Blue River Petcare

Founded in 2009, Blue River is a multi-state owner and operator of high-quality

veterinary hospitals, focusing primarily on general practice small companion animal
medicine. Blue River seeks to acquire veterinary practices that have established
businesses in their respective communities and enjoy a loyal following among pet
owners.
Blue River is a well-established brand in a resilient industry, supported by a highly-
capable management team. The Company is uniquely positioned to capitalize on the
attractive opportunity in the veterinary sector, which is highly-fragmented and benefits
from favorable market tailwinds driving overall growth.
Founded in 2009 and headquartered in Chicago, Illinois, Blue River is a leading
operator of veterinary hospitals caring for household pets, managing a network of over
90 general practice hospitals and 300+ veterinarians across 23 states in the US. Blue
River's unique operational model allows for high-levels of clinical autonomy.

Previous IT services they have had contact with (2016):

Sage Intacct: Accounting Software
- Sage Intacct, Inc is an American provider of cloud-based Financial management
and services available in five regions around the globe -- including the United
States, Canada, the UK, Australia, and South Africa. Its products offer cloud-
based accounting applications that enable business payments, manage and pay
bills, and facilitate payroll functions.
Maner Costerisan
- Maner Costerisan is a full-service public accounting, technology, and business
advisory firm dedicated to providing quality and reliable services targeted to
specific client needs

SECTOR
Health Care

INDUSTRY
Health Care/Veterinary Services Industry

SUB-INDUSTRY
Health Care Facilities & Svcs

Companies in this industry employ licensed veterinary practitioners and provide medical
and health care services for animals. Major companies include Medical Management
International, National Veterinary Associates, and VCA (all based in the US), as well as
CVS Group (UK) and Greencross Vets (Australia).

Demand is driven mainly by the number of cats and dogs kept as pets, which is affected
by demographics and economic conditions. The profitability of an individual clinic
depends on marketing skills, reputation, and the range of services the practice offers.
Large practices enjoy economies of scale in marketing as well as better access to
capital to invest in onsite diagnostic equipment. Small practices can compete effectively
by specializing in particular animals or types of treatment, or by serving an exclusive
area. The US industry is highly fragmented: the 50 largest companies account for about
15% of revenue.

Animal hospitals and clinics treat injuries and diseases but derive most revenue from
animal health procedures like neutering and spaying, vaccinations, and regular
checkups. Some animal hospitals also bathe, groom, board, and provide testing
services. Routine examinations and nonsurgical treatments each account for about 25%
of industry revenue; surgical procedures and lab services, about 15% each.
Merchandise sales (pet food, vitamins, and accessories) and pet care services
(grooming and boarding) each account for about 10%.

Outsourcing in the Veterinary Industry

Outsourcing in veterinary medicine—or, rather, the lack of outsourcing—is an

interesting phenomenon. From a purely historical perspective, outsourcing has been an
extremely successful method of conducting business in corporate America for more
than a century. Most businesses have discovered that it is far more cost-effective to
purchase certain goods and services from others than to attempt to do everything in-
house; as a result, they are able to focus on their strengths and their products are far
more accessible to consumers. Yet for most veterinary practices, this business model
remains in its infancy, and as a result, opportunities for increased revenue and
efficiency are being overlooked.

Perhaps one of the biggest reasons for the lack of outsourcing by veterinary hospitals is
that the industry in general has struggled with a changing business model. No longer
are veterinary practices small, individual entities. Rather, the task of owning and
managing a successful practice has become far more complex over the last decade,
and, like it or not, it requires far more management and business knowledge than ever
before (traditionally not skills in which veterinarians excel). Veterinary business owners
who are reluctant to change put themselves at a great disadvantage compared with
their counterparts who are already taking advantage of outside expertise to run and
promote their hospitals. As practices increase in size and competition between practices
becomes stronger, owners must shift their “do it myself” mentality in order to flourish.

Clients still expect the personalized care and service that comes with smaller veterinary
clinics, but at the same time, they demand increased efficiency, online access to your
business, and a facility that looks like it’s been updated since the 1970s. These
expectations are difficult to meet, and almost impossible for owners who believe that
paying for help is money out of their pocket with no valuable return on investment.
Would large corporations outsource if it meant losing money? Of course not! These
companies understand that there is a cost-to-benefit equation that must be considered.
When the equation proves that parting with money now leads to greater success and
increased future revenues, outsourcing is clearly the intelligent approach.

