RBMA Marketing Lessons

Didn’t make it to any RBMA Marketing forums yet this year? That’s okay, we’ve got the inside scoop. It seems most conversations revolved around industry changes, what’s next, how to use strategic planning and how to gain market leadership.

The glory days of easy-come health care are behind us, take a look at the changes that have occurred over the past decade:

-       more aggressive competition efforts

-       hospitals gaining market dominance by purchasing practices

-       reimbursement cuts causing dips in profitability

-       trends towards low cost providers

-       increased expenses to remain competitive

-       rapidly evolving technology advancements

-       patients opting out of insurance benefits due to high deductible health plans

Thinking about trends in healthcare and examining the changes that have taken place will help you to prepare and protect your practice in the next phases. Here are some things to consider about your practice in strategic planning:

-       understand your state in the market

-       be realistic about strengths and weaknesses

-       identify opportunities for growth in market trends

-       define realistic goals

-       examine commodity vs. quality

We have completed an extensive market analysis of the radiology industry as a whole, examining expected trends and what that means for your practice, in addition to the steps necessary to gaining market leadership in your area.

A Cartoonist's View of Health Insurance

Dear Supreme Court,

Health Insurance Sucks.

Sincerely,

Jen Sorensen

Since it’s Friday, Kaiser Health News was feeling silly and shared this great masterpiece from the mind of cartoonist Jen Sorensen, on the trials and tribulations related to high health costs and the challenges associated with health insurance. It seems like there should be an easier way to find affordable healthcare in the United States… right? In the words of Dane Cook, “it’s funny, because it’s true.”

If you liked this strip, be sure to check out more of Jen Sorensen’s work at Slowpoke Comics.

True Trends in Health Care Markets

I recently read an article entitled How to Build the Radiology Department of the Future which discussed ways tomaintain profits and growth in an evolving health care market.  It highlighted the most efficient and profitable ways to find growth and prepare your practice for the future, however it was written from the perspective of an obvious hospital-system based supporter, geared towards the independent radiologist sector, where common ground is hard to come by.

The author comments on several market trends, such as; the employment of radiologists by hospitals, the importance of quality, hospital partnerships, hospital imaging departments as epicenters of care, falling reimbursement and requests for hospital subsidies for the radiology department.  These “trends” seem to directly play on the fearful emotions of independent radiologists and they need to be aware of the true trends and their options.

True Trends:

-       over 50 million uninsured Americans leading to self-pay patient population

-       32% of patients price-shop and hospital-based practices do not have the most affordable options

-       there is little to no price transparency at hospitals and looking for pricing is near to impossible without the appropriate resources

-       there is now a call for transparency and it is coming directly from patients

-       reimbursement is down for everyone, physicians must look to untapped patient populations

-       consumers are ingrained to think that quality is reflective of cost, patients are becoming smarter than this

(watch the video below expressing the variances of pricing in cities throughout the country, the interviewed patients express the need for transparency and they’re not the only ones!)

Resorting to teleradiology and impersonalized care is not the answer to decreased revenue and patient volume. Creative marketing efforts, physician integration, seamless billing and collections practices and a self-pay processing plan are the components necessary to overcoming the true trends in the health care industry as it exists now and in the future.

The 5 Myths of Self-Pay

Whether you’re a patient or a health care provider, it is likely that you have heard the myths about the self-pay process.  In the past, health care providers have referred to self-pay patients as “no-payers” due to the stigma associated with them that their fees go uncollected.  Trends towards transparency in the health care system, the rise in uninsured patients and resources springing up to serve as reference points for quality, affordable care have started to clear up the myths that exist.

After speaking with a number of physicians and patients across the country, we have assimilated this list of myths, and will address each falsehood:

1. The only way to get quality care is through an insurance plan and services are too expensive without insurance.
2. Providers cannot charge less than Medicare for services.
3. Third-Party Payers will renegotiate contracts depending on a practice’s discounted cash-pay prices.
4. There is no efficient way to collect self-pay payments.
5. People without insurance are ill educated when it comes to health care pricing and quality.

1. The only way to get quality care is through an insurance plan and services are too expensive without insurance.

As long as patients know where to look, they can find highly reputable providers with affordable pricing options.  Uninsured patients can also negotiate pricing in many instances.  Keep in mind that high quality care does not necessarily translate to lack of affordability.  There is very little correlation when it comes to quality and pricing in the health care system; just because a location charges $1400 for an MRI, does not mean it is better than the facility charging $450.

