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Realistically, not many things in healthcare are simple these days, but some improvements could be as easy as 1,2,3.

Improving reimbursements is one of the toughest things to do in good times and even tougher now because of multiple healthcare changes coupled with a sluggish economy. Those of you who have heard me speak will certainly remember my rule of thumb about reimbursements/revenues for physician practices. It goes like this, There are only three ways for a physician to make more money in their practice: 1) See more patients, 2) Charge more for services or, 3) Provide ancillary (revenue producing) services.

Let’s discuss number 3. Many physician practices have had to think out of the box to come up with new innovative services to provide to their patients. A large number have increased their availability through extended hours or night and weekend clinics. (That really falls more under rule number 1 – see more patients), but you get the idea.

As far as additional services, physicians are adding “Preventative Health Programs” for larger employers, nutritional and dietary counseling including various products and supplements, and “Smoking Cessation Programs.” Many have even chosen to provide in-house pharmacies. Physicians have purchased a variety of “results specific equipment” to remain on the cutting edge and provide what they hope will be services in demand by patients. The theory also being that many patients do not even know of additional health or appearance improvement procedures or services that might be available to them. A large majority of these tend to be cash or out of pocket payment instead of traditional insurance reimbursements.

Some physician groups are taking advantage of EMR progress and providing complete medical records on compact electronic media so that patients can keep and take their full medical histories with them or have kept secure by a loved one in case of an emergency such as an ER encounter. A small percentage of physicians have included “premium care services” whereas patients pay for their health care directly to the physician or practice in order to receive VIP treatment, no wait time, 24 hour access to a healthcare provider, and a variety of other perks that insurance would never dream of paying for. Recently we have seen a few physicians sending letters to current patients requesting a two or three hundred dollar fee to remain their patient.

One of the best ways to find out what services patients want and are willing to pay for is by including a section on your patient satisfaction surveys asking patients to check the boxes or write down things they would be interested having available for their next or future visits. This also informs them of services they may not be aware of, such as portable health records as mentioned earlier. It’s better to list as many as you can think of because, again, they might not know what is/could be available at your office.

If you are not doing patient satisfaction surveys, now may be a good time to start – for multiple reasons. One reason is the grading system that is evolving for reimbursement formulas. Having comprehensive positive data to combat insurance companies’ attempts to reduce overall reimbursements provides the physician and his/her practice with a position of strength (provided the surveys are positive) in the event that they need to calculate the value of the practice.

In challenging times, physicians and practices need to be preparing well ahead of expected changes so that your position IS one of strength and that your revenue base is increasing in spite of lower overall reimbursement rates. Just like I said, as easy as 1, 2, and 3.

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