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The Five Levers for Medical Practice Improvement

The Five Levers for Medical Practice Improvement

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John W. McDaniel
Michael W. Carbrey
Rob T. Hardy
Chance W. McDaniel

The book and all 200+ resources is available immediately after purchase as a downloadable zip file (41MB).

As a healthcare practice executive or manager, you likely handle all the operational issues in the practice.  Don't waste another moment of valuable time searching for (or developing) a worksheet or spreadsheet or job description or checklist for your healthcare practice.  The new all-in-one resource, “The Five Levers for Medical Practice Improvement” is here to assist you.

  • Need a buy/sell agreement?
  • Need an employee handbook?
  • Need job descriptions for all your non-clinical staff members?
  • Need a patient discharge letter?
  • Need a set of collection letters?
  • Need a coding compliance program?
  • Need a fee schedule analysis?
  • Need a disaster plan?
  • Need a sample revenue cycle management assessment?
  • Need an OSHA/safety manual?
  • Need a sample chart audit?
  • Need a physician compensation planning guide?
  • Need a managed care contract evaluation and negotiation checklist?
“The Five Levers for Medical Practice Improvement” has it all!

Greenbranch Publishing is pleased to announce a partnership with Co-Authors John W. McDaniel, MHA, Michael W. (Bill) Carbrey, MHA, Rob T. Hardy, MHA, FACHE, CMPE, and Chance W. McDaniel, CPC, of Peak Performance Physicians, who have organized and produced a comprehensive compendium of resources necessary for improvement of financial and operational performance in hospital affiliated and private healthcare practices.

According to the Expert Authors, in any healthcare enterprise, there are five (5) critical areas for financial and operational performance improvement:
  • Reimbursement Systems
  • Billing and Collection Processes
  • Accounts Receivable Management
  • Operations Improvement
  • Practice Growth
These 5 areas allow organizations to leverage its profitability potential for the benefit of patients, owners, and employees.  “The Five Levers for Medical Practice Improvement” is an exhaustive collection of 200+ resources (in Word, PDF, Excel and PPT format) for the healthcare practice, including a chapter overview for each section – to put the forms/checklists/spreadsheets in context for performance improvement in your practice.

Given the increasingly complex nature of the healthcare practice management industry, coupled with changing reimbursement systems, lower payments, and increasing operating expenses, both hospital and physician practice executives need more sophisticated resources to measure, manage and change their organizations.

Whether you are a physician, practice manager, hospital CEO/COO/CFO or Director of Physician Services, you will find that the cost-effective and easy-to-use, up-to-date, and user-friendly for all your operational needs.  Review the detailed Table of Contents below.  "The Five Levers for Medical Practice Improvement" includes everything you need – customizable office procedures and worksheets and templates and excel spreadsheets and checklists – all designed for busy practice leaders and managers.

Features and Benefits
  • Design of forms and resources facilitates implementation and use
  • Resources cover a wide variety of operational and financial areas for the practice
  • Easy customization of forms for an immediate ROI (Return on Investment)
  • Streamline tedious and time-consuming analysis and assessment
  • Equip everyone in the practice with templates that are easy to use
  • Greater confidence in drafting documents
  • Immediate download of files
  • Sense of accomplishment in improving physician practice operations
BONUS!  A complete section on The Physician Practice Start-Up System and Assorted Additional Resources such as a Compliance Handbook, OSHA Manual, and Employment Handbook.

