Ammunition for Your Fight Against Declining Reimbursements

If recent cuts in reimbursements have you seeing red, you’re not alone. Many doctors have told us about their mounting, insurance reimbursement-related financial burdens and shared their frustrations. We recently spoke to a gastroenterologist who was distraught over the proposed 19% cut in colonoscopy reimbursements. His is just one of the hundreds of stories we hear every month from medical doctors and dentists trying to get ahead of diminishing reimbursements and increasing financial burdens.

“A Camel is a Horse Designed by a Committee”

In this case, it’s a committee of 29 physicians, called the Relative Value Scale Update Committee (RUC), whose job it is to rate the relative value of health services rendered and guide the Centers for Medicare & Medicaid Services, known as CMS, on reimbursements. As you know, commercial insurance companies quickly follow whatever CMS decides for Medicare reimbursement.

Back in 2012, CMS identified colonoscopy, EGD and other GI endoscopy procedures as being potentially “misvalued” through the Misvalued Code Initiative. The American Gastroenterological Association and surgical societies provided recommendations for over 100 GI services.

Unfortunately, RUC failed to follow its own processes during their January 2014 code review. To make matters worse, CMS did not base its valuation on the mountain of real-world data collected by three respected GI societies. They ignored the robust data that showed no change in physician time or intensity for colonoscopy procedures. Instead, RUC used time and intensity data from a different specialty, resulting in a recommendation not supported by the RUC/CMS’s own “gold standard” for survey data.

How Physicians Are Turning Reimbursement Lemons Into Lemonade

Gastroenterologists aren’t the only doctors fighting this. It cuts a wide swath across medicine and the medical specialties, causing fear and financial pain. What’s more, it has driven many doctors to reevaluate their practices and find a variety of solutions that allow them to move toward higher reimbursements and more control over their incomes and financial futures. The most popular solutions include:

Concierge Care

How many times have you wished you could break free of the traditional healthcare insurance model and eliminate your reimbursement hassles? With concierge care, you can. You can create real partnerships with your patients based on annual or monthly fees and higher standards of care. The basic concierge medicine model, which has multiple iterations, allows you to spend more time delivering exceptional care to your patients and far less time administering paperwork for health insurance companies.

Weight Loss Services

We know many GI physicians (and other specialists) who have successfully added cash-based weight loss services to their practices. In many cases, the healthcare marketing consultants at Practice Builders helped them create and market the new services to their patients. Having consulted with over 15,000 healthcare practices (doctors, dentists, veterinarians, physical therapists and ancillary providers) since 1979, Practice Builders is uniquely positioned for medical practice marketing with proven healthcare marketing strategies. We have helped many practices in many specialties successfully transition to part-time and full-time weight loss practices.

Integrative Services

Our healthcare marketing specialists have also helped gastroenterologists build and grow integrative practices that focus on nutrition services, diagnosing and treating food allergies, wellness and fitness, weight loss and more. We start with a healthcare marketing plan designed to help you reach your goals.

Instead of living with the fear and uncertainty that come with declining reimbursements, take a positive step toward greater financial stability for your practice and yourself. Talk to a Practice Builders’ healthcare marketing consultant and find out how you can improve your financial outlook for the future. Call 800.679.1200 to learn more.

If you wish to comment on this electronic newsletter’s content or subject matter, please email the editor at: hedgar@practicebuilders.com.