The end of your first fiscal quarter is more than the beginning of spring sports physicals and allergies – it’s a strategic opportunity for independent pediatric practices to assess performance, identify risks, and optimize operations before the year gains momentum.
According to the Medical Group Management Association, practices that regularly review financial and operational metrics are significantly more likely to meet annual revenue goals. It can be tempting to leave financial and administrative review until mid-year, or even until year-end, but formal assessments throughout the year make it that much easier for your practice to note changes and course correct where necessary.
Not to worry – we have your back. Here’s what to review before Q1 closes, plus how to act on what you find.
Let’s start with a simple but critical question: are you on track financially?
Tight margins are no mystery to most pediatric practices, but even small gaps between projected and actual revenue can have outsized impacts, and it’s important to know where you stand.
(What should your margin be? Great question – you can find the detailed answer over on Chip’s blog. TLDR; he recommends at least 10%.)
Your financial wellness checklist:
In pediatrics specifically, reimbursement pressures can make accurate forecasting more challenging. This pressure comes especially from Medicaid, which covers nearly 40% of U.S. children.
Note: If your numbers are off, it may be worth evaluating whether your pediatric EHR is providing accurate reporting and visibility into key financial metrics. PCC’s Dashboard has both financial and clinical insights and lets you compare your performance to other PCC practices.
Consideration of families’ common concerns, even anecdotal, can help you create plans to meet those needs, whether they lie in mental health, access to care, or vaccines. If you are pursuing PCMH accreditation, now is a great time to check in on those goals, too (that data is also available on the PCC Dashboard).
Claim denials remain one of the biggest revenue drains in healthcare. During your Q1 review, take a look at which claims are getting denied. Should they be? Why? This is a great opportunity to call in your biller or billing service and review what sticks out to them.
Q1 Review:
Even a modest denial rate (2-4%) can significantly impact cash flow in a pediatric setting where margins are already thin.
Use reporting within your pediatric EHR or billing system to identify recurring issues—many denials stem from preventable front-end errors. You can also compare notes with other practices and follow up with payors. Q1 is also where you should be looking at how payors are adjusting to new codes. For example, in 2026, immunization non-administrative codes rolled out at the start of the year. How are those paying?
Your schedule is one of your most powerful revenue tools, and one of the most under-optimized. Whether you use PCC’s Appointment Book or something else, now is a great time to open up your Q1 schedule and dive under the hood.
In PCC practices, no-show rates average 4.6% with a median of 3.7%. Common no-show explanations are transportation, school schedules, and caregiver constraints.
Evaluate:
Reducing no-shows by even 5% can meaningfully increase revenue without adding new patients. You may also find an easy fix or two by observing workflows at the front desk – is everyone on board with the same process? Where is there friction?
Many pediatric EHR platforms include automated reminders and self-scheduling features that can help fill last-minute gaps and empower families to schedule appointments. Need help building a patient recall system? We wrote all about it in a previous post.
You won’t be surprised that staffing comes into play in Q1, as it does all year. In pediatrics, non-clinical labor averages at about 25% of expenses for the year, with another 25% for physicians. Finding and keeping staff continues to be tricky, so keeping an eye on staff overtime is one way to identify friction points – that includes your overtime, too!
Take a look at overtime over the last quarter. Who is logging it? When? Is OT driven by particular tasks, such as charting, billing, or administrative work?
Consistent overtime may signal:
If you or your team is staying late to finish charting or billing, your pediatric EHR workflows may need optimization – not just your staffing model.
Alternatively, your team may be taking overtime voluntarily, in which case, you might consider overtime an additional benefit you can leverage during hiring negotiations.
Healthy A/R is essential for consistent cash flow. Best practice is having less than 15 to 20% of A/R over 90 days, less if you can manage it. Yet many practices exceed these thresholds, often due to delays in claim submission or follow-up.
To give your A/R days a trim, take a look at:
A growing percentage of A/R over 60 days can indicate systemic billing or payer issues. Leverage your pediatric EHR and billing tools to automate follow-ups and improve claim tracking.
Research in healthcare management shows that organizations that revisit goals quarterly are significantly more likely to achieve them.
But in independent pediatric practices, operational demands often take over. Be careful not to let creative ideas take precedence over priority tasks. Reviewing your goals for the year, ask yourself:
Ask:
Chip’s advice: you don’t need to focus on every goal at once, nor should you! Choose 1 to 3 “big ideas” and focus on these.
Independent pediatric practices face unique challenges: tight margins, complex payer mixes, and rising administrative burden.
A structured Q1 review helps you protect revenue, improve efficiency, support your team, and stay aligned with your goals.
Just as importantly, it gives you the visibility needed to make informed decisions -- whether that’s adjusting staffing, refining workflows, or getting more out of your pediatric EHR. Take back control by acting early this year, for success today, tomorrow, and for years to come.
Your EHR should be a partner in your success, not a hindrance! Learn more about how PCC can help you remove obstacles and crush your goals all year long. Click below to schedule a 1:1 call with us.