Nurse Practitioners and other clinicians are likely aware that effective today, Medicare has reduced your reimbursement by 2%. While it does not sound like a lot, consider the compound effect of 2% over the year. This was the topic of discussion last week during the NPBO Members Only monthly Success Webinar. It’s critical that all practices take a close look at their financials and consider the possible ripple effect that this decline in reimbursements may have on other payers.
You’ll want to perform an assessment of your practice:
- What is the payer mix of your practice? Break out your patients by payer type. What percentage of your patients are Medicare, Medicare/Medicaid, and your other payers. You should carry this out for all payers.
- Note reimbursements for each payer. Pay attention as well to any secondary plans and if they actually pay. For example, Medicaid does not often pick up the 20% that Medicare does not pay.
- Calculate the effect this drop in reimbursement will have on your practice. What happens if other payers drop reimbursement? (Heads up…some of them are!)
While I have read that the Medicare cuts are coming solely from the 80% that Medicare pays you, I will not be surprised to find confusion with patients and other payers regarding deductibles and co-insurance.
It’s likely, at least for now, that these cuts will not be reversed. You’ll want to make sure your practice is diligent in collecting deductibles, co-insurance and co-pays as appropriate (and per your contracts), keep an eye on your payer mix, and watch your bottom line.
Barbara C Phillips, NP is a professional speaker, author, clinician and business owner who provides business education, resources and support to Nurse Practitioners, Physician Assistants and other Advance Practice Clinicians – both for the employed and self-employed clinician. Additional information about Ms. Phillips is available at www.BarbaraCPhillips.com.