There’s a great debate going on in the medical community about the financial viability of treating patients covered by government-backed healthcare insurance.Many providers have said publically that they can’t afford to see those patients and will send them elsewhere for treatment.
In this timely article, Nitin Chhoda examines why it’s imperative for clinicians to learn about state and federally operated healthcare plans.
The list of federal health insurance plans is impressive. It includes Medicare, Medicaid, Tricare, CHAMPUS, Workman’s Compensation and Medigap plans.
Federal healthcare programs are in operation that provides incentives for clinicians in areas where a shortage of healthcare providers has been demonstrated.
The programs provide payments to recruit and retain practitioners, and awards incentive payments to providers who are already established in those areas. Some states have their own incentive healthcare programs.
Quality healthcare is at a premium in rural areas and patients are often woefully underserved. Clients tend to be older, poorer and have more health problems than their urban counterparts. Medicare maintains supplemental reimbursement healthcare programs for practitioners and clinics in rural areas.
Federal Health Programs Advantages
Each healthcare program has its own set of advantages and federal healthcare plans provide clinicians with a significant patient pool from which to draw. There are 9.64 million patients enrolled in the Tricare program alone.
Medicare pays 80 percent of patient costs and payment for practitioners participating in the Medicare healthcare programs receive reimbursements that are 5 percent higher than non-participating clinicians. Ninety percent of clean claims are processed within 15 days and payments are made within 30 days. Providers can join the Medicare network or accept patients on a case-by-case basis.
State Healthcare Programs
A majority of states operate their own healthcare programs for women and infants, along with children up to a specific age. Plans may offer prenatal and obstetric care for women and infants, along with a myriad of services for children and teens.
Coverage typically includes well child visits, dental and vision care, vaccines, prescriptions and medical supplies, mental health and substance abuse coverage, surgery and hospitalization, and diagnostic tests.
Participating in state run healthcare programs increases a clinic’s client base and many of the services can be accomplished quickly, giving simpler physical therapy documentation process, allowing practitioners to see more patients.
Many practices are choosing to employ nurse practitioners to see this particular demographic. Even after salaries, clinics can double the number of patients being treated and revenues.
Practitioners participating in state and federal healthcare programs increase their patient base and their overall revenues.
Providers practicing in rural areas can further stimulate income through supplemental and incentive programs. Government-operated healthcare programs serve millions of individuals throughout the nation, providing practitioners with a steady stream of revenue.