The cost-to-benefit equation also takes time and quality into consideration. With regard
to quality, there is simply no one in the world who is good at everything! Peter F.
Drucker, a highly respected author on business management, puts it best: “One cannot
build performance on weaknesses, let alone on something one cannot do at all.” 2 Take
this one step further and consider that if a project means undertaking tasks that you are
neither very good at nor happy doing, it will likely get pushed even further to the bottom
of your “to do” list. We do what we like to do and are good at—it’s human nature!

As for the time factor, even if you are a veterinarian who also happens to be an
accountant, businessperson, computer genius, graphic designer, interior designer, and
all around fix-it person, one very important fact remains: there are not enough hours in
the day for you to do everything yourself. Take a minute and think about the projects on
your “to-do” list for your practice. How long have they been there? For example, how
long have you been planning to update your website or paint the examination rooms? A
year? Longer? If you had outsourced them to get them completed—or at least under
way—what benefits might you already be seeing with regard to client retention,
referrals, and an increase in new client numbers?

Some of the most common areas in which a veterinary practice can benefit from
outsourcing are financial planning and analysis, bookkeeping, payroll processing,
benefits administration, marketing, Web site creation and maintenance, social media
presence, client communication, and hiring new veterinarians and managers. Let’s take
a closer look at just a few of these areas.
Taxes and Financial Analysis

Consider a scenario in which the person who has been preparing your personal taxes
for years has also been preparing the taxes for your practice and is one of your closest
friends. While this is technically outsourcing, it is based solely on friendship,
convenience, and (probably) price, none of which are good reasons to pick a service
provider. You have a part-time bookkeeper who pays the bills and enters them in your
accounting software, and at the end of the year, you send your friend the necessary
reports to prepare your tax returns. It’s cheap and easy, and so far you haven’t been
audited, so it’s working just fine, right? Wrong.

Now consider that, over a period of time, the practice has added another doctor and
several staff members and has increased its gross by more than 100%. Although your
taxes are still being filed on time, no one is taking the time to review financial reports,
such as profit and loss statements, on a regular basis. This means that no one is
watching for discrepancies or potential problems, such as inventory costs that are
excessive based on sales, declining income from certain services (e.g., dentistry), or
payroll expenses that are higher than recommended percentages. Certified public
accountants (CPAs) not only review financial statements on a monthly or quarterly basis
to look for these and many other issues but also possess a wealth of information and
resources that your friend the tax preparer probably does not have. For example, CPAs
keep current on the multitude of tax laws and changes to ensure that you are benefiting
from or minimizing your exposure, whichever is appropriate for you. Without the
assistance of an industry-knowledgeable CPA, practice owners often do not realize
financial problems until much further down the line, causing them to incur tremendous
losses that could easily have been avoided. While at the outset, the fees for a CPA may
seem large, the expertise provided not only quickly pays for itself but also has the
potential to greatly increase your bottom line.

Hiring

Hiring managers, new veterinarians, and sometimes other staff members, is probably
the task that veterinarians are least willing to outsource. Most of this resistance has to
do with sticker shock: hiring services often charge 20% to 25% of the hired individual’s
first-year salary. However, not using such services is a very short-sighted approach to
doing business.

Let’s focus on hiring veterinarians. There is a big difference between wanting another
veterinarian and actively seeking another veterinarian. Actively seeking involves placing
advertisements, collecting resumes, phone screening, and interviewing, all of which
require a great deal of time and effort. It does not mean hoping for a miracle or
expecting the “perfect” candidate to walk in the door and beg to be hired. (That’s
probably not going to happen.) And if an owner has the time to aggressively recruit staff,
he or she probably does not need an additional veterinarian! The key is to determine
whether the lack of an additional veterinarian has had a negative effect on growth and
revenue. If the answer is “yes,” then outsourcing the hiring process is the best option.
The right hiring company will not only find someone faster but also do all the legwork so
that the practice owner’s time is not taken away from an already overwhelming
schedule. Once a successful match is made and the new veterinarian begins working,
the service should pay for itself in a matter of months.

Marketing Materials

For most practices, the choice to create marketing materials in-house, either in print or
on the Internet, is one of the worst decisions they can make. Unfortunately, in an effort
to cut costs, many are still doing just that. Let’s face it: looks matter, and today’s
consumers have very high expectations. It is no longer okay to create hospital
brochures from a word-processed document on your copier or to use the same logo
image as the practice across town. Image plays a tremendous role in a client’s decision
to bond with a practice, and as such, it must be consistent, professional, and
memorable. While it isn’t necessary to hire a Madison Avenue ad agency to create your
logo or design your brochures, it is critical to invest in a professional company that
offers these services.

