● Family & Primary Care ●
Keep your family medicine practice independent — and profitable
Independent primary care is under pressure from every direction: shrinking reimbursement, rising staffing costs, and hospital systems bidding for your patient panel. The practices that stay independent are the ones run with executive discipline.
Sound Familiar?
The margins are real, but they hide in the details
Full schedule, thin bottom line
Visit volume looks healthy while under-coded E/M levels, missed annual wellness visits, and unworked denials quietly cap what each full day actually collects.
Staffing costs outrunning revenue
MA and front-office wages have climbed sharply. Without ratio benchmarks and role design, payroll grows faster than the panel that pays for it.
Value-based contracts you can’t see into
Quality bonuses, attribution, and shared savings only pay if someone owns the data and works the gaps. In most practices, nobody formally does.
● Two Ways to Engage ●
Same executive expertise. Two engagement models.
Both engagements bring senior healthcare-executive expertise to your family medicine practice. The difference is the number of hours per week your outside expert is involved — and who executes the plan.
Fractional Executive
We lead it with your team
A COO, CFO, or CEO-level operator embedded in your practice on a weekly cadence — running leadership meetings, working directly with your staff, and owning outcomes. Executive-caliber leadership at roughly 20–30% of the cost of a full-time hire.
Consulting
We build it, you run it
A focused engagement built around analysis and a clear, prioritized roadmap. Often the better value when you already have the leadership in place to execute a well-built plan — project-based, defined scope, defined deliverables.
How We Work
Five steps. Every engagement.
Every engagement — fractional or consulting, any specialty — follows the same five-step operating discipline.
Where We Focus
What we work on inside primary care practices
The operating levers that decide whether an independent family practice thrives or sells — managed on a monthly rhythm.
■ Revenue cycle discipline
Coding accuracy, charge capture, denial management, and AR aging worked on a schedule — primary care margins are too thin to donate 5–8% of revenue to billing leakage.
■ Visit mix & capacity
Annual wellness visits, chronic care management, transitional care, and same-day access — building the visit mix that serves patients and sustains the practice.
■ Staffing model & ratios
Right-sized support ratios, top-of-license task design, and cross-training that keeps the office running when someone calls out.
■ Value-based performance
Attribution tracking, quality-gap workflows, and contract-level economics so incentive dollars are earned deliberately instead of arriving (or not) as a surprise.
■ Ancillary & adjacent revenue
In-office labs, behavioral health integration, and other ancillaries evaluated on real contribution margin — not on a vendor’s pro forma.
■ Independence strategy
Clear-eyed analysis of the stay-independent vs. sell decision, and the operational improvements that make staying independent financially rational.
“Hospital systems aren’t buying family practices because primary care doesn’t work. They’re buying them because it does — when it’s run well.”
Questions
Frequently asked questions
How can a small family medicine practice stay independent?
What is a healthy overhead ratio for a family medicine practice?
Is value-based care worth pursuing for an independent practice?
What does a fractional practice executive cost compared to a practice administrator?
The Family Medicine briefing series
Five sourced, data-driven reports on the business of running a family medicine practice.
CCM pays $66/patient/month in 2026, RPM roughly $99, AWV $160. What each pays and what running them compliantly requires in an independent family practice.
APP productivity in physician-owned practices climbed 22 percent in wRVUs in 2024. Here is the break-even math and deployment model for family medicine.
AAFP: average DPC panel 413 patients, physician income $288,779. The revenue bridge math for transitioning a family practice to a membership model.
The 2500-patient panel benchmark has no data behind it. AAFP tools and current research on right-sizing your panel and recovering access.
MIPS 2025: a plus or minus 9% Medicare swing, a 75-point threshold, real exemptions. The honest calculus for small independent family medicine practices.
Book your complimentary discovery call now
Thirty minutes. No pitch. An honest read on where your practice stands.
Free Consultation