Our weekly series of “Getting Back to Basics with Your Business Systems” is designed to help ensure you are running a profitable business. This week we will review the potential money you are losing due to the demand of patient management and reporting. Read below and follow over the next few weeks as we reveal new pointers that will allow you to take an “outside” look at your business systems and encourage you to make changes if needed.
Get paid for EVERYTHING you do!
The market is changing and your reimbursement models should be changing with it.
It’s no longer all about Fee for Service. Patient and population management and reporting is more demanding and time intensive than ever. You should be paid for this management! After all, you are ultimately footing the bill for it (i.e. personnel, training, risk, etc).
Managed Care Contracting does include fee-for-service (FFS) payments and likely always will. But increasingly and especially for Primary Care Specialties there can be an element of Capitation (Per Member Per Month) payments in addition to the FFS. What the health plans do not talk about, as much as they should, is that your cost of doing the business of Population Health is paid for by the PMPM dollars …but very little any more. They are trying as best they can to make it a zero sum game. You saving them money on the FFS side and the Population health costs them noting – they win, you lose.
Take heart, there are lots of ways to win. It takes experience, industry knowledge and…often more than anything the willingness to ask, what may feel like, a lot of dumb questions and demand answers! Remember, payers do not provide health care, they sub-contract it to you! Believe it or not, you have all the power, you and your colleagues often times just don’t know what exactly and how to wield it.
You can get started TODAY with RT Welter’s FREE revenue assessment. Offered with no obligation, you will receive a free revenue assessment and free follow up consultation to see where and how much you might be losing. CLICK HERE to learn more about the assessment and contact us to schedule your review!
Click the links below, from our “Getting Back to Basics” series, to ensure you are getting the most out of your practice!