Web Site

Competition is now a real concern for practice owners, and an online presence can be a
huge force behind practice survival or failure. According to many practices that actively
survey their new clients, as many as 80% list the quality of the practice Web site as the
decision-making factor in their choice to seek a specific hospital’s services. Successful
Web sites are dynamic, professionally made, and simple to navigate, and they offer
content that is informative, current, and well written. To get the maximum possible
reward from your Web site, do not hire an amateur! In fact, having an outdated or
“homegrown” Web site can be more damaging than having none at all—it is much
easier to make a good first impression than to redeem a poor one. And if you don’t think
people remember, think again.

Another important reason to hire a professional to create your Web site is that he or she
will understand the intricacies of the Internet. For example, a professional site designer
can ensure that your practice is strategically placed on search engines and appears
under multiple search terms. Although these issues have nothing to do with veterinary
medicine, they have everything to do with the exposure, growth, and sustainability of a
practice. If paying for these services is an issue, consider that a good Web site is far
cheaper than even a small ad in the Yellow Pages, and it reaches so many more people
that most practices opt to cancel their Yellow Page listing once their Web site is up and
running.

Social Media

Social media is the latest “product” added to the mix of small-business “must haves” for
gaining exposure and promoting client loyalty and retention. Entire studies are being
conducted on the effects of social media on businesses. A 2009 study found that
financial performance increased by as much as 18% in 1 year for companies engaged
in social media.3 Comparatively, companies that did not engage in social media
opportunities saw an average revenue decline of 6% in the same time period. These
figures are incredible, considering that social media barely existed 5 years ago.

Since just having an up-to-date website can be a challenge, it is no surprise that many
veterinarians and practice managers do not relish the idea of having to include social
media updates in their list of things to do. Maintaining a current presence on social
media sites is a perfect task to outsource.

How to Find Resources

Finding resources is often the most difficult part of outsourcing. However, many
individuals and companies now cater directly to the veterinary industry. Often, these
individuals come from within the industry itself or have chosen to create a niche within
the market. As with all other service providers, it is important to do your research and
ask for references to ensure that whomever you choose to work with has an excellent
reputation and the experience to back it up. One resource is VetPartners, which is an
association of veterinary consultants and professionals; their website, vetpartners.org,
offers an online membership directory with the ability to search based on services
provided.

Internal outsourcing may be a viable option for some projects. Internal

outsourcing refers to making use of the unique skills of someone within your practice.
Many veterinary staff members have experience in other industries, and one of your
existing employees may be just the right person for a project that needs completing. For
example, many employees are incredibly savvy about social media. However, if you are
considering internal outsourcing, research your employee’s abilities and experience as
you would when hiring any other service provider. In the case of outsourcing your social
media updates, you must be sure that the person you hire can be trusted to mind his or
her online manners. It is also important to be clear that any projects handled in this way
are completely separate from the employee’s regular duties. When internal outsourcing
works, it can be a great way to keep things in-house, provide extra income to a valued
employee, and probably save the practice some money as well.

Regardless of the service to be outsourced, make sure to consider the following when
choosing a service provider:

 Can they provide several references for you to contact?

 If applicable, are there examples of their work that you can see?
 Are they accessible and easy to work with?
 How long have they been in business?
 Have they worked with other animal hospitals before, or is this uncharted territory
for them?
  Do they meet deadlines, and if not, how will you be compensated?
 Are they reasonably priced for what they offer?
 What is their fee structure?
 Will you have to sign a contract?

The following are some additional due diligence considerations specifically for
outsourcing the task of hiring staff. A reputable firm should do all of the legwork,
including:

 Complete a thorough screening process

 Provide written interview notes from at least two interviewers
 Obtain a writing sample from the candidate
 Perform a minimum of three reference checks
 Perform license and background checks
 Conduct drug screening
 Guarantee a replacement (for a limited time period)

The more complex the job of owning and running a business becomes, the more
important it will be for veterinary practice owners to become adept at understanding and
evaluating the cost-to-benefit equation with regard to outsourcing. Fortunately, the
number of service providers focusing on the needs of veterinary practices continues to
grow. This will keep prices competitive and options plentiful for veterinarians seeking
reliable companies to whom they can outsource.
The ability to understand and accept a business model that uses outsourcing is crucial
to owning and running a successful veterinary practice in today’s competitive
marketplace. It is also the best guarantee that veterinarians will have the opportunity to
continue focusing on what they do best…earning income by providing high-quality
medicine for animals.

