WASHINGTON In spite of poor Medicare reimbursement, physicians who use infusion therapy can take steps to make their practices more profitable, Steven M. Coplon said at a conference sponsored by Elsevier Oncology.
Under Medicare's system for reimbursing infusion drugs, "essential services are underreimbursed or not reimbursed at all," said Mr. Coplon, chief executive officer of the West Clinic, a Memphis, Tenn., oncology practice. "But the cost of drugs, staff, facilities, and malpractice insurance all continue to increase."
To stay in business, practices have to look more closely at the revenue that they are getting for their services. For example, "on one drug regimen [given frequently to Medicare patients], we're making $24 on $7,061 worth of investment," he noted.
One way to increase revenue is to increase the amount the practice brings in from private payers, he continued.
"Negotiate it to the best of your ability; go for every code you can possibly think of. Get creative," he advised. "If they're willing to say yes, you can make up for a lot of these margins you're losing on the Medicare book of business."
Another way to increase revenue is to diversify, Mr. Coplon said.
Instead of just providing drug, chemotherapy, administrative, and laboratory services at an oncology practice, how about adding radiology, pain management, palliative care, gynecologic oncology, and hospitalist care? he asked.
Roberta L. Buell, vice president of provider services and reimbursement at P4 Healthcare, Sausalito, Calif., said practices should also consider whether their billing procedures are "optimal." In an optimal practice, "80% of receivables should be less than 90 days overdue," said Ms. Buell. "And if your practice is more than 50% Medicare, you should be doing much better than that."
Elsevier Oncology and this news organization are wholly owned subsidiaries of Elsevier.