CASH IS KING: Why Implementing a Cash Payment System Is Essential
PRACTICE MANAGEMENT
Nancy Singleton
It’s no secret that the healthcare system in our country is the bureaucratic equivalent of a nuclear disaster, and little is being done to correct the course. Americans are paying out the nose for health insurance and still aren’t getting the care they need to be truly healthy. This is where you come in. Chiropractors play a vital role in providing the high-quality health care that’s so badly lacking in the United States today.
First, let’s look at some simple arithmetic that illustrates the emergency that insurance markets have created for American families:
In 2015, the United States spent $3.2 trillion on health care.1 That’s nearly $10,000 per person, which adds up to $40,000 for a family of four (more than the average American’s annual paycheck!). A trip to the emergency room for chest pahi can rack up a bill that exceeds the cost of a semester of college. Some simple lab work can cost more than a car. With the exorbitant prices being charged for health care, it’s easy to understand why more than two million Americans experience medical bankruptcy each year.2
We also have the least efficient system, as far as administrative costs go. The complex structure of healthcare funding (including paperwork and the workforce required to push these papers) has created an unsustainable administrative burden. A simpler financing system could save Americans over $350 billion each year—nearly 15% of total healthcare spending.3
For chiropractors, working with insurance can be particularly troubling. Since chiropractic care is often considered
“complementary” or “alternative” medicine, coverage can vary enormously horn one plan to the next. While many providers include chiropractic care, the amount of reimbursements has been waning, and insurers are finding more reasons not to cover treatment. Because of this, patients in your clinic are not only worried about what their insurance will pay, but if and when it will pay at all.
The irony is that insurance makes little sense for long-term wellness care. We purchase insurance for things that we don’t want to have to use. Think about it—car insurance, life insurance, health insurance, homeowners insurance. We don’t want to have to use those insurance policies. We only tap into them when a disaster occurs.
So, how did chiropractic care get tangled up in the insurance mess? It seems that many people only think about getting an adjustment when they’re experiencing acute back pain, but this isn’t how chiropractic care is meant to be used. Though chiropractors do provide support through the acute phase of a condition, they also do so much more. True chiropractic care is long-term care with a strong preventative component. It’s a way to stay healthier, happier, and more balanced. So why worry about insurance at all?
Believe it or not, you can be financially successful as a chiropractor without insurance. My husband and I switched to an all-cash practice in 2006, and never looked back. In our case, a series of harrowing insurance mishaps convinced us that putting all of our eggs in the insurance basket was an unreliable, risky bet. So we built a solid cash system and began using sound nutritional protocols to provide services to our patients that insurers would never cover. We were finally free to treat patients whichever way we thought was best, and it showed! Our patients began seeing better results, and our clinic grew to reflect that success.
You can do the same. When you switch to cash, your patients will get better, well-rounded care, and you’ll find that your income is far more reliable. Moreover, because people are used to paying with cash for wellness services, you’ll find that this approach makes more sense to your patients too.
As you build your repertoire of cashbased services, you can focus on regular adjustments and therapies, or you can do what we did and take the opportunity to begin offering nutrition-based services in your clinic. If you go this route, you may want to consider offering in-office educational seminars, supplements, takehome wellness kits, and other forms of nutritional support. In our clinic, we offered a variety of cash-based, doctorassisted nutritional programs to help our patients become truly healthy. These included:
• Healthy weight loss
• Neuropathy solutions
• Hormone balancing
• Insomnia solutions
• Smoking cessation
• Detoxification and cleansing
• Immune boosting
• Stress relief
• Skincare
• Thyroid care
These simple, effective, cash-based programs increased our cash how without much extra effort. They can do the same for you. When you show your patients that you’re truly invested in their health, they’ll be more likely to continue seeing you for long-term care. They’ll be more likely to refer friends and family members, more likely to buy supplemental products and services, and more likely to post a positive review online. Ultimately, freeing yourself from insurance will make it easier for you to provide the high-quality, meaningful care that your patients deserve and desire.
Our current insurance climate is volatile. You can choose to agonize over whether insurance will cover certain services and how it will affect your patients, or you can choose to approach things differently. Ultimately, you have no control over insurance markets, so finding and implementing an alternative solution is
the best, most reliable option. You can prepare yourself for insurance droughts by having cash systems in place to see you through.
Whether you decide to go all-cash or implement a handful of cash-based services in your clinic, helping your patients realize that chiropractic care is really about long-term wellness will serve your practice well. When your patients understand the true value of your services, they’ll want to come back again and again regardless of the method of payment. When you utilize cash-based services, you’H find that you feel much freer to focus on providing high-quality care, and your patients have one less thing to worry about. What’s not to love about that?
References:
1. National Healthcare Expenditure Fact Sheet. (2017, June 14). Retrieved July 26, 2017, from https: www.cms.gov/ research-statistics-data-and-systems statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html
2. Hansard Medical Study; Himmelstein, D. U., Warren, E., Thorne, I)., & Woolhandler, S. (2005, February). MarketWatch: Illness and injury as contributors to bankruptcy. Retrieved July 26, 2017, from http:/ content.healthajfairs. org/content/suppl/2005/01/28/hlthaff w5.63.DCl
3. Jiwani, A., Kahn, J. G., Himmelstein, I)., & Woolhandler, S. (2014, November 13). Billing and insurance-related administrative costs in United States ’ health care: Synthesis of mi cro-costing evidence. Retrieved July 26, 2017, from https://www.ncbi.nlm.nih.gov/ pmcarticles/PMC4283267
Nancy Singleton is a 1989 graduate of the Los Angeles College of Chiropractic Assistants. She has been consulting and helping doctors grow their practices for more than 25 years. She and her husband, Dr. Todd Singleton, teach chiropractors how to implement multiple cash systems into their existing practices. For more information, call 801-917-0900, e-mail contackaNingletonSystems.com, or visit www.NancySingletonsArticles.com.
