can sometimes become "billing companies that happen to provide patient care" rather than care providers who handle billing. Today, I want to build on that conversation by examining why focusing on billing optimization alone creates a dangerous blind spot in practice management.

The SaaS Paradigm: What Healthcare Can Learn

When we look outside healthcare, successful businesses obsessively track their entire customer journey. They understand that revenue is merely the result of a well-optimized conversion process.

Consider a SaaS company like Salesforce or HubSpot:

Imagine if they only tracked "active users" without any visibility into how they acquired those users. Picture their CEO announcing: "Great news! We have 1,000 active users this month. No idea how they found us, how many visited our website, what percentage signed up for trials, or why some converted while others didn't—but hey, 1,000 users!"

They'd be laughed out of the boardroom. Yet this is precisely how many therapy practices operate—focusing exclusively on who showed up and what was billed while remaining blind to the journey that brought patients there (or didn't).

The Hidden Cost of Looking Backward

A striking example: one large therapy chain proudly showcased how they'd recovered $1.2 million through improved billing practices in a calendar year. When analyzed more deeply, their data revealed they were losing approximately $3 million per month due to patients not showing up for appointments.

…looking only at visit counts is "looking at the wrong end of the telescope." Billing is never the process—it's always the result. Billing is never the process—it's always the result.

Jerry Durham

Building Your Practice Funnel

In our February newsletter, Jerry highlighted crucial metrics like lead-to-arrival rate, cancellation rates, and drop-off rates. Let's take this a step further by mapping these to what other industries call a "conversion funnel":

1. Leads - How many potential patients contacted your practice? (equivalent to SaaS website visitors/signups)
2. Conversions - How many scheduled an appointment? (equivalent to SaaS trial activations)
3. Arrivals - How many actually showed up? (equivalent to SaaS paid conversions)

Remember Jerry's "dirty secret" from our February newsletter? "Only about 30% of people who start a plan of care complete a plan of care." This is the healthcare equivalent of a SaaS company having a 70% customer churn rate—a business-killing metric that would trigger immediate intervention in any other industry.

The Power of Forward-Looking Metrics

SaaS companies can predict their quarter's revenue with remarkable accuracy weeks in advance by analyzing their funnel metrics. They know exactly how many website visitors convert to trials, what percentage of trials convert to paid accounts, and how much each customer typically spends.

Healthcare practices can achieve similar predictability. As Jerry noted, tracking daily progress toward monthly goals allows you to course-correct while there's still time: if you need 400 leads monthly and you're only at 85 by March 7th, you can take immediate action rather than discovering the shortfall at month-end.

The Financial Impact: Small Funnel Improvements, Big Results

Just like SaaS companies see big returns from small conversion improvements, therapy practices can experience similar gains.

For example, improving your scheduling rate from 70% to 77% on 100 monthly inquiries yields 7 additional appointments.

At an 85% arrival rate and $1,200 average treatment value, that's $7,140 in additional revenue—simply from a small improvement in one conversion point.

The Leaky Bucket Problem

Think of your practice as a bucket. New patient inquiries pour in at the top, but many leak out before becoming revenue. Unlike retail businesses that can compensate with volume, therapy practices face unique challenges:

• Each potential patient costs significant marketing dollars to acquire
• Your clinical hours are finite and can't be easily scaled
• Patient relationships require ongoing nurturing, not one-time transactions

As Jerry noted in February, what happens before a patient arrives is just as critical as the treatment itself.

Getting Started: Building Your Practice Funnel

Building on Jerry's recommendation to track what actually matters, here's how to implement a conversion funnel in your practice:

Click here for the list of recommendations!

1. Track inquiries: Record every phone call, email, and website form submission
2. Monitor scheduling rate: What percentage of inquiries convert to appointments?
3. Measure arrival rate: What percentage of scheduled patients actually show up?
4. Calculate retention: How many patients complete their full treatment plan?

This approach aligns perfectly with Jerry's advice to stop counting visits and start measuring what creates value.

Start Tomorrow: Your 30-Day Patient Funnel Implementation Plan

Ready to move beyond billing and transform your practice? Here's a practical implementation plan:

Days 1-7: Audit & Baseline

• Create a simple spreadsheet to track all incoming inquiries
• Document your current process for handling phone calls and scheduling
• Calculate your baseline metrics: How many leads are you getting now? What percentage schedule? What percentage arrive?

Days 8-14: Front Desk Focus

• Meet with your front desk team to share the new vision
• Create a simple script for handling inquiries that focuses on conversion
• Implement a daily huddle to review the previous day's leads and conversions
• Set initial improvement targets for scheduling rate

Days 15-21: Arrival Optimization

• Identify your top reasons for no-shows and cancellations
• Implement one new arrival-focused intervention (text reminders, confirmation calls, etc.)
• Create an arrival dashboard visible to all staff
• Celebrate improvements in arrival rates with your team

Days 22-30: Retention Focus

• Analyze why patients drop out before completing care
• Implement one retention strategy (progress reports, milestone celebrations, etc.)
• Begin tracking completion rates by provider
• Set team goals for improving plan of care completion

Applying This to Different Practice Settings

Solo Practitioners: The good news? You have complete control over implementation. The challenge? Limited time. Start by blocking 15 minutes each morning to review yesterday's inquiries and conversions. Use a simple Google Form on your phone to track data during the day.

Small Groups (2-5 Providers): Designate one team member as your "funnel champion" who owns the metrics. Meet weekly to review your numbers as a team. Create friendly competition to improve conversion rates, with the winning provider earning a small reward.

Larger Practices (6+ Providers): Consider implementing specialized roles - having one person focused solely on lead conversion can dramatically improve your numbers. Create location-specific dashboards to compare performance across sites, and use your size advantage to A/B test different approaches to each funnel stage.

Questions to Ask Yourself

• If you were a SaaS company, would you be satisfied knowing only your "user count" without understanding how they got there?
• What's your equivalent of a "trial-to-paid conversion rate" in your practice?
• How much are you investing in improving your patient acquisition funnel versus your billing processes?
• If you improved each conversion point by just 10%, what would be the impact on your bottom line?