Would you believe that failure to collect consistently and adequately at the front desk can actually create a negative impression of your practice's patient service? And that skipping financial conversations to keep the focus on patient can actually backfire? Money conversations can be hard for all involved. And, when a practice staff is very focused on patient-centered service, it can seem counter-intuitive to emphasize financial details -- especially when patients are ill or injured. But, ironically, not being clear about financial terms and not collecting appropriately can actually cause your patients to feel worse about your practice than a conversation about money ever could. When you fail to collect adequately at the front desk, your patients will receive a bill -- and, if you are waiting for their insurance to pay its portion first, that bill may not even be mailed until a month or more after their visit. By that time, the patient may have forgotten all about the visit -- and never even considered they would owe a balance, especially if staff never mentioned that they would or provided an estimate. It's likely they've already allocated their monthly budget to other things. And maybe they're confused about the bill -- and now will spend time trying to figure it out, perhaps on hold with their health plan, or feeling they have to call your biller. All of this adds up to aggravation. And if they don't believe (or don't want to believe) they owe the money, they can become quite angry with your practice. Nobody likes unexpected bills. Properly estimating patient costs and alerting patients that they have financial responsibility for all or part of their service is one of the kindest things you can do for them -- and critical to maintaining a positive relationship. Learn more about front desk collections at my upcoming webinar on 9/23/14 (9AMPST/12PMEST) -- sponsored by Wellero and hosted by Physicians Practice. It's free! Register here.
A feature in June's issue of the Los Angeles County Medical Association's Physician Magazine put the spotlight on increasing efforts by hospitals to "align" with doctors -- whether by creating customized contract arrangements designed to better match doctor and hospital incentives, or whether through compensation structures implemented after acquisition of physician practices. (Naturally, acquisitions make alignment even more important, as hospitals race to make these costly investments pay off.) In fact, the article pointed out that -- based on American Hospital Association (AHA) data -- more than one-third of the surveyed hospitals use integrated physician salary models today. This all seems familiar to me as I recall the flurry of primary care practices seeking opportunities for hospital acquisition back in the late '80s. The motivation for physicians then was the fear of managed care combined with the lure of hospitals offering attractive purchase prices and lucrative guaranteed salaries. Physician-hospital alignment didn’t work so well back then, but will it work now? I’m not so sure. The first time around the objectives of the physicians were in stark contrast to those of the hospitals, which wanted to secure referrals and gain a competitive advantage. Physicians bought into the security of employment and a guaranteed salary with little thought about the implications of becoming hospital employees. The physicians within these acquired practices did not do well when demands were made by their new employer. Physicians also assumed that large hospitals with more business savvy would be better equipped to manage medical practices efficiently. However, hospitals with corporate mindsets, slow decision-making processes and no experience with running practices were not prepared to manage the acquired practices. The relationships became adversarial. Soon hospitals began to see some of these practices as simply a sea of red ink. Soon consultants across the country were recruited to deal with the situation and unwind the deals. Fast forward to 2014 and there are some major differences in the healthcare climate surrounding alignment. A new fear has emerged for physicians. It is the Affordable Care Act and its potential implications. Mature physicians wonder if private practices will be