Monday, September 28, 2015

Financial Pressures Facing Physicians Today

There are several major financial pressures that affect physicians today, from collecting co-payments to rising technology and operational costs. The year 2015 has proved particularly challenging with the cost of ICD-10 and financial penalties for practices that could not attest to meaningful use.

The table below details five financial pressure points facing physicians in private practice today and the solutions to help mitigate these pressures.

Pressure Points
Co-pays & Deductibles
·      Have the receptionist discuss payment with patients at pre-registration before entering the office.
·      Collect co-payments at the time of service.
·      Implement online and mobile payment processing.
·      Schedule automatic or recurring payment plans that collect from bank accounts, debit cards, or credit cards.
·      Ensure the patient’s ICD-10 codes are accurate to prevent Medicare and Medicaid denials of payment.
Claim Denials
·      Develop and implement a pre-billing checklist to prevent errors.
·      Develop and implement a claims manual that documents the requirements and nuances of every insurance carrier in which the practice has a relationship.
·      Consider dropping insurance altogether and becoming a private pay practice.
Technology Costs
·      Use low-cost or free EHRs.
·      Use cloud-based EHRs and billing systems to prevent against data loss and upfront costs of new software and computers.
Rising Operational Costs
·      Implement extended hours to grow revenue.
·      Devise a patient check-in kiosk to streamline patient flow through the office.
·      Emphasize communication, education, flexibility, and understanding of the practice’s needs to employees so they may perform at a higher level.
·      Employ non-physician providers to see patients during regular and extended office hours.
Pay For Performance
·      Report Physician Quality Reporting System (PQRS) data to the Centers for Medicare and Medicaid Services (CMS) in a timely manner. Ensure the data conforms to CMS’s guidelines.
·      Consider joining a shared savings program, such as an accountable care organization (ACO).
·      Under an ACO, contract with a payer to provide care to a designated patient population during a set time period while meeting agreed-upon quality and cost benchmarks.
Maintenance of Certification (MOC)
·      The application fee for the MOC program is upwards of $1,000.
·      To better understand the program’s costs and requirements to prepare for examinations, the American College of Physicians (ACP) has developed the interactive tool ACP MOC Navigator, which is available at

As the table demonstrates, there are workable solutions to help overcome the financial challenges physicians in private practice face today. Additional tips for collecting co-payments include reminding patients before their appointment that a co-pay will be due at the beginning of their appointment and informing the patient of the estimated costs of service. If payment is an issue, offer a payment plan to the patient prior to the patient leaving the office. All office staff should be knowledgeable of the practice’s fees, procedure costs, and payment options, as some patients may feel more comfortable speaking to a medical assistant or nurse than the physician about payment. Always address patients by name and let them know they are valuable to the practice; this helps facilitate a positive discussion about payment.

“The economics of medicine are changing at a rapid pace. It’s important for physicians to remain abreast of these changes in order to keep their practice doors open,” says Dr. Cockerell.

Please read the article Pressures Private Practice Physicians Face Today to learn more about the general challenges physicians in private practice face today.


Cockerell, C. (2015). Lessons for Dermatology from the Tao Te Ching.  Retrieved September 28, 2015, from 
Medical Economics (2015). Top 15 Challenges Facing Physicians In 2015. Retrieved September 24, 2015, from
Medical Economics (2015). Top 5 Challenges Facing Physicians In 2015.  Retrieved September 24, 2015,  from

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