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Can You Convert Your Practice to a Cash Practice?
With all the changes coming down the pike with the healthcare reform bill
, you should be strategizing on how to accommodate these changes into your practice, while still maximizing patient care and profitability for your practice. While this seems like a tall order, (only because it is) you do have time until the majority of mandated changes take place in the healthcare insurance industry. Most of the effects of the healthcare reform don't take place until 2014, with only a few beginning in 2012.So, let's look at some of the adjustments that you can make, gradually, to ensure that you can continue to provide quality care to your patients in the future.
One potential aspect of your practice that will need to be emphasized is the switch to a cash practice. This need not be as hard as you may first envision the switch, but in many instances it may be required, especially once the rationing of healthcare becomes necessary. And make no mistake about it, the healthcare reform bill almost guarantees that healthcare rationing will take place in the future.
In my younger days, I spent time in New Zealand and in England and saw first hand how their National healthcare systems worked for the average citizen. Even though there was universal healthcare coverage, many people paid cash for services that they wanted (or needed). There was a two-tiered healthcare system in place; an official system where the government paid for healthcare, though the wait was sometimes long, and a cash system (often separate doctors) who accepted cash for quicker appointments and procedures. This was especially true for alternative providers, whose services were not covered by the national healthcare system, or were only reimbursed with a medical doctor's prescription.
I originally thought that only the rich would be able to afford the high tax rate to help support the National healthcare system AND pay additional cash for services that they wanted, but that was not the case. Many working class citizens (especially those who were self-employed or farmers) could not afford to wait to be seen by the government provided doctor, so they went to cash only doctors. These patients had to get back to work as quickly as possible in order to keep food on the table and a roof over their heads. This was especially true for those seeking treatment that was deemed non-critical by the government.
The point I'm trying to make is that even in a society where medical care is free', people will pay for medical care out of their own pockets, if they feel that they benefit. Here in America, too many people have had their medical care provided by someone else (usually their employer) and have come to view medical care as a right', when clearly it is not.
The challenge that doctors face is changing their patients' attitudes back to where they are responsible for their own healthcare. If, and when, patients take the responsibility for their own healthcare, doctors can return to treating patients as they require care, not as an insurance company (or government) decides the patient needs to be treated. Returning to a fee for service, cash practice, will benefit both the doctor and the patient.
The patients of most alternative healthcare providers (which you have already incorporated into your practice, right?) are already accustomed to paying cash for the treatment that they receive. Most of these patients probably have medical insurance provided for them through their employer, yet they go outside their coverage to receive the care they feel they need. This clearly shows that people will pay cash for healthcare treatment, if they feel that their insurance doesn't provide for their needs. These patients will be much more amenable to paying cash for their medical treatment also.
From a purely logistical, financial, viewpoint you, as the doctor, should be able to provide better and less costly treatment if you provide the treatment and the patient pays for their treatment as they leave. This is more efficient than having the employer hire an HR firm, who pays an insurance company, who pays an adjuster, who pays a claim sent in by a medical billing firm, (who was hired by a medical practice), after hiring someone to review the treatment notes, which were sent by a transcription service (hired by the doctor's office), after the doctor dictated his notes justifying his treatment for the patient.
That is why the ultimate cost to the patient can be up to 50% less for the same service in a cash only practice. Of course, the patient doesn't realize all these costs, which they are already paying for, are already built into the system.
There are still the problems of malpractice concerns and the documentation and defensive medicine which that entails; and the millions of lost jobs involved in the whole insurance-medical-legal complex, but these issues can also be resolved and will be discussed in future postings.
www.hna-net.com
Can You Convert Your Practice to a Cash Practice?
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