High unemployment rates & a declining economy has left the average South African tight on cash. To ease cash concerns, many private healthcare patients have bought down or canceled their medical aid membership altogether, resulting in bigger out-of-pocket expenses when a healthcare concern arises. The problem with this is that when a cash-strapped patient is grappling with a health concern, they have 2 options: i) Visit the doctor (even though they might not be able to afford it) or ii) Wait to receive care when they can afford it; however the latter may lead to greater health issues that will result in costlier outcomes for the patient & our healthcare system.
So while you don’t want your practice to grow in bad debt, it’s in everyone’s best interest to find ways to treat these ‘cash-strapped’ patients, while taking into account their financial situation & your practice’s revenue requirements.
Here are 3 tactics you can use to continue to treat these patients without compromising on care or revenue.
1. Contract in with the medical aid(s) that most of your cash-strapped patients belong to
The best way to ensure you get paid timeously for consultations, with as little impact to your patient’s pockets as possible, is to contract in with the appropriate medical aid(s). For example, if a large proportion of your patient population who are unable to pay belongs to a specific medical scheme, it makes sense to explore contracting with those medical schemes. This is because not only will your practice be paid directly from the scheme – minimising the need to collect directly from patients – but you will also be paid at the maximum scheme rate.
For example, the graph below shows the number of claims & the Rand value of claims for a General Practitioner’s (GP’s) practice over a period of a year. You will see that 60% of the practice’s patients belong to Discovery Health. If this GP was to contract in with Discovery Health, they would see their average claim value increase from R426.02 (current rate) to R514.30 (contracted-in rate) per consult or an extra R109 909 per year*.
2. Provide financial info to patients upfront
Giving patients insight into the financial implications before the consult will not only take the angst out of the anticipated bill but, they can then be given the opportunity to make appropriate financial arrangements.
Patient benefit checks make this conversation easier. When you or your staff know how much the patient will be covered for before their appointment – you have the information you need to have an open discussion. Nothing is more triggering for a patient who’s worried about money than to get an invoice higher than they expected after their visit. If co-payments are due, it’s best to communicate that in advance &, if appropriate, you could offer the patient a payment plan. It might mean you’ll wait longer to get paid, but you are more likely to be paid in full, not to mention build trust & loyalty with the patient.
For more information about the kind of payment options you can offer, click here.
3. Create treatment plans that are sustainable
Knowing what the patient is & isn’t covered for can help you create a realistic healthcare plan that the patient can actually stick to. While we are in no way suggesting you compromise on care, there are a few ways you can help financially strapped patients stretch their medical aid savings. Here are some examples of cost-effective alternatives you could offer:
- Generic medications. Offer your patient the option of a generic medication if it is covered by their medical aid &/or is more affordable. Most generics are as effective without adding to the patient’s financial burden.
- Telehealth consultations. Aside from the cost of the actual consultation, patients incur other costs to arrive for their appointment. Petrol, possible loss of income if they need to take time off work or arrange childcare – these all add up. If your chronic patients require regular check-ups, consider giving them the option to continue with their care via Telehealth consultations. You are still able to bill for the consult but at a potentially lower cost. Your patients will appreciate the convenience & cost savings.
- Medical aid rates. It’s worth investigating the shared financial benefits for your practice & your patients by charging medical aid rates for the plan they’re on. The fewer out-of-pocket expenses the patient has, the more likely the patient is to stick to their treatment plan & get the care they need.
Financial health has an undeniable impact on physical health – both for your business & your patients. Implementing these 3 tactics will go a long way in ensuring that you can provide care to even the most cash-strapped patients without impacting your bottom line.
Do you want to improve your practice’s performance & streamline costs? To talk to us about a free practice health assessment & how we can help boost your profitability, click here.
Notes & references
* Based on 1245 claims being sent to Discovery during that year
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