The business of medicine in 2018 is more difficult and complex than ever before. Political trends and policy changes have left the state of health coverage in flux, directly affecting healthcare on all levels and creating wide-reaching uncertainty across all patient populations. In today’s healthcare world, managed care groups can change the rules of engagement, and health insurance carriers annually lock medical professionals into opaque agreements that make doctors reconsider their independence. With continued policy changes likely, you can expect a major reshaping of the ways both consumers and providers will be able to obtain and utilize insurance. This article explores a few strategies your practice can implement to ensure maintenance of clinic revenue and quality coverage for your patients.
1. TRANSITION TO A CONCIERGE PRACTICE FOR SELF-INSURED PATIENTS
One of the latest trends in clinical practice focuses on patients who are able and willing to pay for the highest level of medical care. The concierge model of medical practice centers around delivery of patient care in a personal and flexible clinical setting. Patients who are able to see a doctor in a concierge medical practice can expect very little wait, longer face-to-face times with the doctor, and a personal touch that is difficult to deliver in managed care agreements, which require higher patient volumes.
Within this model, physicians can retain a higher level of independence in the design of their treatment plans, and can spend more time addressing the individual needs of each patient who visits their practice. The level of flexibility available to concierge-style physicians and their patients often translates to increased potential revenue and a higher level of patient satisfaction. If you feel that this may be a good option for your practice, there are many consulting groups that can help your practice transition to this creative new model.
2. PARTICIPATE IN CLINICAL TRIALS / RESEARCH
Increased investment in new drugs, medical devices, alternative care models, and other research opportunities has created an important role for providers in the realm of clinical trials. Deciding to engage in clinical research can provide access to care for uninsured patients and those who may not have the financial means to secure the care they would like. Clinical research can also be a good option for providing alternative care for patients with few treatment options within existing medical models.
Although this isn’t a quick and easy path to additional revenue, medical providers who succeed in creating research practice lines typically report a high-level of satisfaction, elevated stature in the medical community, and positive financial outcomes for their efforts. Depending on your interests and goals, there are opportunities to fully transition your clinic into a research site, or to simply run a few clinical trials within your practice. Find an experienced consultant to guide your practice’s involvement in research, or consider joining a network that might assist you in finding studies that meet the needs of your clinic’s patient population.
3. GET CERTIFIED AS AN INDEPENDENT MEDICAL CLAIMS REVIEWER
As a provider, you’ve dedicated your life and mental ability to helping people in need, and you’re devoted to the continual improvement of the quality of healthcare. In today’s challenging healthcare landscape, there is a real need for peer-to-peer oversight and quality control. Becoming an independent claims reviewer can be a great way to extend your dedication to the advancement of healthcare quality and ethics beyond your individual practice.
This certification allows you to use your extensive training, knowledge, and drive to offer objective opinions regarding patient diagnoses, treatment plans, and future medical care needs. As a qualified claims reviewer, your clinic will not only see additional revenue resulting from this duty--you and your practice will hold stand-out expertise in your field. Your opinion will be cited, and you’ll be relied on as a medical expert as you help non-medical professionals settle claims to the benefit of both patients and providers.
4. ADD PERSONAL INJURY & WORKERS’ COMPENSATION TO YOUR PRACTICE OFFERING
Post-accident injury care is one of the most complex areas in healthcare coverage. Insurance companies have a vested interest in keeping the process confusing enough to limit patient and provider participation after an accident. This confusion leads to extra administrative work for your staff and missed opportunities for clinic revenue as you provide care for patients in need. Plus, without clarity in injury care coverage, patients are often left without access to or knowledge of the opportunities for care that will provide the best long-term outcomes.
The most successful providers engage healthcare-focused capital funds to offset internal costs of injury care. Partnering with an experienced revenue cycle management (RCM) company can give your clinic instant back-office support for personal injury and workers’ compensation patient claims. Such a partnership can lift common financial roadblocks from your practice as RCM experts navigate co-pays, high deductibles, and delayed reimbursements that are common when dealing with accident claims. SyndeoCare has turn-key solutions for doctors who want to realize substantial increases in practice revenue without having to invest in labor, durable medical equipment or expensive marketing campaigns. Providers who engage in these partnerships are able to focus on quality patient care without the financial pitfalls that are common with injury claims.
The landscape of healthcare in 2018 may be rife with uncertainty, but that doesn’t mean the quality or value of your practice has to suffer. Each of the suggestions highlighted in this post will bring a level of patient-focused expertise to your clinic. By adapting your practice, you can maintain independence and flexibility, and create new streams of revenue while reaching new levels of quality patient care. Whether you transition to a concierge clinic, participate in research, become a certified claims reviewer, or work with expert affiliates such as SyndeoCare, there are many options for adapting your practice in the face of uncertainty.