Tuesday, May 23, 2017

Remaining Solo: 5 Strategies

1: Go micro: go super small.  One doc.  One staff or no staff.   EHR, patient portal, no phones.  No insurance.   Good option for family doc. 

2: Go concierge: charge extra fees.  No insurance.  Good option for family doc

3: Go super special: cosmetic, anti aging, infertility.  Easier said that done. Good for plastic surgeon and derm.

4: Go non par: take no insurance.  Bill at crazy out of network rates.   Good for neurosurgery, Ortho, general surgery

5: Go stupid busy: how the rest of us do it. Take everything.  See everything.  Work everyday, everywhere.   Not sustainable. 

For option 5: rethink contracts.  Get in with IPA. 

Any other options? PM me.

Thursday, May 18, 2017

5 Threats to Independent Care

Independent practice is under inexorable assault.  Here are the 5 latest threats.

  • MACRA/MIPS  This is a very complex endeavor.  No one who I have spoken to really knows precisely how to proceed.  It is also a zero sum gain: the bonus payments from successful practices come from the deductions from the unsuccessful ones.  
  • Cyber security  If you use any electronic resources, which includes electronic claims submittal, you are at risk for malicious cyber attack.  Protection in the form of best practice IT solutions and insurance cost $$$
  • Cost sharing/deductibles  Even for patients with insurance, the dollar amounts of deductibles have risen dramatically over the past 10 years, far outpacing wage increases.  This translates to fewer patient visits and more expensive collection efforts
  • Consolidation   Health care has become consolidated over the past 15 or so years.  In some markets there is only one payer. On the provider side there has been a major shift to employed models into larger and larger entities.  This means drying up referral networks combined with declining reimbursements to offices and increased premiums for employee health insurance.
  • Income inequality  The majority of increases in wealth, income, and standard of living have gone to the top 1%.  Most doctor practices cater to the lower 99%, who struggle to pay bills and as such, put off health care as long as possible.  
Sorry for the doom and gloom but it is what it is.  Solutions in next post.

Thanks for listening.

The IU.

Wednesday, May 17, 2017

The latest and greatest tools

Always important to have the latest and greatest tools. You know the saying: with the right tools any job is easy.  


Wednesday, May 10, 2017

I am back!

I could find my login for this blog but just remembered it. I am back. Sorry for the delay. I have nothing else to say.