The physician’s role has always been invaluable in society, and today’s doctor is paid accordingly. The high intensity of the job and demand for knowledgeable physicians equates to larger salaries, but changes in the healthcare field on the horizon could impact doctor finances.
Since the pandemic, the focus on healthcare has shifted. Patients want the option and convenience of telehealth care. Insurers continually shift their policies to require more rigorous documentation and cost-efficient procedures. These demands have changed the healthcare field, and, as a physician, you want to be prepared for the impact it may have on your bottom line.
In this blog, we’ll discuss future healthcare trends and how you can prepare for the challenges they may bring you before they impact your finances.
1. Changes in Payment Models
For decades, physicians have had the choice to participate in insurance networks under PPOs and HMOs, or to remain “out of network” and face the consequences of potentially losing patients.
Now, these network-based models are disappearing in favor of value-based care. This patient treatment model pays physicians and other medical providers based on the patient outcome. The idea behind the model is that if the patient’s health determines your payment, it’s in your best interest to ensure they receive the best possible care.
Value-based healthcare includes management of a patient’s overall health from a team of doctors working in tandem. Patients may receive an order for a sleep apnea test from their pulmonologist, only to find out that the person managing the test is on-site.
Fee-for-service payments are made to one clinic and dispersed accordingly. This model may sound efficient, but it’s likely to result in a decrease in payment reimbursement structures, which can have a significant detrimental effect on your revenue.
Additionally, many insurers require complicated coding and prior authorization before payment is made or referrals are approved. This administrative step becomes a hassle for patients in need of quick care and can derail your treatment plan if the insurer denies your recommendations. If your staff doesn’t receive prior auth, your procedures for that day could be denied.
2. Retail Clinics Are on the Rise
Once the place you went to pick up your prescriptions, many chain pharmacies today offer physician services. For instance, CVS has a “minute clinic” where you can get vaccinated while you wait for your medication.
Patients can go to a retail clinic and receive treatment similar to what’s available in an urgent care or general physician’s office. A visit to the pharmacy also provides solutions such as:
- Flu shots
- Treatment for sinus infections
- Care for cold and upper respiratory infections
- Personalized mental health care
- Psoriasis treatment
- High cholesterol management
With the convenience of retail clinic treatment and on-site medication pick-up, it’s not surprising that many patients prefer these types of settings over traditional physician offices. However, depending on your specialty, this change can mean a decrease in your patient volume and income stream.
3. Requirements for Technology
From telehealth to more secure online protocols, integrating technology into the workplace is essential but expensive. Whether they’re concerned about going into public due to their compromised immune system or they appreciate the convenience of on-demand, in-home care, many patients prefer televisits. But offering this to your patients means integrating strict IP infrastructure, staff training, and added insurance to counter cyber breaches.
Insurers also require advanced technology to house your patient records electronically. This movement may save paper and make patient care more efficient, but it’s time-consuming and the systems required to incorporate electronic health records can be pricey. The result is another expense that could be difficult to offset in some offices.
4. An Increase in Insurance Rates
Like most costs, malpractice insurance rates continue to steadily rise. Yet, some factors have turned this slow upward trend into a spike of higher premiums.
Factors such as increased rewards given in lawsuits, the COVID-19 pandemic’s impact on claims, inflation, and cybercrime have impacted malpractice rates. Until premiums stabilize, doctors should plan to protect their assets and save money elsewhere. This article by OJM Group is an informative dive into physician asset protection above and beyond malpractice coverage.
Conclusion
Evolution in the healthcare industry has kept humanity alive through innovations like vaccines, medication, and improved sanitary practices. But the trends on the horizon are impacting doctor finances, and being proactive will help you mitigate the effects on yours.
