Physician practices that think they don't have the clout to go head-to-head with payers likely have more leverage than they realize, according to a Physicians Practice report.
By investing time and energy, physician practices can realize and increase their leverage to make changes to help their finances, according to Randy Cook, president and CEO of Brentwood, Tenn.-based consulting firm AmpliPHY Physician Services. There are four main factors physicians should look at to evaluate their power in payer negotiations, he told Physicians Practice.
1. Market position. Mr. Cook advised physicians to evaluate their market position. This includes the number of providers offering the same services in the marketplace and the community demographics. Providers can retrieve this data from various sources, such as their local chamber of commerce.
2. Primary care orientation. Physicians also need to examine their primary care orientation, which involves the degree to which patients seek them out for specific services, according to Mr. Cook.
3. Geographic isolation of services. Providers should know how they are unique in their marketplace and which services only they provide to the surrounding community in order to make themselves more attractive to health plans.
4. Patient demand. Mr. Cook advised physicians to assess their patient demand by determining their new patient visits ratios compared with all visits, analyzing their payer mix and surveying patients asking for their medical records because they intend to seek care elsewhere.
Armed with knowledge about their market position, primary care orientation, geographic isolation and patient demand, physician practices can provide hard examples in negotiations for better reimbursements, according to Mr. Cook.
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