With the coming of the New Year several health care professionals are noticing some drastic changes in their reimbursements.

First significant change is that patients have a higher deductible.  Higher deductibles mean that insurances will not pay until after the patient has met his/her deductible.  While there is a possibility that some patients do understand this process they may still try to get away without paying by saying: “bill my insurance”.  

Reality of life is that the best opportunity for you to collect your money is while the patient is in your office.  In some cases this may result in other changes to your Practice as you may need to have a space where you can explain to the patients why they have to pay in advance.  Additional changes relate to the accountability of the funds as lack of check and balances may result in some of these funds getting lost. 

Another issue that some Practices are experiencing is the increase in patient with insurances but lower reimbursement.  I personally have experienced a reduction in foot traffic, a reduction in income and more procedures that are not covered.  It is quite a conundrum as my overhead continues to skyrocket due to the all increasing legislation, healthcare technology requirements and the all dreaded ICD-10.

Some of our colleagues have turned to Concierge Medicine as the cure for our maladies.  Others are looking at diversification and have added multiple services and procedures.  Of course a few others have embraced the process and are going the way of increasing patient volume in order to increase income.

My take on it is a hybrid.  We implement concierge programs based on location, specialty and area demographics.  In other words, no two concierge programs are the same.  We also look at ancillary services and products in order to increase our reimbursement.  Why should my clients go to Walmart or CVS to buy products that I could offer in my office?  This topic alone was one where I spent quite some time researching and came up with the answer that is my fault for not providing my clients with the opportunity to buy the right product from me.  Worst thing about it is that we may end up explaining how to use these competitors’ products.

I do believe that part of the solution is based on the hospitality model.  There is no reason why we cannot follow on the footsteps of Disney and the Hard Rock Café model.  We should be ale to offer the services they need and making the whole process an experience where they feel good they came to us.  But of course it is easier to write it than to complement as we need to change our whole culture to make it work.  However, as a good friend of mine, Dr. Jorge Otero phrased it: “thank you for choosing our services.  We know you have other options and are honored you selected us at ABW Pediatrics to take care of your child.” 

With all of these changes all I have to say is: let’s take control of our market, offer our clients a life experience and practice good medicine.