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Both before and after June 2012, when the Supreme Court upheld the constitutionality of the Affordable Care Act (aka: Obamacare), I have received numerous questions surrounding this topic. This episode is all about my thoughts and predictions regarding Obamacare and its likely effect on out-of-network clinics and the cash-based business model as a whole.
More specifically, we discuss these cash-based practice topics:
- Why I may sound a little winded in this episode’s recording.
- How you can win a free 30-minute phone consultation with me (see below).
- Three key characteristics and actions that led to my entry into, and positive experiences with, the private-pay business model.
- Why I do not believe I will lose any cash-pay patients as Obamacare is implemented and the majority of the population obtains health insurance.
- Why I am not worried about the Affordable Care Act having a significant effect on my practice and my ability to treat patients in the way I feel is best.
Resources and Links mentioned in this episode:
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[Click to Tweet] The effect that Obamacare will have on Cash-Based Practices – @DrJarodCarter
Leave a comment below for a chance to Win a Free 30-minute phone consultation with Jarod. Answer the following question:
How do You think the Affordable Care Act will affect Cash Based Practices?
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Jarod, do you have transcripts of these podcasts available?
Thanks for asking Ryan. I actually haven’t gone that route yet because it’s an added expense on top of what has become much more expensive than originally expected in the first place … it takes a lot of time and money to produce these in a really professional way, and transcribing them would require even more. Maybe in the future if I can tell the podcast is leading to more book sales or other revenue.
Completely understand. Best of luck with the podcasts!
I tend to be an eternal optimist.
I started a successful cash-pay practice almost 2 years ago, and about 90% my patients followed me from the clinic that I was working at, which was In-Network. People will find and pay for good quality care, in my experience. That will be potentially harder to find in an In-Network setting if reimbursement continues it’s current trend downwards, and the Affordable Care Act unfortunately causes increasingly difficult challenges for In-Network providers to hold onto good PTs. good PTs just won’t want to stick around in that kind of environment.
As long as you keep providing excellent care and getting results that people think are worth paying for, your practice has the ability to continue to thrive.
Well put, Renee. Thank you for taking time to comment!
Thanks Jarod. Stumbled across your website a few weeks ago, wish I had found you sooner. Your information had been incredibly helpful and helping motivate me to redirect some aspects of my practice to make things even better. Thanks for ask your work, it is very much appreciated.
Thanks for the kind words Renee. So glad what I’m doing here is helpful
I don’t Tweet , so will eave you my comment about the effect of the ACA and cash based practice here: I am currently in the process of transitioning from 22 years of private in-net work practice in CT to a 100 % cash-based practice. Already about 25% of my clients pay cash (and most already have insurance) and can therefore benefit from longer and more comprehensive and integrated sessions. I am in full agreement with you Jarod. – For patients with insurance through the health exchange, we already see and feel even lower reimbursement rates – by about 10-15% – compared to regular rates paid by insurance companies with whom we are already in net-work providers. This trend will only lead to a further squeeze on our ability to provide the type of care we are capable of providing and our patients deserve, and if anything, I think it will further strengthen the role and place for cash-based practice.
Thanks for your work and pod-casts – I find them to be both very informative and reassuring for my current transitioning process.
Thanks so much for your comment, Bente, and congratulations on starting your transition to a cash-based practice!
You bring up an interesting point that I didn’t really even cover in the podcast… The idea that ACA may drive even more practices to go cash-pay because the reimbursements for services are even lower than what they’re already receiving.
Thanks again and please keep us updated on your progress with the transition!
Jarod,
As usual great Pod Cast I can’t agree more. I recently did a post on my clinic blog about this, trying to get patients to realize that they are now consumers and that slowly more of the cost burden is shifting to them, it will be up to them to decide how they spend their $$.
http://www.feldmanphysicaltherapy.com/blog/physical-therapy-and-the-affordable-care-act-obama-care.
As usual thanks for the wealth of information!
Great article, Justin! Just shared it on Twitter.
Have you had any current or new patients comment on it when they are in the clinic with you; or any new patients who decided to come see you because of it?
Jarod,
Thanks! I actually have gotten some good response, from patients. I think it helped open up a good dialog with some current patients about how they may see things change. As of now I’ve had 3 people who have come because they realized that in-network they were paying $50-60/visit and not getting their money’s worth.
Things in NY are extra special because PT is considered a specialist under the co-pay/co-insurance rules (not sure how that works else where), so I have found a few people who find because they are looking to save money.
I think it’s awesome you’ve been able to effectively educate (and generate) new patients on the fact that OON PT is quit often a cheaper long-term option than going with their insurance. Kudos!
Jarod,
Great post/podcast! I am in complete agreement with you.
I think that the big factor and why Obamacare will help cash based practices is that more and more people will have high deductible plans and as Justin mentioned, will become better consumers of their healthcare dollars.
With a $5,000 deductible, maybe a $50 co-pay and 30 visits to PT. In the end, what’s the in-network benefit if physical therapy if it is the only service you need during the year?
Once people get used to the fact that they are in charge of their healthcare dollars, they’ll start making choices based on where they get the best value.
Couldn’t have said it better myself, Aaron. Looking forward to having you on the podcast soon!
thanks Jarod. Me too!
Commenting on Obamacare after listening to your podcast. Our clinic is 99% 3rd party claim submission. I believe the biggest impact on us will be the higher deductibles patients are taking on, meaning we will have to collect more from the patient after it has run through their insurance. We have found local hospitals are actually holding on to their claims longer, causing their deductible to be eaten up more by the physician and therapists after surgery. They are holding claims up to 6 months in some cases, which allows them to be paid mainly by the insurance company while the private practices are having to work to collect the deductibles. So the trend I see with 3rd party insurances is with larger institutions floating these claims longer while smaller clinics that rely on quick, efficient turnaround of their claims are going to have to work harder to get paid.
Wow… that’s the first time I’ve heard of hospitals holding claims, and smaller practices then having to collect the deductibles. Thanks for contributing!
Hello Dr. Carter,
I am currently a PT student with about one more year left (December 2015). As a future Physical Therapist, I have been considering opening my own private cash-based practice. I have only recently asked advice from a professor about opening a private practice. Her advice was to apply for Hospital acute settings upon graduation. From there, I will be able to establish a report with Doctors whom will eventually refer out to my own clinic after seeing my work. I would love to hear your thoughts on that plan, as well as, possibly any advice you have for a physical therapy student looking to eventually open her own private practice. Also, would you consider it too early to buy your “My Cash Based Practice” Program?
Thank you!
Hi Samantha,
No offense to your professor, but that is pretty terrible advice. If you are planning on opening an outpatient orthopedic private practice, you need to get as much experience and skills in that setting as possible. Furthermore, it is very rare for hospital-based physicians these days to be “allowed” to send a lot of their outpatient PT referrals to a private practice not associated with the hospital. So even if you did establish a good relationship with those physicians, it likely wouldn’t result in many referrals to your new private practice. ( Further explained here: https://drjarodcarter.com/marketing-directly-to-public/)
My advice to you is to seek out positions at great outpatient orthopedic clinics where you will have the best possible mentorship and highest skilled coworkers from whom to learn as much as possible. Soak up every bit of both treatment-based and business-based information to prepare yourself for practice ownership.
And to answer your question… I have had a number of students purchase The Cash Based Practice System</em> and be very happy they got an early start with the information, so I would not say it is too early for you to start learning more in-depth about this model.