It’s a fact of medical practice management life that unilateral decisions by other organizations can show up out of the blue and negatively affect the practice business, such as when a payer changes reimbursement terms or stops paying for a code that was previously reimbursed. In situations like these, practices have no obvious short-term option […]
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A recent Peterson-Kaiser Health System Tracker study revealed an interesting finding: average copayments are declining. Their study, which analyzed claims data from Truven MarketScan, found that average copay amounts paid by patients decreased by 26% from 2004 to 2014. Seems like a positive trend for patients and practices … except that it’s not. It’s part […]
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Many physicians we work with face the tough decision of whether to keep their practices independent or join a larger organization.  Oftentimes, physicians and practice managers believe they must consider such a move to “gain a larger footprint” for negotiations with payers. The advantages of larger groups in payer contract negotiations versus small and solo […]
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Mary Pat Whaley at Manage My Practice has posted great information about payers ‘encouraging’ practices to accept payment by virtual credit card, instead of by check or EFT. This method of payment is not a good deal for practices.  Merchant fees are deducted from credit card payments — meaning a further reduction in the reimbursement […]
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News reports have been trickling in over the past couple of weeks — growing in number — about Medicare Advantage (MA) plans dropping doctors. First, we heard about UnitedHealthcare in CT dropping doctors — then news came out about the same carrier dropping patients in NY, FL, RI, NJ, and, just yesterday, OH.  Sam Unterricht, […]
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When is the last time you analyzed your practice’s payers?  Too often, physicians and practice managers feel powerless against health plans — and don’t even question whether to continue to accept a particular plan.  Yet, even if your practice is located in a market in which you’ve found it increasingly difficult to negotiate higher reimbursement, that doesn’t mean […]
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Many medical practices we work with focus their marketing efforts (if they do marketing at all!) on physicians who refer to them and direct communication with their existing patients.  Yet there is another marketing channel that can be extremely effective for physicians that is often overlooked: your area’s major employers. It’s common to assume that […]
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