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Preparing for Reform’s New Patients

Preparing for Reform’s New Patients

After many months and much debate, healthcare reform in America is now a reality. While the Patient Protection and Affordable Care Act has only recently been signed into law, now is not the time for a wait-and-see approach. Make no mistake; the new legislation will have a significant effect on your practice. Physicians with foresight will seize this opportunity to take a hard look at their practice operations. Take steps to prepare your practice now, rather than struggle to keep up with the changes reform will most certainly bring.

Here are a few steps you can take to prepare your practice for the influx of new patients:

  • Get ready for new — previously uninsured — patients.
  • Newly insured patients may be unfamiliar with how health insurance works. They might not know about their copay and deductible obligations, leaving it up to you and your staff to fill them in. Assess your practice policies on collecting copayments and billing for deductibles. Those policies should be published in plain language for new patients, and patients should be counseled on their payment responsibilities as soon as they come into your practice.

  • Evaluate your payer mix.
  • An increased patient volume can also mean a shift in your payer mix. If one insurer winds up dominating the individual insurance market, a payer that once represented 10 percent of your revenue may swell to 30 percent. That’s not a big deal, of course, if you are comfortable with that payer.

    Look closely at your payers and determine which ones reimburse well and keep costs low. Be more selective and consider a short list of payers you may potentially drop in the future. If you are participating with, say, two dozen insurance companies, it may be time to pare it down. Look at costs and rates, as well as volume.

  • Rethink your scheduling.
  • How would you accommodate a 10 percent increase in patient volume without hiring additional staff? Maybe you need to extend your hours, at least temporarily, or consider other scheduling strategies.

    One option for practices with several physicians is a flexible “sick call” where physicians take turns seeing only urgent patients (which can be scheduled more frequently), while the others see well patients. This can help your practice see more patients than a traditional schedule would normally permit.

  • Consider additional staff.
  • It takes time to recruit and hire staff, so your practice should assess its level of staffing now and decide if the current number of physicians is sufficient to meet a growth in demand. Adding nonphysician providers is also an option. Hiring a nurse practitioner will cost less than adding another full-time physician and can help extend physicians’ time by handling patient counseling and education.

    Whatever you do, don’t panic. Although the legislation contains several provisions sure to affect physicians, most elements are phased in over time. And, in reality, an increased demand for physicians is a nice problem to have. Ideally you will be able to see your patients sooner in the disease process, when treatment can be more effective and less costly.

    Sara Michael is senior editor at Physicians Practice. She can be reached at sara.michael@cmpmedica.com.

    A version of this article was originally published in the February 2010 issue of Physicians Practice.


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