The Affordable Health Care Act changed the healthcare landscape and it’s evolving further through new Medicare decisions. The only way for practitioners to financially survive the uncertainty is through diversification. To help practitioners prepare for the future, Nitin Chhoda addressed Medicare payments and diversification.

MedicareIn a forced Medicare economy, clinicians need to diversify their practice to prepare for the loss of income that will come through the Affordable Health Care Act and the reduction in Medicare payments.

Practitioners need to implement cash paying services they can add to create additional revenue streams.

What Statistics Say …

Multiple payment reduction (PPR) now places limitations on payments. Medicare currently pays seventy five percent for PPR visits and it applies to clinicians in single or group practices.

Clinicians have seen a six percent reduction in payments on the low end and twenty percent on the high end.

Physicians have already seen the impact in the physician quality reporting system (PQRS). So far in 2013, practitioners have seen the incentive program go from voluntary participation to one that will be mandatory for eligible providers in 2015. Payments in PQRS are steadily being reduced.

Beginning in 2015, the program assesses penalties for providers that are “poor” reporters.

Many providers are concerned that Medicare could theoretically use PQRS data collected at eighty nine locations throughout the nation to set payments by geographical area. Apprehension also exists that Medicare might establish caps on the number of visits a patient can have to be considered “well.”

So What Are We Going to Do?

Will we be looking at patients as human beings or at the number of visits they’re allowed? Do we discharge them even if they’re not well because we won’t get paid?

Medicare may never increase – do we drop these patients? I would hope not, but I believe we’ll see commercial carriers doing the same things as Medicare.

The solution is a two-step process. Clinicians must be more efficient in the time they spend with patients, the types of codes they use, and the units billed when dealing with Medicare. An EMR is essential to plan, implement and market diversification efforts.

Systems such as In Touch EMR and In Touch Biller Pro, contain the functionalities needed to handle the undertaking, along with sophisticated training and strategies.

Diversify Payments and Create Cash-Paying Programs

Practitioners must also identify cash paying programs to make up for the loss in revenues. They can add the following to their practice:

  • Medicare coverageCash paying services such as products and services paid at the time they are received.
  • Accepting payments through cash, checks, debit and credit cards.
  • Selling supplements, medical products and durable medical supplies to serve the patient better.
  • Other cash paying options include weight loss clinics, massage therapy and personal training.
  • Diversifying into multi-faceted practices with alternative medicine, nutritional information, aquatic therapy, acupressure and corporate wellness programs.

Electronic medical records provide mobility for increased opportunities.

Changes in Medicare, combined with the Affordable Health Care Act, are changing the way clinicians operate their practice. Faced with very real financial deficits in reimbursements, clinicians must utilize cash paying programs and use their time more efficiently to ensure Medicare patients receive care and practices continue to flourish.