The emails are coming in more furiously from chiropractors around the country who appear to be worried sick over Obamacare. While a significant portion of the battle is political and will not be a discussion in this article, as a chiropractic business owner, there are definitely things you can do now to insulate yourself against what may be coming our way – especially since it remains to be seen exactly how Obamacare will specifically affect chiropractors.
Depending on your practice, you may need to consider all or some of these items. But I can’t think of a single chiropractic business that can ignore all of them and survive.
1. Prepare for ICD-10: Although it is tangentially related to Obamacare, it is coming. Regardless of the various forms Obamacare takes, the format for your diagnosis coding will be the same: starting October 2014, you will use ICD-10 codes – like it or not. It is also going to take you months to get your office fully prepared, perhaps longer if you have new staff or CA’s who are unfamiliar with anatomy and terminology.
Action Step: Want to get a head start? If you act quickly, you can get in on the super-early bird pricing for our Chiropractic ICD-10 training series that will have you and your staff ready to go well before the deadline!
2. Learn to Navigate Medicare 2.0 : Opting out of Medicare his not really a viable option for chiropractors unless you consider Option A (die) or Option B (commit a federal crime). Given those grim opportunities, most chiropractors will need to get better at navigating Medicare 2.0 which, realize it or not, is here - ahead of schedule. The one major change in the landscape is hinted at via PQRS reporting. Since Functional Assessments are reported in 30 day increments, that should tell you a lot about Medicare’s treatment model and your treatment plans: 30 day increments. If you are setting care plans that are way too long, updating dx codes way too infrequently, and/or re-assessing your patients progress once in a blue moon, prepare for trouble. What does this have to do with Obamacare? Officially, nothing – since PQRS is a Medicare iniative. Practically speaking, however. It may be everything since Medicare is lone healthcare giant in the United States that represents the single closest model for which universal health care can be based upon. In other words, you better get swift at navigating Medicare mess else you may find yourself in trouble with many payers when Obamacare rolls around.
Action Step: If you haven’t done your Medicare PQRS reporting, you likely missed your chance at the bonus incentives but still have time to avoid penalties – see our Medicare PQRS training video for steps on how to report.
3. Consider Compliance. It’s no coincidence that the increase in changes via the Affordable Care Act, the Omnibus Rule, the move to make the Office of Civil Rights and Department of Justice oversee HIPAA and about 197 million other miniscule changes seem to have arrived about the same time as the massive increase in the number of audits the feds are conducting in the healthcare arena. Face it folks, auditing is big business. When a trained and commission based auditor waltzes into your door or arrives third-party via a letter, you better take it seriously and it would be wise to realize that you could be quickly out a significant chunk of change thanks to what they perceive as your mistakes. Whether you were aware of your mistakes or not, the fines remain brutal and the stakes keep getting hire. Ignorance is no excuse, compliance is something more than a binder on a shelf and you and your staff need to intimately understand what that does and does not include.
Action Step: Take a look at your compliance manual. Is it older than 2009? It won’t work. Dusty? It’s not doing you any good. Non-existent? Obviously, not going to work! What about your procedures? Are you confident that everything you are doing is correct? If not, how will you take steps to ensure that you are. Consider protecting yourself with the Chiropractic Audit Armor program, our interactive compliance training and mystery caller program. Or do it on your own. Just do something – you will be glad you did!
4. Think About Transitioning Sooner Than You Think. Notice, I am not saying “Sell your practice now!” but it would be advisable for you to consider exactly when you are going to do that and compare that to the timeframe of Obamacare. In consideration, you may need to be a little more flexible with your exit plans than you initially had in mind. For example, if you want out in five years, but don’t plan to talk to your Associate about buying in until year four, think again. If you have been considering a partnership, consider sooner, rather than later. If you want to do a traditional sale, prepare for the fact that you may be accompanied by a lot of other folks who aren’t so happy about Obamacare and thus, it may take a lot longer to find your buyer than you initially planned. Basic economics say that if the supply of practices go up and the demand stays the same, it may not be pretty for the selling side. On the other hand, if you have an excellent practice, you may see a tremendous increase in interest from young DC’s who want to be part of a successful venture and not navigate Obamacare alone. In this way, many transition experts are predicting a big increase in interest in “hybrid partnerships” (where seller only sells portion of the practice to buyer, but stays on to continue working) thereby lowering overhead, combining production power and reducing the potential damage that Obamacare may inflict upon a solo doc entity.
Action Steps
If you are getting close to transitioning, consider my Ultimate Chiropractic Exit Strategy program to give you some planning strategies for a successful sale, retirement or practice transition.
If you are already there and ready to exit now (or soon) and have a prospective buyer for whom you would like to transition, consider taking advantage of our FREE Exit Plan Consult when you complete our Exit Strategy Questionnaire. There’s no obligation to use our transition consulting services, but a quick chat may help point you in the right direction or provide a much needed dose of reality.
If you are a younger DC who is considering a Partnership Buy-In opportunity or who would like to purchase a practice, congratulations! In this uncertain times, I believe it is a wise move to use the existing momentum of a practice rather than try and start from scratch. Need to find a place to purchase or partner? Fill out our Transitioning IN form and we will look in our network of docs who are searching for DC’s like you to see if we can connect the two of you towards your mutual goals!
5. Boost Your Cash/Non-Insurance Based Revenues. Though it sounds like common sense to increase cash to insulate yourself from insurance changes (it is), the reality is that you cannot do this overnight. It takes time to build cash income streams. My big three action steps to get the most bang for your buck:
Action Steps
Leverage your existing patient base – don’t start a brand new venture outside of chiropractic even if it is cash based. You have patients who already trust you; meet a parallel need they have that you are not currently addressing.
Do not compete with big box stores. You don’t have the buying power to win. That doesn’t mean you can’t sell supplements or orthotics or other things that the chains do. But it does mean that you need to significantly differentiate what you are selling in order to avoid an apples to apples comparison that will leave you on the short end of the stick.
Choose something with back end benefits. No offense to the pillow manufacturers, but most patients aren’t coming in to your office because of your fantastic pillow you sold their friend. Find something that can bring patients in your door with or without your chiropractic services and it will generally add to your new patients at the same time.
Top Two Choices That Meet All Three Criteria
Massage (see our Build a $300K Massage Program for how to do it right!)
Rehab (see our 6 Figure Rehab Program for how to do it right!)
AND…Don’t Forget the AND!!
I started out by stating that a significant portion of the Obamacare battle is in the political arena. Don’t forget that. Support your state and national associations so that we don’t leave ourselves out of the fight for our rights.
Obamacare & Chiropractic: What You Can Do NOW To Protect Your Business!
is a post from: The Strategic Chiropractor Blog where you can learn chiropractic billing, coding, documentation & collections strategies that help you maximize reimbursements and minimize audit risk.
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