preventive care Archives - Capko & Morgan

Avoid payment confusion while maximizing the service advantages of preventive care

When we work worth practices in adult primary care, OB/GYN, and pediatrics, we often recommend they consider proactively recalling patients for preventive visits. Because preventive visits are usually reimbursed entirely by insurance with no patient cost-sharing, helping patients stay current with preventive care can be a win-win for patients and the practice. A preventive visit recall effort can also help your practice address challenges like: Lower demand and productivity during the first quarter of the year, when patient deductibles reset Summertime revenue shortfalls because of lower visit volume Excess demand for pediatric check-ups during back-to-school and back-to-camp seasons Disengagement of patients who have lost touch with the practice and aren’t monitoring their own health Uncertainty about whether some patients are still connected to the practice Recalling patients for preventive visits allows you to better balance the demand for your clinicians’ time. If you add more preventive slots and book them during times when your practice is slower, you’ll also add predictable revenues. Your patients will benefit, too, because they’ll see their physicians when the practice is less hectic and more appointment options are available. When practices reach out to patients to book an overdue preventive visit, it’s usually a marketing effort that is well-received. Often patients hold off on booking a check-up because they are unaware that many preventive services are covered without a copay—so they’re delighted to hear that an annual physical is something that won’t cause financial pain. There is one avoidable snag in booking preventive care that often trips practices up, however, and it’s a pitfall that puts patient relationships at risk: Not all services that could be provided in a typical check-up are considered preventive from a billing perspective. That can lead to “surprise” patient costs and bills. These unexpected costs can be very upsetting. Even though the causes are usually just innocent oversights, some patients will feel they’ve been cheated or deceived. One way unexpected out-of-pocket costs occur is when a problem is discovered or revealed by the patient during a preventive visit. If the problem requires additional work or tests, that usually means an

By Morgan|2022-01-01T22:51:53-08:00January 26th, 2017|

Good for patients, good for your practice: Winning Cigna ad promotes check-ups

This amusing television ad from Cigna is bound to attract a bit of attention from fans of Grey's Anatomy, Scrubs, House, ER, and MASH. It's cute. If you recognize any of these tv docs, you'll likely enjoy it. And it has a message that can help patients get more out of their insurance, and help your practice, too. The gist: we'll use our skills as fake doctors to urge you to go see real ones for preventive services. Nice recommendation. Preventive services give your practice a reason to reach out to patients -- a gentle way to remind them your practice cares, and to keep them engaged. And it's a great way to get more use out of the EHR your invested so much time and money in implementing. With the deductible reset just over one quarter away, if you're a primary care practice (or other practice that offers a qualifying preventive service), you might also think about booking annual check-ups in Q1 of 2017. If your practice is among the many that see a slowdown in Q1, your patients will appreciate being able to come in when it's less busy. And deductible-free visits are good for your cash flow and cash-strapped patients' wallets after the holidays.

By Morgan|2022-01-01T22:51:55-08:00September 8th, 2016|

New ZocDoc survey spotlights patients’ reluctance to seek care, even preventive care

ZocDoc just published a compelling new article and infographic pulling data from a survey they recently conducted about patient behavior. The data put a quantitative face on what many of us have been observing anecdotally and reading in blog commentary online -- namely, that patients are increasingly reluctant to see their providers, and costs and scheduling challenges are a big part of why. One tidbit that jumped out at me, since preventive care is something I consider a win-win opportunity for practices and patients, is that 80% of patients surveyed were putting off preventive care. Some of the key reasons ZocDoc found were the inconvenience of keeping an appointment during work hours (in fact, more than 40% said they would likely cancel because work took priority) and the inconvenience of making an appointment in the first place. Preventive care should be increasingly valuable to patients as deductibles and co-pays have grown across all types of health plans. But many patients don't realize that this is usually a way they can take advantage of their coverage without cost-sharing. Many other studies have shown that patients are more confused than ever about their health plans; this puts the burden upon practices to fill in the information gap (but that also spells opportunity for practices that do so). Are you doing all you can to engage patients and encourage them to take advantage of their preventive care benefits? Some ideas to consider: Consider offering an early morning or early evening appointment option at least once per week -- or even occasional Saturday appointments Look into online scheduling to allow patients to book appointments without having to make a call during work hours Use EMR list tools (remember them from MU?) and your portal to reach out to patients who haven't had preventive services or are overdue Put information about what's included in preventive care -- and why it's important -- on your website