Selected Table of Contents

    • Chapter Summary
    • Coding Compliance Program
    • Evaluation and Management Utilization Analysis
    • Documentation Chart Audit
    • Individual Physician Education
    • Documentation Guidelines for Evaluation and Management Services
    • Fee Schedule Analysis
    • Managed Care Contract Analysis
    • Managed Care Contract Status Report
    • Managed Care Contracting
    • Managed Care Contract Evaluation and Negotiation Checklist
    • Managed Care Contract Review Checklist
    • Physician Reimbursement Improvement Services
    • Chapter Summary
    • Sample Revenue Cycle Management Assessment
    • Trending Analysis
    • Sample Business Office Assessment/Review
    • Delinquent Account Collection Approval Form
    • Financial Agreement
    • Patient Collections Notice
    • Patient Discharge Letter
    • Patient Discharge Letter Due to Non-Payment
    • Chapter Summary
    • Sample Business Office Assessment Review
    • Chapter Summary
    • Financial/Operational Resources
    • Comprehensive Physician Practice Management Assessment (TOC)
    • Charges/Collections/Adjustments Analysis
    • Monthly Practice Advisory Report
    • Practice Trending Report
    • Physician Reimbursement Improvement Program
    • Operating Expense Analysis
    • Job Descriptions
    • Biller
    • Billing Coordinator
    • Bookkeeper
    • Clinical Supervisor
    • HIPAA Security Officer
    • Insurance Coder
    • Laboratory Technician
    • LPN
    • LPN/Medical Assistant
    • Medical Assistant
    • Medical Receptionist
    • Nursing Assistant
    • Office Manager
    • Registered Nurse
    • X-ray Tech
    • Practice Administrator
    • Corporate Compliance Program
    • Medical Practice Leasing
    • Non-Disclosure Agreement
    • Physician Practice Management Services
    • Performance Advisory Program
    • Chapter Summary
    • CPT-4 Frequency Review
    • Developing and Maintaining Referrals
    • ICD-10 Frequency Review
    • Group Practice Development Template
    • Patient Origin Analysis
    • Medical Practice Valuation Data Collection Checklist
    • Career Options for Physicians
    • Performance Improvement Initiatives for Physicians
    • Medical Practice Strategic Long Range Planning
    • Sample Business Plan
    • Additional Resources Summary
    • Practice Compliance and Integrity Program
    • Implementation Manual Medical Practice Compliance Program
    • Coding Compliance Program
    • How to Develop and Implement a Coding Compliance Program
    • How to Develop and Implement Medicare/Medicaid Coding Compliance Program
    • Medical Practice Disaster Plan
    • Disaster Planning Form
    • Employee Handbook
    • HIPAA Security Table of Contents
    • HIPAA Security Risk Assessment
    • HIPAA Security – 1 Information Security Program Requirements
    • HIPAA Security – 2 Information Security Electronic Communications
    • HIPAA Security – 3 PC Software License Management
    • HIPAA Security – 4 Information Security EMR/Practice Management Monitoring
    • HIPAA Security – 5 Information Confidentiality and Security Agreements
    • HIPAA Security – 6 Information Security Physician and Office Staff with an EMR
    • Access and Confidentiality Agreements
    • HIPAA Confidentiality and Security Agreement
    • Business Associate Agreement HITECH Blank
    • HIPAA Security Plan Review Documentation Form
    • Discharge-Hire Checklist
    • HIPAA Security Incident Reporting Form
    • HIPAA Security Officer Job Description
    • HIPAA Notice of Privacy Practices of the Offices of
    • Medical Staff Development Plan
    • OSHA Compliance Manual Safety Procedures
    • Chapter Summary
    • Proposed Incentive Compensation Plan - Hospital
    • Quantitative Example
    • Qualitative Example
    • Physician Compensation Arrangements: CEO Pitfalls
    • Market Analysis Assessment
    • Physician Needs Assessment
    • Physician Employment Agreement
    • Sample Medical Director and Coverage Agreement
    • Sample Medical Director Services Agreement
    • Professional Services Agreement
    • Sample Physician Employment Services Agreement
    • Rural Health Clinic Physician Services Agreement
    • Physician Recruitment Agreement
    • Sample Expense Sharing Agreement
    • On Call Coverage Agreement
    • Medical Office Building Lease Agreement
    • Income Guarantee Worksheet
    • Physician Income Guarantee Program Checklist
    • XYZ Health Systems Case Study Outline
    • The New Physician Paradigm
    • Contractual Agreements for Physician Services
    • Physician Compensation Agreements What Not To Do
    • Fair Market Value Employment Recruitment Agreement
    • Employment Offer
    • Necessary Documentation Regarding Physician Compensation Arrangements
    • Letter of Intent Physician Employment Agreement
    • Fair Market Value On Call Coverage Services General Surgery
    • Chapter Summary
    • Physician Practice Start-up System Checklist
    • Physician Recruitment and Retention Continuum
    • Income Guarantee Worksheet
    • Application for Employment
    • Applicant Interviewing – Questions to Ask
    • Appointments List
    • Authorized for the Release of HIV Status
    • Authorization to Release Protected Health Information
    • Buy/Sell Agreement
    • Buy/Sell Agreement Checklist
    • Certification of Disability
    • Checklist for a New Medical Practice
    • Checklist of Medical Office Equipment and Supplies
    • Consent to Diagnostic Procedure
    • Employee Employment Review
    • Expense Sharing Agreement
    • Group Practice Information Implementation Checklist
    • HIPAA Privacy Officer
    • Hospital Recruitment Agreement Checklist
    • Hospitalization Log
    • Immunization Authorization
    • Immunization Record
    • Informed Consent
    • Job Ads for Medical Practice Employees
    • Lease Review Checklist
    • Medical Consultation Referral Report
    • Medical Practice Internal Control Checklist
    • Medical Practice Merger Checklist
    • Medical Records Pre-Certification Form
    • Medicare Medical Necessity Statement
    • Medicare Signature on File
    • Medicare Surgical Financial Disclosure
    • Medication Log
    • New Physician Office Operations Checklist
    • Patient Health History
    • Patient Information Update
    • Patient Medical Information
    • Patient Registration Information
    • Patient Satisfaction Survey
    • Problem List
    • Progress Notes
    • Referral Log
    • Release of Information and Assignment of Benefits
    • Return to Work Certification
    • Request for Release of Medical Records
    • Sample Announcement Card for New Physician
    • Surgery Consent
    • Telephone System Questionnaire
    • Waiting Room Checklist
  • SAMPLE FORMS and CHECKLISTS (Medical Practice Financial Policies and Procedures Forms)
    • Accounts Payable Audit Block
    • Accounts Payable Authorized Designee Form
    • Applicant Rating Form
    • Assessing the Collection Agency Performance
    • Attendance Record
    • Attendance Record Communication Sheet
    • Authorization Agreement for Automatic Payroll Deposits
    • Bank Deposit Log
    • Change in Patient Information
    • Collection Letter
    • Collection Letter 1
    • Collection Techniques for Office Staff
    • Customer Complaint Log
    • Delinquent Account
    • Direct Deposit Form
    • Disciplinary Action Form
    • Electronic Claims Transmission Rejection Checklist
    • End of Day Reconciliation
    • Financial Agreement Schedule of Payments
    • Hazard Surveillance Form
    • Insurance Claim Processing Compliance Report
    • Insurance Company Summary Sheet
    • Managed Care Data Tracking Worksheet Example
    • Managed Care Organizations Basic Survival Information
    • Management Review Guidelines for Billing and Collecting
    • Medical Necessity Prepayment Screens
    • Medical Records Confidentiality Statement
    • Office Manager Checklist
    • Overtime Form
    • Patient Daily Sign In Sheet
    • Patient Information to be Reviewed During Registration
    • Patient Registration Form
    • Patient Waiver Form
    • Payment Plan Form for Past Due Accounts
    • Personal Leave of Absence form
    • Petty Cash Log
    • Petty Cash Reconciliation Form
    • Reference Check Form
    • Return to Work Authorization Form
    • Sign In Sheet
John W. McDaniel

