OP/ED — Concierge Medicine: A hedge against Medicare/Medicaid reductions?

By Sigmund Software, LLC is part of the VSS Medical Group

MAY 2015 – Ever increasing costs and ever more regulatory controls are adding ever more pressure to many practices already seeing reductions in their Medicare and Medicaid reimbursement levels. This pressure has in turn led many practices to seek alternatives revenue streams, and one increasingly popular source of revenue in particular: Concierge medicine.

In this business model a practice is not dependent on payers, insurance companies, or Medicare incentive payments. In fact, many concierge doctors don’t even accept insurance payments or patients. Rather, in concierge medicine, doctors set fixed monthly or annual fees. For payment of this flat fee, patients receive unlimited access to their doctor. Occasional co-pays balance things when needed, but in the course of regular business everybody wins. The practice receives a steady and independent source of income. Patients receive the healthcare they need with a simplified payment structure, often at a lower cost than through a health plan, one which makes their health costs far more manageable and worry-free.

Practices and doctors engaged in concierge medicine are exempt from Medicare billing issues. No ICD coding disputes. No claim denials. Future plans to reduce Medicare incentives hold no fear. Meaningful Use incentives, along with the regulatory requirements governing them, can be ignored. Simply, without Medicare or Medicaid, there are no hoops through which a practice needs to jump.

This of course does not mean that concierge doctors do not need health IT. Quite the opposite. The use of patient portals and health information exchange systems will allow faster and more effective data transfer. Practices which adopt health IT will see patients flocking to their doors. Interoperability with hospital and clinical systems will make patient medical data flow much faster, giving improvements in workflow which will allow treatments of more patients, faster. Patients will also like this, be assured.

Whether a practice is engaged in concierge medicine, Medicare, Medicaid, or any alternate business model, it is clear to see that technological improvements to practice systems will ultimately hold the key to effective revenue cycle management and overall profit margins, as well as improved clinical quality of care and patient treatment. As with most spheres of business, technology offers golden opportunities for those that adopt early, and this applies even more so to healthcare.

SOURCE: http://www.sigmundsoftware.com/news/sigmund-blog/283-concierge-medicine-a-hedge-against-medicare-medicaid-reductions.html

Categories: Op/Ed, Physician

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