Restructure at strategic, enduring levels

Tip #1 Strategically review expenses by line item

• Consolidate multiple line items that fit together (Medical/dental supplies, other supplies, implants)
• Look at the combined line item view over the past 3 years, showing the expense as a percent of revenue
• Identify where you spend the most and look at spending trends (has each item trended up or down? Have costs grown at a faster rate than revenue growth? If so, that isn't good. Where should spending be decreased or eliminated? How can you move to a lower cost supplier or renegotiate with your current one?

Tip #2 Think about strategic restructuring, not just cost cutting

• Have labor costs (as a percent of revenue) been high? If yes, re-think roles and organizational structure.
• Does your organizational structure drive cost down and effectiveness up? If not, redefine roles behaviorally and restructure now before  you re-hire 
• Are processes helping to decrease costs or not or do you need to tighten up compliance to process

Tip #3 Look at the performance of locations, compensation structure and your payor base 

• Take a hard look at under-performing locations that aren’t cash neutral
• Re-structure your relationship with Associates to add equity and reduce cash
•  Consider accepting more insurance or even Medicare, given unemployment rates