John W. McDaniel is Founder & Chairman of Peak Performance Physicians, LLC. From its New Orleans, Louisiana base, the firm has exhibited impressive growth as evidenced by its nationwide clientele and a strong reputation in the physician practice management industry. In addition to its work with hospitals and physicians across the United States, Peak Performance Physicians, LLC presents educational workshops, publishes a healthcare newsletter and offers an Administrative Residency in Medical Practice Management for Tulane University School of Health Systems Management for future health care executives, offers an internship in Medical Coding through the University of New Orleans and offers an Administrative Residency through the Health care Management Program of the University of Alabama. Mr. McDaniel is a contributing author and a member of the Editorial Board to Physician Practice Options, a monthly physician practice newsletter with a distribution of 200,000 physicians and also serves as Editor-in-Chief of The Physician's Compliance Alert.

Furthermore, Peak Performance Physicians, LLC is the only physician practice management organization fully endorsed by several state hospital associations and other various medical organizations throughout the United States. Peak Performance Physicians, LLC is also an endorsed company by the American Academy of Family Medicine. In addition to overseeing the development and growth of Peak Performance Physicians, LLC since 1989, Mr. McDaniel also has fifteen years experience in hospital administration, having served as President and Chief Executive Officer of health care systems in North Carolina, Alabama and Louisiana. He earned a Masters Degree in Health Care Administration from George Washington University and was selected as their 1985 Alumni of The Year In Health Services Administration. Mr. McDaniel has been published in The Wall Street Journal, The Harvard Business Review and has made numerous presentations to industry and professional associations affiliated with the health care industry. He is also co-author of the book, Disaster Planning for the Clinical Practice. Contact him at: LinkedIn: John W. McDaniel

Michael W. Carbrey

Michael W. Carbrey Michael W. Carbrey is Executive Vice President and Chief Operating Officer of Peak Performance Physicians, LLC. Mr. Carbrey has over 30 years health care experience in a variety of roles including Hospital Administration, Contract Management, Health care Consulting, Practice Management and Acquisitions. His experience in Physician Management extends back to 1984 when the hospital that he was running purchased seven physician practices.

