Take a look at the variety of small practice business models that exist today:
- Concierge - concierge can mean different things to different people; a practice that accepts insurance and also requires an additional fee from all patients on top of insurance payments or a practice that accepts no insurance cash only per month for access to providers.
- Medicare Subscription - similar to concierge, but applies the additional fee for Medicare patients only to pay for additional services not covered by Medicare, particularly an annual physical examination.
- Direct Pay - this is a primary care model where patients pay a monthly fee each month that covers unlimited primary care (sick and well visits) and some in-house laboratory services. This model also includes direct-contracting with employers.
- Telemedicine - gaining popularity for more than just rural specialty care, telemedicine is seeing patients via a secure video connection.
- House Calls - this model is coming back as a pure practice model because physicians and other care providers do not have to invest in a brick and mortar office. Coupled with the ability to accept payments via their smartphones and the influx of baby boomers, this model is gaining popularity quickly.
- Nursing Home - Another "rounding" type of practice like the House Call practice, physicians spend 100% of their time in nursing homes seeing patients.
- On Call Specialty Practice - specialty physicians, typically surgeons see patients’ pre and post-surgery in the office of the referring physician and have no brick and mortar office.
- Cash Practice - this is a 100% cash model with no insurance payments accepted. Typically, physicians will provide patients with what they need to be reimbursed from their insurance plan. Because insurance is not filed, the practice can afford to discount their prices.
- Co-op Practice - this is a time-share-type practice where one practice or a non-physician owner leases space to physicians, providing everything for one fee except billing, EMR and a medical assistant.
- Micro-practice - an even skinnier form of the co-op practice, the physician works without any assistants and does everything him/herself with just a computer, utilizing one exam room. Micro-practice physicians see on average 8 to 10 patients a day.
And the number of provider delivery models is growing every day. Traditional models of a single provider simply buying a building and starting a practice is almost extinct. These models continue to change and grow as opportunities for capital change and grow. Relationships are just as important today for growing a physician practice as it ever was. The primary difference is relationships with who?
EHRs are offering low interest and even free systems when you bundle multiple systems together and purchase. You buy a billing system they will throw in an EHR. Social media and IT connectivity has become just as important to practices as the membership to the local country club was 50 years ago.
Knowing what model suits providers’ ultimate goals, personality and career aspirations may take time to find, but one thing is sure, we will always need providers and payment models will continue to evolve.