Understanding the cash-only medical practice market

Understanding the cash-only medical practice market

With today’s medical environment so dependent on complex insurance company regulations and complicated billing procedures, many physicians are looking for niche medical practices that will allow them to maintain their income standards while reducing their paperwork. One such niche is the cash-only medical practice, which is essentially a medical office that does not maintain contracts with insurance companies and instead requires patients to pay cash for medical services rendered. Breaking your contracts with insurance companies and building a successful cash-only medical practice will likely take some time, and many doctors decide they need to transition gradually rather than switching overnight from an insurance-paid medical practice to a cash-only medical practice. cash payment. If a cash-paying medical practice sounds like the type of office you’d like to run, it might be time to start doing some market research to find out if your practice has the potential to be successful:

* What is the state of your local market? Does your local community have a large number of uninsured or affluent patients? If you run a medical practice in an affluent community, you may be able to build a large pool of patients—even patients with insurance—who are willing to pay money for high-quality, effective medical care. On the other hand, if your local community has many middle- or lower-income residents with HMO plans that do not provide any out-of-network benefits, you may find that you have difficulty building a cash-only practice.

* Would your current patients be willing to switch to a cash-paying medical practice? It’s a good idea to survey your current patient panel to see if they would be willing to continue using your medical services if you transitioned to a cash-only medical practice.

* Should you continue your contracts with the more profitable insurance companies? Not all insurance companies negotiate unattractive rates with their underwriters, and not every insurance company has unreasonable document requirements. You can choose to work with two or three specific insurers, while requiring patients who don’t use those companies to pay cash for medical services. This is your medical practice, which means you can choose who you contract with.

* What medical services will you provide and how much will you charge for them? Some doctors find that they can take on fewer patients with a cash-paying medical practice and also find that they can focus on the specific medical services that appeal to them. You may choose to focus on urgent medical care rather than chronic conditions, or you may choose to perform fewer diagnostic tests. Whatever services you decide to offer your cash-only patients, deciding how much to charge for them will take some research. Ask other doctors, especially other cash-only doctors, in your area how much they charge; there is nothing unethical about it as long as there is no discussion about collective rate setting. You may also want to consider how much net your medical practice will have to pay to cover your overhead costs.

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