Technological Trends in the Veterinary Industry

INCREASE PATIENT COMMUNICATION OPPORTUNITIES

Improving communication between the veterinary practice and patient base provides
numerous opportunities for repeat visits. Companion animal offices can benefit from
sending appointment reminders for vaccines, seasonal parasite control and grooming
appointments, either by postal mail or electronic communication. Integrated software
platforms available in the marketplace provide opportunities to sort by appointment
dates, condition and season. Many practices further utilize this data to offer seasonal
care or yearly packages including preventive care, dental cleaning, emergency visits,
and discounts on boarding, grooming, pharmaceuticals and nutraceuticals.

For large animal practices, electronic communication allows veterinarians to maintain

contact with clients beyond an annual visit. By tracking herd data, veterinarians can
share training opportunities, medication storage and handling requirements, and
procedural safeguards. You can distribute new product information, regional infection or
infestation concerns, and legislative updates each quarter. Webinars, white papers and
quarterly pest reports create additional opportunities that can result in more visits and
increased revenue potential.

IMPROVE QUALITY OF CARE

As technological improvements continue to advance the level of care veterinarians are

able to provide, affordability and accessibility have allowed more widespread integration
into smaller practices. Diagnostic lab equipment has become easier to acquire and
maintain in-house, offering more immediate results that can seamlessly integrate into
electronic patient charts.

Laparoscopic and laser surgery provide less invasive procedures and shorter recovery
time, while diagnostic imaging such as CT scan, ultrasound and MRI allow earlier
diagnosis and provide baselines for before and after care. 2 Diagnostic imaging offers
more options for larger animals, too, including more in-depth looks into the head and
digestive tract; potential use in neurologic, orthopedic and soft tissue treatment; and
studying heart diseases.3

Since its introduction in the 1980s, strides in 3-D printing to make orthotics and
prosthetics, to aid in surgical reconstruction and to make practice models also offer
exciting new developments in education and surgery as the technology becomes less
expensive.4,5 The practice of pet microchipping is growing, as well. Along with placing
the implants, veterinarians record pet registration information in microchip manufacturer
databases, which are interconnected through the American Animal Hospital
Association’s lookup tool.6

Biotechnology advancements in veterinary care continue to follow trends in human

healthcare, including cancer vaccines and stem cell therapy. And as statistics show
people are willing to allocate greater amounts of money toward pharmaceuticals and
treatments for their pets, new drug interventions also may offer higher profit potential
moving forward.

With so many new diagnostic capabilities, veterinary practice software has evolved to
integrate with laboratory and diagnostic equipment and to streamline data, lab results
and images directly into a patient’s medical record. This data capture can be shared
with other veterinary specialists for dual treatments, consultations, training or
educational purposes. The use of Internet-based platforms also allows vets to share
and access data in a central repository. This level of integration also provides
opportunity to connect to mobile devices to allow veterinarians to easily access data for
off-site appointments, producer calls or equine visits.

INTEGRATE PATIENT AND PRACTICE DATA ONTO A SINGLE PLATFORM

By integrating scheduling, charting, blood work, testing, billing and patient reminders
into a single platform, veterinary practices can realize significant time and cost savings,
increase productivity and improve patient care. For smaller practices with fewer
resources, outsourcing certain components such as client communications, payment
and collections, data security, inventory management and staff training can reap
tremendous benefits. Technological integration streamlines the delivery of information,
reduces labor time and chance for human error, and increases a practice’s ability to
reclaim payments to enhance efficiency.

