Cash Vs. Insurance Model of Functional Medicine

The question of insurance vs. cash practice is one that comes up on a regular basis.  Many offices find themselves wanting to convert to a cash pay only practice, but fear there may be a loss of business.

I would simply ask you to look at your numbers and analyze whether you find yourself working for free.  Things to look at include:
  • How much your pay your employees to deal with insurance billing, claim filing, follow up, audits etc.
  • How many man hours are spent per week trying to get you paid.
  • The negative emotions your employees experience when trying to deal with frustrating insurance companies.
  • What percentage of claims are denied vs. paid.
  • What type of fee reduction you are taking when getting paid.
  • How much patient volume you have to push to make enough money to keep your doors open.

Don’t Let Fear Make the Decision

I typically see doctors resist a cash model practice out of fear of losing potential patients.  In this case, many of them work longer hours, seeing more volume, with higher stress loads to make less than a cash practice seeing half as many patient visits per week.  Remember that being busy does not mean you are successful.
This is a classic case of “More being Less”.  Remember that more patients doesn’t equate to better income or reduce clinic burn out.  More patients = more stress.  More patients = less time to give quality care and advice.  More patients = paying more staff to offer good customer service.  Take a step back and look at what you are doing in your practice.
Consider a gradual shift by eliminating your worst insurance payers first.  Convert these patients to a cash model while offering superior care.  Increase your prices to reasonable rates.  Get paid what you are worth.
When you devalue your service by working for free, you are psychologically telling yourself that what you do for your patients has little value.  This is a recipe for disaster.
Committed to your success,
Dr. O
Dr. Peter Osborne

Dr. Peter Osborne