Reinventing Your Practice Amidst the ACA Pinch

Are you feeling the pinch now that the federally funded Medicaid primary pay bump has expired? If so, you’re certainly not alone. Many primary care doctors in Colorado who see Medicaid patients this year will get a fee cut averaging between 25-35 percent, according to recent findings in the Urban Institute’s Health Policy Center Brief.

In fact, doctor’s offices all across the nation are struggling to stay in the black due to the influx of Medicaid patients as a result of the Affordable Care Act (ACA). Unfortunately, Medicaid reimbursements are at an all time low just as the Medicaid population is surging. Rather than refusing to treat Medicaid patients like many other practices across the country, you can search for new ways to increase your revenue stream.

We’re seeing clients face this challenge head-on by finding innovative solutions to stay profitable. One solution a Colorado practice found was marketing their expertise in the allergy arena. The reimbursement from allergy shots is helping the practice deal with the cut in the Medicaid payment level.

Additional ways of increasing revenue include adding ancillary services that complement the practice and its clientele. For example, a practice with a growing number of older women might be the right fit for cosmetic services (known as "med spa"), whereas one with many diabetic patients might focus on counseling for them. It’s important to factor in expenses, however. For example, cosmetic lasers can generate a lot of income, but are expensive. On the other hand, diabetes and weight-loss counseling are less lucrative, but expenses are quite low.

You might also consider opening an in-house pharmacy, which can increase revenues by $50,000 or more per year. With changes in the Medicare Part D program, physicians are now able to dispense prescription drugs to patients directly at the point of care and get reimbursed for it.

Thank you to all the practices who continue to treat Medicaid patients; as you know this is a vulnerable population that desperately needs quality healthcare. Perhaps by using some of the tips shared here, you can tap into new revenue streams and boost your bottom line, so that you can continue to care for Medicaid patients.

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