In specialty healthcare, patient outcomes depend on far more than clinical expertise alone. Behind every successful surgical intervention is a complex infrastructure of operational, financial, and administrative support that enables physicians to focus on delivering care.
As healthcare organizations face increasing reimbursement pressure, rising operational costs and growing complexity in care delivery, the connection between clinical excellence and financial performance has never been more important.
In this conversation, Dr. Matt McGirt, Chief Medical Officer, discusses neurosurgery, leadership, practice sustainability, and why clinically informed revenue cycle management has become essential to long-term success.
The Surgeon Perspective
What drew you to neurosurgery, and spine specifically? What keeps you in the OR while carrying executive responsibility?
I was drawn to neurosurgery and spine surgery because it’s a great balance of technical advancement and innovation with acute, high-impact effect on patients’ lives. There are very few things that compare to being able to mechanically fix a disease process in front of you, quickly and definitively – as is so often the case in neurosurgery. The risk and disappointment associated with adverse events is equally sizable. Which is why practicing neurosurgery never get old. Its remains a privilege to be trusted by patients and their families when they are most vulnerable and in need.
What does a patient never see about the infrastructure required to deliver their operation?
Patients frequently don’t realize it’s a total team approach to delivering safe, effective care at the right time and in the right way. It begins with the support staff in the operating room the day of surgery. It continues through the full support staff in the clinic who complement the process and the decision support around whether care is needed. It extends further to the clinical operations staff who coordinate and facilitate the process by which a community engages with the practice.
And without the operators who run and maintain the fiscal side of a clinical practice, such as revenue cycle management, none of the teammates in the operating room or the clinic would be empowered to do what they do as effectively as they do it.
Our surgeons and advanced practice providers (the people our patients see most) are standing on the shoulders of several dozen teammates who form the foundational infrastructure for clinical care delivery.
When did you first realize clinical excellence alone doesn’t guarantee a practice survives?
A clinical services organization can only survive if the economics supporting its infrastructure are healthy. The last decade has brought some of the greatest changes in the healthcare business ecosystem, with unprecedented challenges.
If the clinical side of the house is low quality and fails to respond to an evolving standard, the practice will fail. But equally, if the fiscal side of the house can’t keep up with the evolution of market challenges, the clinical side won’t have the support to survive either.
Most of my national peers in surgery are realizing this right now — that with rising costs and decreasing government and third-party payer revenue, without an innovative business and revenue cycle team it’s becoming near impossible to survive as a buisness, regardless of clinical excellence and reputation.
Leadership & Practice Sustainability
Some surgeons find the business side of healthcare challenging. What advice do you have for them?
Most surgeons appreciate being able to focus entirely on clinical lifelong learning in a medical field that’s both technically and cognitively complex, while having colleagues and support staff with genuine interest and aptitude on the business side. Most surgeons appreciate that synergy. It’s a large amount of work that simply isn’t their individual interest or their aptitude – and recognizing that distinction is the healthy version of this.
PracticeCore has built workflow intelligence out of decades of clinical outcomes and revenue transformation work. When a client partner comes to us, what does our combined clinical and financial vantage let us see that a traditional RCM vendor doesn’t?
CNSA has spent nearly nine decades learning and perfecting, through an iterative process, the clinical operations and fiscal management required to optimize a care delivery organization. Almost no other RCM company can say that.
In clinical care, we practice evidence-based medicine – decisions are made on proven historical data and high-quality analysis. We’re able to do the same thing at PracticeCore with revenue cycle management and overall management services in pain, spine, neurosurgery, and physiatry. We provide fiscal solutions that are tested and proven in our own practice. And culturally, we can relate to our clinical-facing clients in a way that purely administratively founded companies cannot.
CNSA has stayed independent through an era of consolidation. What has that required?
Constant innovation and evolution in every aspect. Recruiting the best and brightest of each generation, both clinically and administratively. Deploying the newest technologies. Reinventing our business model. Recognizing changing organizational allies and potential synergies as they emerge.
Continuous and honest self-appraisal – and a genuine willingness to evolve clinically, administratively, and fiscally – is critical.
What’s the most expensive misconception physicians hold about the revenue cycle?
Most physicians are never educated or trained on the immense detail involved in the process between delivering care and receiving payment for that service. So, it’s very easy to under-recognize the complexity, the burden, and the depth of knowledge an organization needs – and must continually invest in – to make sure that process happens efficiently and optimally.
Aligning Clinical Care & Revenue Operations
Where has our partnership changed the strategy – a place where cash acceleration and quality excellence would have pulled against each other, and having both perspectives in the room produced a better answer?
I’d say the two don’t pull against each other – they compound. The increased RCM efficiency that drives revenue for a given infrastructure and level of productivity is the power source that allows reinvestment: into quality improvement, into technology, into human capital, and ultimately into the patient experience. The more effective PracticeCore is, the higher the quality – and the more sustainable that quality – that our clinical partner can deliver.
What did you always want from a revenue cycle partner that you weren’t getting before PracticeCore?
As a physician owner, what you can control is the quality of the care you deliver and how hard you work to care for as many patients and as well as possible. But at some point, you can only increase productivity to a level where quality may begin to suffer. No one wants to reach that point.
So, from a practice profitability standpoint, you must look under the hood at the fiscal efficiency of how you’re paid per production unit to move the needle. It’s only through revenue cycle partners like PracticeCore that a physician practice owner can increase revenue – or in some cases begin to claw back to earning fair market value. Surgeons being paid fairly for the services they provide only starts with payer negotiation. It’s largely determined by the effectiveness of their revenue cycle management team on what is actually collected. We at CNSA have optimized that process with PracticeCore.
Final Perspective
Healthcare organizations often discuss clinical quality and financial performance as separate priorities. Dr. McGirt’s perspective highlights a different reality: lasting success depends on aligning both. When operational, clinical and revenue cycle teams work from a shared understanding of patient care, organizations are better positioned to improve outcomes, strengthen financial performance and sustain growth.
As specialty practices continue navigating industry change, the ability to combine clinical insight with financial expertise may prove to be one of the most important competitive advantages.
Author Note
Moses B. Landon serves as Head of Revenue Cycle Management at PracticeCore, where he works with specialty physician groups to optimize revenue performance, operational efficiency and long-term practice sustainability.