Medical Practice Costs Creep Higher

Evenson says there isn't much on that list that is controllable. Demand for RNs and LPNs is the main reason clinical staff salaries keep increasing, says Evenson. "It's an area where demand is dictating growth."

Medical practices are under enormous cost pressure. They have little control over fixed costs, such as building and occupancy rates, they're subject to market pressures that dictate higher labor costs because of nursing and expertise shortages, and their doctors are looking at possible double-digit reductions in reimbursement rates because of the looming fiscal cliff lawmakers are debating now.

"It's commendable that medical practices are so diligently monitoring their costs," says Susan Turney, MD, MS, FACP, FACMPE, president and chief executive officer of MGMA-ACMPE.

"It is almost impossible, however to make informed business decisions and craft long term strategies when a disastrous cut to Medicare physician payments looms on the horizon. When costs continue to increase and practice professionals are forced to conservatively plan for their future, it hinders their ability to innovate and rapidly evolve as our industry calls for transformation."

An undercurrent to all of this is how much practices have to invest in IT.