By Morgan|2022-01-01T22:51:59-08:00June 29th, 2015|

Preventive services can be the antidote to the deductible reset

The deductible reset is looming in January, and it's poised to wreak its usual havoc with cash flow. Cash-flow impact could easily be even worse this year, given that deductibles have likely increased and become more of a problem for many of your patients. Naturally, alerting patients to the possibility that they will be responsible for a significant portion or even all of their service costs at the time of booking is a necessary first step -- as is ensuring that front desk staff are trained on taking payments at the time of service. But, if you are a primary care practice or other specialty that offers preventive services, there's one more thing you can do to protect your cash flow: you can identify patients who are due or overdue for preventive services, and encourage them to book during Q1. Because services identified as preventive by the Affordable Care Act almost always* carry no patient financial responsibility (not even copay), patients may be more eager to use these services -- especially if they've recently started paying for coverage and haven't perceived much value for their premiums. Annual/scheduled preventive care can be a win-win for patients and practices. The revenue is often higher than a standard office visit, and it's usually reimbursed promptly. Reaching out to patients to remind them about preventive care is a way to communicate that you care about them. And, you'll be giving them good news about their health plans -- some patients may not realize that they can get a preventive service such as an annual well-adult exam, screening colonoscopy or mammogram without cost-sharing. One caveat: be sure that patients understand that some lab tests your physicians may want to utilize may not be covered. Patients also need to know they'll be responsible for their normal portion of costs if a visit scheduled as 'preventive' actually turns out to be a problem-oriented visit. And it's always a good idea to remind them that these payment terms are part of their health plan and the ACA -- not the whims of your practice. *grandfathered plans may be

By Morgan|2022-01-01T22:52:02-08:00January 3rd, 2015|

Patients are worried about high deductibles — here are some ways to respond

Even this late in the year -- when we typically assume many patients will have met their deductibles -- we are hearing from practices that some patients seem to be delaying or avoiding care because of concerns about costs. This is not limited to the ACA plans, which tend to have high deductibles, especially on the 'bronze' end. Even patients with corporate plans are now facing enough out-of-pocket responsibility that it affects their decision-making. Some patients who may have had a trivial deductible in past years now have one with real teeth-- one that is less likely to be fulfilled unless a major illness or injury happens during the year. As a result, some practices aren't seeing the expected influx of patients who want to get needed care before the end of the year -- and some physicians and practice managers are concerned about the well-being of both their patients and their practices as a result. Patient caution and awareness of cost may be a good thing in some cases (if it helps patients become more judicious about using optional services, and or encourages more engagement with providers and health plans). That's certainly one of the goals of high deductibles. But the problem is, in some cases high deductibles might also discourage patients from getting care that they really need. And, of course, it certainly doesn't help your practice to establish and maintain a relationship with patients when they're afraid to come in for a visit(!). It can be frustrating to know how to respond, since physicians and practice managers can't do anything to change the terms of the health plans their patients are on. What's more, if you've been watching this blog, you already know that it's very important to stay within the lines of your payer contracts (e.g., selective discounting or waiving of co-insurance is likely verboten). There are a few things you can do, though -- and it's a good idea to take a look at some of these things now, because the deductible reset (January 1) is right around the corner. Preventive care: If you are

By Morgan|2022-01-01T22:52:03-08:00November 14th, 2014|