Stop Complaining About Declining Reimbursements and Do Something!
I’m continually miffed by the outrage expressed by physicians about their declining reimbursement rates. Now there’s a whole new list of reimbursement models that are starting to be pushed including “Medical Homes”, ACO’s (Accountable Care Organizations), vertical integration and bundled reimbursement. Many pundits believe they are disguised words for “capitation” and will result in further decline in physician revenue.
I don’t hear any other business in America complain about their declining “reimbursement” rates. Why? Because they don’t get reimbursed by a third party. Why is it that physicians think third party reimbursement is the only way to get paid? If you don’t like the way you get paid and you feel at the mercy of those who set the reimbursement rates, then I would suggest finding another way.
As I speak to physicians of all varieties around the country, the ones who are most enthusiastic about their career are the ones who are finding a new way to get paid. The most common strategy is to integrate ancillary and cash procedures into the practice. Patients (better referred to as consumers) spend billions out of pocket on their healthcare. They would prefer to do most of their out-of-pocket spending at their doctor’s office. Most doctor’s don’t offer the choice.
It’s time to stop complaining about reimbursement rates and surrendering to the third party payers. There is a whole other world of compensation out there waiting for you to grab. Figure out how you can capture a small slice of the out of pocket spending from your patient base. That’s all you need. There are proven programs out there that work. Many physicians will attest that this, more than anything, has brought life back into their practice.
This entry was posted on Tuesday, November 23rd, 2010 and is filed under Cash Medicine. You can follow any responses to this entry through RSS 2.0. You can leave a response, or trackback from your own site.
- #1 by Dr. Susan Sykes on November 23rd, 2010
The patients expect you to bill their insurance and have a hard time understanding when you opt out of their insurance or offer them cash plans, even when the cash plan is better for them than billing their insurance. I have lost patients because I told them I could no longer bill their insurance because their level of care was no longer covered, even though they still had benefits.
I know that theoreticaclly, if I provide outstanding service (which I think I do) it will not matter if I am in network with a patient’s insurance, but how many people off the street know how to differentiate me from someone else. They feel safer going to someone in network than not and it becomes their main criteria.
- #2 by M.BrandweinDC on November 23rd, 2010
Give examples of what services can be offered for cash reimbursement
- #3 by Tom Jones on November 23rd, 2010
Wow…. This was nasty. Not proud of yins at all for posting this…..
- #4 by austin on November 23rd, 2010
Of course you want patients to pay. If you aren’t paying what the doctors are worth, mind as well put it off on the patient. The more they pay, the more your company gets to fill its vaults.
- #5 by Fred Roh, EdD on November 24th, 2010
This post was not intended to be nasty but rather spell out the reality of what doctors now face. When I speak of cash medicine, I’m referring to healthcare products and services that are NOT reimbursable by insurance. There are many that doctors around the country are noffering and patients are paying out of pocket. A few are: pain managment using theraputic lasers, nutraceuticals, in-office drug and DME dipensing to name a few.
- #6 by Chris Carraway, DC on November 24th, 2010
There are quite a few choices out there. Nutrition is one area to help patients and charge cash. Weight loss, smoking cessation….etc.
I started using low level laser therapy (LLLT), since I am in the pain abatement business like you. LLLT is an FDA clear therapy that is backed with a moutain of science behind it. Patients love it. It works fast, is noninvasive and my patients are paying cash for it. 90% of my patients opt for LLLT when I explain it to them. They are referring folks regularly for LLLT. Adding it to my practice has meant a lot to my bottom line this year.
- #7 by Ven Challa, MD on December 15th, 2010
It costs $ 60 for a head MRI in India Vs. $ 1560 in my hometown USA. It is all cash and carry medicine over there and everyone is happy. There is an MRI on every street corner (not literally but quite close). Providers in USA loved the reimbursements that lured them into insurance based medicine and now are being squeezed by the ratcheting down, led by Medicare and Medicaid. My suggestions are: 1) offer cheaper cash and carry medicine 2) be choosy or accept as few as possible of Medicaid and Medicare, so that the govts. get their lesson, and 3) us providers should stick together or we perish.
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Thursday, 05 July 2012
posted by bob feser
Third party payments are accepted because they are perceived to have value. If the value erodes enough they will no longer be accepted. This would result in cash payments for healthcare at all levels. Practitioners could still submit claims but reimbursement would be to the patient. Entitlement benefits and insurance benefits are agreed upon by the consumer and the providing entity, why be trapped in the middle? Cash may be required for all healthcare to keep it from being transformed into a public utility.
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