He has developed web sites for physician groups and started the first physician prac- tice management portal Established in the infancy of the internet it boasted the largest physician usage in 1996 and 1997. It was during this time period that Mr. Carbrey established a physician practice management consulting company, Carbrey & Associates, Inc., and established a national referral base for management consulting.

Mr. Carbrey joined the Administrative Team at South Texas Health System, wherein he oversaw the Physician Management and Development portions of the system. In this role he also oversaw physician recruitment for the five facility system. The system established a Physician Practice Organization (501a) and purchased and managed a 13 person, $52 million dollar cardiology practice; Mr. Carbrey was the president of that organization.

Recently, Mr. Carbrey rejoined Peak Performance Physicians, LLC, a national physician practice and hospital consulting company. Peak Performance Physicians consults with Hospitals on Physician Integration, and Physicians on Medical Practice Improvement.

Mr. Carbrey has been published in healthcare journals, and has been a guest lecturer at the Family Practice Residency Program in McAllen, TX, teaching practice management tools to the residents and faculty. Additionally, he is listed as a guest lecturer and consul- tant for the Texas Medical Association. Mr. Carbrey served as a Hospital Corpsman in the U.S. Navy, and was honorably discharged. Contact him at:

Rob T. Hardy

Rob T. Hardy is President and Chief Executive Officer of Peak Performance Physicians, LLC. Rob has been involved in Central Texas healthcare since becoming an Austin EMS paramedic in 1977 and completing a BS degree at the University of Texas is Health Education. After 11 years in EMS, he went into the public health field at the (then) Texas Department of Health. After completing a Master's degree in Healthcare Administration in 1992, he embarked upon a long and varied career in physician practice management. Having held various executive level positions at Austin Diagnostic Clinic, Murfreesboro Medical Clinic and Surgicenter, Scott and White, Austin Pathology Associates, King's Daughters Clinic, and Advanced Pain Care. He has also served as a consultant and interim administrator in such varied settings as a critical access hospital and rural health care clinics. Board Certified by both the American College of Healthcare Executives and the American College of Medical Practice Executives, Rob is currently working in the physician practice management industry, helping physicians and administrators make sense of the ever-changing world of modern health care. A PhD candidate (ABD) at the University of Texas, he is a believer in lifelong learning. He is married to Carol, another UT grad, and they are the proud parents of Helen, a Master's candidate at Middle Tennessee State University and a Texas A&M graduate, and Jonna, an sophomore at Baylor. Contact him at:

Chance W. McDaniel

Chance W. McDaniel, CPC, is the Vice President of Coding and Compliance for Peak Performance Physicians, LLC. Mr. McDaniel is responsible for overseeing the Coding and Compliance Programs and Medical Practice Compliance and Integrity Programs for hospital affili- ated and private practice physicians clients. He also serves as Managing Partner of RepMD, which represents physicians looking for practice opportunities with both hospitals and private medical practices within specific geographic areas.

Mr. McDaniel received his B.A. degree in Telecommunication from the University of Alabama. Contact him at:


"For the seasoned executive or the student of health care management The Five Levers for Medical Practice Improvement is a "must have" reference.  Having spent a career in healthcare management I have yet to find a resource that in one place presents such a fine and premier set of reference materials. John and his associates have hit the mark; this is a true "bulls eye" – one source publication.  I can't overstate the practical regular use the healthcare manager, student or physician will make of this publication.  It will prove invaluable as a "go to" manual for anyone truly committed to understanding the complex environment of practice management. I highly recommend this for the executive's reading and reference library."
Mark F. Keiser, MBA, MHA, MPH, FACHE
Access Health Louisiana Kenner, LA

"I've known John W. McDaniel, MHA, Founder and Chairman of Peak Performance Physicians, LLC, for 30 years and have worked with him on behalf of numerous of our hospital association members of both the Texas Hospital Association (THA) and the Texas Organization of Rural & Community Hospitals (TORCH). He and his company are one of the most knowledgeable organizations around today when it comes to Physician Practice Improvement. They offer an extensive range of physician advisory services with a client base of major hospital companies, health care systems, rural and community hospitals and medical practices. Healthcare providers who have used Peak Performance Physicians, LLC have reported to me only the highest praise for the work done."
Vicki A. Pascasio, FACHE
TORCH Management Services, Inc. (TMSI)
Austin, TX

