As of this writing, we are almost three quarters through 2019! Where does time go?! As we continue to take care of clients and immediate issues that are in front us, do not forget about your business planning for 2020 and beyond.
As a private practice, you and your team have seen its fair share of changes over the last few years. Some of those changes felt like they occurred overnight. But as you prepare your practice for the future, there are certain trends that you need to recognize now to prevent being caught off guard financially in the future.
Trend #1: The financial cost shifting of payment of your services to your Clients in the form of higher deductibles and co-insurance amounts continues to increase
Gone are the days of $10 co-pays for clients’ therapy visits. Your commercial clients now have deductibles that can exceed over $3,000 per person and for some, much higher. What that basically means is that most of your commercial clients are paying your practice directly for the services rendered.
Is your practice having these “financial conversations” with your clients regarding their financial obligations? I know this is one of the hardest parts of a clinicians’ practice. It is uncomfortable and can get in the way of the client/therapist relationship, if not addressed properly. But ignoring this trend will potentially cost your practice money and cause you to chase clients for their payment of services. Assuming our clients understand how their insurance plans work and their financial responsibility to pay for your services in a timely basis could be a very large leap of faith.
These financial conversations should take place regularly to make sure that “everyone is on the same page” and if there are financial issues around payment, they can be addressed early rather than allowing them to fester and create ill will.
Trend #2: More Clients are covered under Public Sector Payers, causing Practices’ Payer Mix to shift
Because of Medicaid expansion in Ohio, there are now over 500,000 individuals covered under Medicaid. Medicaid eligibility is now based on income guidelines for many citizens. And of course, the State of Ohio is contracted with Five (5) Medicaid Managed Care Plans (MCPs) to manage the health care costs of eligible Medicaid Ohioans.
Many practices report that they have seen a significant increase in the number of clients being treated that are covered under one of the Medicaid MCPs. And why not tap into that trend? The Medicaid MCPs typically do not require authorization for routine therapy visits and from a reimbursement standpoint, the Medicaid MCPs’ rival the reimbursement levels provided by their commercial insurance colleagues. But probably the biggest advantage, the Practice will not have to chase clients for huge deductibles and/or co-insurance amounts.
Is your Practice (and your clinicians) enrolled in Ohio Medicaid? Is your Practice credentialed and contracted with the Medicaid MCPs in your geographic area? What may not have been a viable payer option a handful of years ago, needs to be revisited today.
Trend #3: Clients will continue to use alternative forms of payment other than the traditional cash and/or check
We are in the midst of some powerful market changes. Technology is certainly revolutionizing our collect lives! Smartphones, the proliferation of apps, buying online, telemedicine are just some examples of these changes impacting our practices.
Private practices need to adapt to these technological changes too. Practices need to take advantage of the latest payment technology whether using a payment device that fits on a Smartphone or an online payment processing system.
With the health care service costs shifting more and more to your clients, accommodating clients’ Flexible Spending Accounts (FSAs) or Health Savings Accounts (HSAs) are a must. We must make it easy for clients to pay for their services.
I know for many private practices, it feels like incorporating all of these changes into your practice is like taking a drink of water from a fire hose. It can feel overwhelming and sometimes, totally out of our reach.
At G&M Consulting, we understand the issues that face behavioral health private practices. Our team has over 35 years of experience in credentialing, contracting, revenue cycle management and marketing. Please let us know how we can be helpful to your practice. Please feel free to contact us on our Contact Tab on our website!