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 infusion-drug reimbursement, “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 must look more closely at the revenue they get for their services, he said. For example, “on one drug regimen [given frequently to Medicare patients], we're making $24 on $7,061 worth of investment. Even Sam Walton, when he started Wal-Mart, worked on a higher margin than that.”
One way to boost revenue is to raise 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 strategy: Diversify. Instead of just providing drug, chemotherapy, administrative, and laboratory services at an oncology practice, why not add radiology, pain management, palliative care, gynecologic oncology, and hospitalist care? Within each service, of course, are different subsets—radiation oncology can include CT, PET, PET/CT, and MRI, he noted.
Roberta L. Buell, vice president of provider services and reimbursement at P4 Healthcare, Sausalito, Calif., said practices should consider if their billing procedures are “optimal.” In an optimal practice, “80% of receivables should be less than 90 days overdue,” Ms. Buell said. “And if your practice is more than 50% Medicare, you should be doing much better than that.” Also, be aware of your practice's “chair turn” per day and see if it can improve.
Elsevier Oncology and this news organization are wholly owned subsidiaries of Elsevier.