For independent physicians, surviving and running a profitable practice is becoming more and more of a challenge. Of course, independent physicians have long faced reimbursement cuts, regulatory burdens, and malpractice costs. This is not new territory for physicians. However, physicians are now expected to provide higher quality care at a lower cost. Their reporting and tracking demands have increased. And the high-potential for liability remains a concern.
It is not a stretch to anticipate that increases or decreases in patient encounter volume will likely be matched by similar trends in allegations of malpractice. As a way to avoid potential liability, some physicians report practicing a much more conservative approach to their treatment and diagnosis options. In other words, there may be a tendency to practice a kind of defensive medicine. For example, physicians may order more diagnostic procedures than might be necessary in an effort to protect themselves from potential future litigation.
Compliance issues are also a part of this mix. Staying compliant in a fast-moving, digital world can be both complicated and expensive. The ICD-10 compliance deadline is an additional burden. And it comes at a time when physicians are trying to meet several other federal technology requirements and risk penalties if they fail to do so.
With the necessity of electronic records, keeping patient information secure is growing more complicated. Many physicians are not aware of the requirement to complete and keep an updated security risk analysis. This is a requirement of both the Health Insurance Portability and Accountability Act and meaningful use.
The “Requirement” for Satisfaction
Government programs such as the Physician Quality Reporting System indirectly tie Medicare reimbursements to patient satisfaction scores. The problem for physicians is that the goal of patient satisfaction isn’t always aligned with the goal of providing the best care. And because physicians are being judged by their performance grade card, it’s in their best interest to protect their livelihood. This may cause physicians to modify their practice patterns, in an effort to improve their scores.
Doctors who say “no” to their patients, for example, who may be requesting unnecessary antibiotics, do so with the understanding that patient dissatisfaction could end up eventually affecting them in the form of a pay cut. That’s situation is inherently problematic.
Actually Getting Paid
Many private practices are choosing to opt out of Obamacare entirely, citing reimbursement rates that are simply below acceptable standards. For those who are not opting out, they are finding themselves under constant pressure to get paid for the work they do.
If a patient in a subsidized plan falls behind on their premium payments, the Affordable Care Act requires insurers to cover their medical bills for 30 days. But for the next 60 days, insurers may hold off paying the claims — and ultimately, deny them if the patient doesn’t catch up on his premiums.
What does this mean to doctors? In this scenario, a doctor will not get paid for their services. If the insurer ends up cancelling the policy after 90 days, doctors can bill patients directly but collecting that money is another challenge. For some medical specialties, treating patients who have fallen behind on their payments could end up being quite costly.
Non-Insurance Based Revenues
So how are some physicians adding popular in-demand procedures and treatments that are non-insurance based? Quite simply, they are bringing their marketable skills and expertise to an industry that is hungry for their talents – they are entering the consumer-driven aesthetics industry.
With non-insurance based revenues, they do not face the same administrative nightmares that have ballooned under the Affordable Care Act. And they are generating profits that far exceed their traditional practices. The numbers are impressive. By simply adding 10 Aesthetic & Weight Loss patients per month, a practice can earn in excess of $500,000 in non-insurance Revenue. That’s a staggering amount when compared with the financial and other pressures facing independent physicians.
Fortunately, there are industry experts that are able to help physicians transition to the lucrative aesthetics industry. One of the leading programs, the Aesthetic Medicine Symposium, has been structured and streamlined to not only provide physicians with hands on training in the most popular and profitable procedures, but also a financial and business foundation to be successful in this new economy.