Tag: Management

09 Apr 2016

More patients may not mean more collections


We live in a ‘more world’ where more of everything seems to indicate that we are doing better. The reality that this may not necessarily be true occurs to us in quiet moments. This applies to medical care too. More medicines cause more diseases instead of fixing problems. When doctors see more patients with the objective of increasing collections, it almost comes at a cost. When we examine data, we find that increasing patient volumes (just for the sake of doing so) may not translate to greater collections (or payments) from insurance companies.

Quality of patients and the care they get is more important than the volume in the long run. Let’s conduct a simple experiment. Select all the patients seen by a doctor for one week from two months ago (by this period, majority of the insurances should’ve reimbursed). Conduct a basic payer mix analysis (mix of insurances that patients have) and procedure mix analysis (consults/ procedures that physicians performed – from office visits to colonoscopies. Tracking payments for all these visits/ patients reveals that most of the money (upwards of 90% some times) comes from 5 or so insurance companies. From a business standpoint, could we stop adding patients for the purposes of making more money and focus on the ones we have – so that overall quality of care improves?

Freed up time may then be used to extend care to those who really need it, regardless of what insurance they carry or their ability to pay. It would be far more fulfilling to deliver care without expecting reimbursement than doing so by expecting high reimbursement and be frustrated later with the ‘system’ when insurances delay or deny pay.