2. Providers cannot charge less than Medicare for services.

There is no existing prohibition for offering a discount to uninsured or underinsured self-pay patients.  The CMS (Center for Medicare Services) has stated that discounts, when based on financial situations, are not considered kickbacks, and thus they do not violate any existing laws or regulations.

3. Third-Party Payers will renegotiate contracts depending on a practice’s discounted cash-pay prices.

Providers are expected to have “reasonable and customary” charges, which are established based on the cost of providing the service.  That amount is what is billed to all payers, including self-pay patients.  In most cases, insurance providers contract with medical offices a discount off of the charges. Often times however, the self-pay prices are simply a reflection of a practice’s Medicare Fee Schedule.  As with Medicare, providers can offer discounts based on financial situations. This should not alter the reasonable and customary charge based on costs, or the amount a payer is willing to pay by contract.

4. There is no efficient way to collect self-pay payments.

In the past, physicians rarely saw full collections on self-pay payments because of ineffective processes.  Practices spent an extraordinary amount of time and money chasing down lost payments, looking backwards instead of forwards.  Self-pay collections will improve with transparency and by collecting the payment before or at the time the procedure is performed.

5. People without insurance are ill educated when it comes to health care pricing and quality.

Gone are the days when being uninsured meant you were unprepared, unemployed or uneducated.  Employers adopting consumer-based health plans and high-deductible health plans have led Americans to realize that acquiring care on a cash-pay basis and price shopping is oftentimes more economical for their families.  This being said, 32% of patients are actively price shopping for care. We have learned that in most cases, these uninsured patients are typically the most knowledgeable of pricing, quality and the health care system as a whole.

Tags: self-pay, uninsured patients, cash pay, price shopping, self pay, no pay, high-deductible health plans, medicare fee schedule, CMS

Spreading Health Care Marketing Dollars

As Florida natives, we’re spoiled daily by the Tampa Bay sunshine and our affinity for spur of the moment fishing trips.  On a recent day on the water we were having a particularly tough time catching anything, due to the sheer amount of other fishers near our honey hole.  It was a gorgeous day, so it wasn’t hard to understand why there were so many people on the water, but it got me thinking about a conversation I’d had earlier in the week with a physician about his marketing issues.

Dr. Desperate was frustrated because he’s been spending thousands of dollars each year on advertising campaigns with little to no return on investment.  Billboards and magazine ads are great, but what are the odds of a patient needing an affordable MRI driving down the road and saying, “Why yes, I do need to go there, I’ve been waiting to see a billboard telling me where to go!” Not going to happen! That patient is going to go online and look for options.  Dr. Desperate was getting lost in the shuffle and as a result, getting no bites on his lines.  His reimbursement down and patient volume decreasing steadily, he complained, “Are there even any more patients out there?”

Imagine this analogy. Casting one line into the water will get you one fish at a time, no matter how many fish are there.  There is a reason the pros use nets when they’re bringing in the big numbers.  In recent years competition has grown as survival techniques for professional fishermen, and many areas have become overfished.  The ticket to successful fishing, and marketing too, is to find that untapped stream and use collective nets rather than weak rods. 

 

Websites like Save On Medical allow your practice to take a dip into the untapped stream of cash pay patients.  With over 50 million uninsured Americans and 25% of Americans trapped in high-deductible health plans, there is a large population (32% of patietns) of price-shopping patients.  They need options, and your practice should be one of them.

Since it’s Thursday and Thursday is the perfect day to think about your marketing impacts, let’s take some time to do some exercises to strengthen your marketing muscles. Today, ask yourself the following questions, and no cheating, you’ve got to be honest with yourself to get stronger!

-       How are you measuring the effectiveness of your marketing dollars? Are you as happy as you could be?

-       Who is really responsible for your practice’s marketing? If it’s a representative, are you only as good as they seem? If it’s your receptionist or patient coordinator, is that really a good sales tactic? If it’s you and you’re a physician, don’t you have anything better to be doing?!

-       How far does your reach stretch and are you aware of the captive patients that are falling through the cracks?

-       Do you have a cash pay pricing strategy and what are your methods for collections?

-       How do you compare to your competitors? What can you steal from them that they are doing well?

-       Perception is everything, how do your patients perceive your facility, staff, physicians, technology and patient experience?