February Analysis of Cash Transition

Results of first two months transition to Cash Only practice


February 2008:

1st two months – January-February 2008 transition to Cash Only + Medicare

Solo physician, suburban practice, large HMO penetration.

Conversion to cash practice, Medicare, and Wellness-Retainer model at affordable market based prices.

January and February’s numbers may not indicate future months as some old insurance money came in and is included in percentages given.

Also 2 insurers remained thru part of January due to their contractual terms that I chose not to fight as it only set me back a few weeks.

But February’s old insurance money was very low as compared to January.
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Comparisons given below are percentages comparing Jan-Feb 2007 to January-Feb 2008.

I will try to post further months and quarterly data as it comes in.

Patient Volume decreased by 33% for Jan-Feb 2008

New patients seen decreased by 63% for Jan-Feb 2008

$ per patient seen increased by 204% for Jan-Feb 2008

Revenues increased by 73% for Jan-Feb 2008

Old insurance money should not take me thru further than March 2008. Feb 2008 revenues are consistent with Januarys with much less in old insurance income.

Ok All, Lets here the questions and comments!!

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The numbers posted above reflect my suburban solo family practice in a highly penetrated managed care location.

The numbers so far are very encouraging. However they may not indicate the future.
A large part of the initial revenues have been from established patients enrolling in my practices Wellness plans. The enrollment fees start at $200 per year. For more info on the wellness options please click here. In order to sustain the revenues and the increase in $/patient I must continue to enroll patients both new and old in these plans. I hope that March 2008 has equal numbers to the first two months, but April and on need to bring in new patients to the practice. I do intend to start a marketing plan shortly to bring in these new patients. I have had a few so far, and I believe word of mouth will spread to bring in these new patients as it always has in the past.

Why the optimism? The patients who have enrolled so far in the wellness plans have stated to me they are very happy with the product and feel the fees are very fair and reasonable. Also the service we have been able to provide with same day appointments and improved patient advocacy has been very well appreciated by my patients.

What are the problems so far?
The biggest problem so far has been patient’s not understanding that health insurance networks do not dictate who they can see for their medical care. They feel they are breaking rules if they go out of network. They do not understand that they can pay directly for an office visit without using insurance.
Some believe that as an out-of-network physician that they will not have coverage for prescriptions, or other care accessed outside my office if I prescribe it. These are all issues that I have found need a lot of hand holding and teaching of how the system truly works. Once I explain how nothing changes other than my fee, a light goes on in their heads and it becomes a decision of a few extra dollars per visit to see me.

Another problem is all the other doctors in my area who still take their insurance and are thus cheaper per visit than I. But, I have already had half a dozen patients return to my office due to the inability of these other offices to accommodate same day appointments for sick visits.

Other Good Effects:

Expenses have gone down. My medical billing expenses have been slashed by at least 75%.

I have eliminated one medical assistant during my day hours, and went from two to one medical assistant during evening hours. I anticipate my payroll expenses to be slashed by about 25-30%.
For other good effects for my patients please see my blog post of 2-20-2008.