Whether you opt to purchase integrative software or decide to outsource some services,
there are many ways technology can significantly benefit your veterinary practice:

 Schedule appointments, track client information and show patient history on a

single platform
 Integrate patient data and track practice performance
 Measure and monitor business efficiency and profitability
 Capture and store diagnostic images
 Easily search practice records by client, disease state or by other specified
criteria
 Track and order retail and drug inventory
 Integrate with lab equipment for seamless result charting
 Access practice data from a mobile device for off-site visits
 Identify the success and response rate of patient reminder efforts with detailed
analysis reports
 Review practice analytics for top selling treatments and items to track top clients
and patients
 Integrate practice management software to provide a dashboard that identifies a
practice's strengths and opportunities for improvement by tracking 40 key
performance indicators on a monthly basis, such as customer loyalty, revenue
growth and retention

TELEMEDICINE, APPS AND THEIR CHANGING ROLES IN THE INDUSTRY

Telemedicine is even currently a topic of discussion among the American Veterinary

Medical Association (AVMA), which has been investigating the role of telemedicine and
how it might be used appropriately within the veterinary profession. 7

Telemedicine makes professional development and continuing education training more

accessible and economical and can be used as a teaching tool for veterinary students.
Telemedicine offers immediate access to specialists who can quickly review radiology,
pathology slides and other diagnostic data to even more remotely located practices.
This faster and increased reach continues to revolutionize the way veterinarians
diagnose and treat patients.5
The health sciences and veterinary medical libraries at the University of Minnesota and
the University of Pennsylvania provide lists of apps organized by use for veterinary
students, general veterinary reference, small animal, equine, exotic/wildlife and food
animal.8, 9

CONCLUSION

There are several digital and technological trends that are transforming the veterinary
industry:

1. The seamless delivery of information between practitioner and patient provides

opportunity for repeat contact through appointment reminders, vaccination
updates, tracking health conditions and upselling yearly maintenance care.
2. As technological improvements continue to advance the level of care,
affordability and accessibility have allowed more widespread integration into
smaller practices, including diagnostic imaging, biotechnology and 3-D printing.
3. The integration of patient and practice data into a single platform provides
detailed information on improving employee productivity, streamlines the delivery
of information, reduces chance for human error, reduces labor time, and
increases a practice’s ability to enhance efficiency and improve patient care.
4. Telemedicine and mobile apps continue to make information more accessible in
less time and for less money.

CASE STUDY: Veterinary Practice Payroll Case Study

https://www.payrolloptions.com/accurate-time-payroll-
outsourcing/testimonials/veterinary-practice-payroll-case-study/
Conclusion of case study:
Despite Jo improving the way she managed the payroll herself, and learning a
surprising amount about payroll in a short time, she still decided that outsourcing was
the best option for her and her company. She would not have to worry about an
incorrect calculation or submission, and suddenly she would have more time to spend
on everything else she needed to complete.
Jo also decided to take up the option of BACS payments to automate the payments to
her staff. Keying in individual amounts via online banking was one of the chores that
really needed to go, and the opportunity for Payroll Options to make the payments on
her behalf was too good to miss.

Jo now has peace of mind that the payroll is being looked after correctly, more time in
her day, and can even take holiday around pay day.
IT Outsourcing Services That Align with Your Veterinary Practice Goals
Navigating technology can be a daunting challenge for any doctor, business owner,
practice manager, or IT director. Having a trusted business and technical adviser who
can support you through all elements of technology strategy, IT management, and
technical support delivery can help save significant costs and headache. By aligning
practice goals with technology strategy, employee effectiveness and productivity
increases, goals are achieved in a timelier manner, and technology serves as a
strategic asset in the delivery of patient care.
We understand the unique business and IT needs that you face on a daily basis. Our
team of IT professionals has experience supporting__________________, and are
looking to expand our expertise with other practice management software solutions.

 Budget for IT expenditures by removing variable costs associated with IT

management
 Apply technology as a strategic asset to gain competitive advantage
 Focus on practice objectives, tasks, and patient care rather than handling your
own IT problems and providing help to other team members
Sources
https://www.businesswire.com/news/home/20190702005182/en/Partners-Group-to-
Invest-in-Blue-River-PetCare-a-Leading-US-Operator-of-Veterinary-Hospitals
https://www.vetfolio.com/learn/article/in-practicewhen-not-to-do-it-yourself-outsourcing-
in-the-veterinary-practice
https://northamerica.covetrus.com/resource-center/education/case-studies/growing-role-
of-technology-in-a-veterinary-practice

Merriam-Webster Collegiate Dictionary. Accessed December 2010 at merriam-

webster.com/dictionary/outsource.

Drucker PF. Managing Oneself. Cambridge, MA: Harvard Business Review Classics;

2008.

The World’s Most Valuable Brands. Who’s Most Engaged? ENGAGEMENTdb. July

2009. Accessed December 2010 at engagementdb.com/Report.