"Let the truth be told, that doctors, including myself, are not very competent businesspeople.  This is not because of lack of skill (or desire) to become more knowledgeable about the business aspects of a medical practice.  It's merely because the medical school training is solely focused on doctors learning clinical skills.  I have written several books on marketing and the business of medicine and have read dozens of books on controlling the business component of a medical practice, but none is a comprehensive and thorough as John McDaniel's resource, Five Levers for Medical Practice Improvement.  I believe every doctor and every office manager will consider this compendium as the bible for their practice."
Neil Baum, M.D.
Author of "Three Stages of a Physician's Career" Greenbranch Publishing, 2017
Professor of Clinical Urology
Tulane University Medical School
New Orleans, LA

"The Five Levers provides hospitals and practices with one-stop shopping for access to essential materials for developing and operating a successful physician practice.  The reader will find that the forms, checklists, spreadsheets and other resource materials provide essential user-friendly practical guidance that are extremely useful to ensuring the successful operation and financial performance of a practice.
The experienced team at Peak Performance Physicians have compiled, in one location, a compendium of years of practical guidance that you will find invaluable."
Jack M. Stolier
Sullivan, Stolier, Schulze & Grubb, LLC
New Orleans, LA


"Harrison wrote the "go to" textbook on Medicine, Sabiston on Surgery.  If there was ever an authority I would choose to write the definitive treatise on Medical Practice Management, it would be John McDaniel and his expert team at Peak Performance Physicians.  Fortunately you, the reader, hold their wisdom in your hands!
Princeton Brain and Spine physicians have relied on the guidance, mentorship, and strategies of PPP for nearly two decades.  We began as a one physician, two employee practice.  Over the years we have transformed into a 13 healthcare provider, 70 employee multispecialty group in a highly competitive environment.  A big reason for our successful growth, development, and unity is that, from inception of the practice to present day, we invested in a long-term consulting relationship with PPP.  That investment yields great dividends.
This resource is a compendium of PPP's extensive experience and battle-tested comprehensive methodology in the mercurial and challenging world of medical practice management.  I highly recommend this book and their consulting expertise.  Every great team needs a great coach.  Working with PPP, we feel like we've had John Wooden!"
Mark R. McLaughlin, MD, FACS, FAANS
Founder, Princeton Brain and Spine Care
Princeton, NJ

"I have had the distinct pleasure of not only being part of John's team early in my healthcare journey, but also working closely with him on numerous high profile and successful initiatives throughout my career. John has created a physician-focused approach to enhance the operations of medical practices for both independent and hospital owned entities thus leading to many successful outcomes. In addition, the value created by John's work and vision goes far beyond the day-to-day operations; it is carried out for years to come.  This publication is a testament to John's dedication to the physician practice arena and sheds light on a different way of thinking about the future of care delivery.  Well done."
Ben Frank, MBA
Past CEO and current senior healthcare leader
Cleveland, OH

"I have worked with John W. McDaniel, Michael W. (Bill) Carbrey, and Rob T. Hardy, of Peak Performance Physicians on several medical staff, physician, and hospital compliance and operational issues.  In my experience, Peak Performance Physicians have proven to be very knowledgeable and have helped me and my clients navigate through some very difficult and complex compliance and operational issues.  In an ever-changing environment, it is important to have trusted consultants that you can use when needed."
Robert L. Spurck
Reed, Claymon, Meeker & Hargett, PLLC
Austin, Texas

"Peak Performance has been a real asset to our organization.  We utilized their services to evaluate our hospital-owned physician practice and found them to be very thorough in their approach and analysis.  The product of their work was a wealth of data which will aid us in improving the practice and performance.  I strongly recommend their services to anyone struggling with the challenges of growing or improving practice performance in today's increasingly complex provider environment."
Dennis Medley
Physicians Medical Center
New Albany, IN

"I have known John McDaniel and Peak Performance Physicians for over 5 years, and after fully engaging him and his company our practice has, "turned around."  Reading the Five Levers for Medical Practice Improvement, I can see how his team was able to improve our medical practice.   If you really want a DIY (Do-it-Yourself) project for your practice, The Five Levers is a great place to start."
Lawrence Allen, MD
Diagnostic Center of Medicine, LLP
Las Vegas, NV