Re: micropractice dead zones = high overhead

[Guest guest]

anyplace with very high overhead.

rent, malpractice, staff or other expense

or low reimbursement like only medicaid unless you are a rural health clinic with better reimbursement.

Subject: micropractice "dead zones"To: Date: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice "dead zones". I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone know where I can find the info?

[Guest guest]

Did post an article?has no idea which way is up after the last two days but has it right It is the combination of reimbursement, malpractice and maybe cost of living too I would think

HAd a friend who was a doc on NAntucket for a while but to pay the least educated receptionsit there was so burdensomely high it made overhead out -weigh any good reimbursement etc.Only you know if you live in a dead zone WE hear that eastern Pennsylvania is one , much of NJ ,some of california

But w e think Oregon is The Emerald City:)

anyplace with very high overhead.

rent, malpractice, staff or other expense

or low reimbursement like only medicaid unless you are a rural health clinic with better reimbursement.

Subject: micropractice " dead zones "

To: Date: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice " dead zones " . I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone

know where I can find the info?

-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD

ph fax

[Guest guest]

We haven’t really come up

with a way to map these yet; it is a project worth working on though. So

far, anecdotal. I have considered trying to look at this with average

reimbursement, percent insured, cost of living, cost of malpractice, etc, but

haven’t had the time yet. Anybody interested in a little project??

Sharon

From:

[mailto: ] On Behalf Of Egly

Sent: Tuesday, August 26, 2008 2:26 PM

To:

Subject: Re: micropractice " dead zones "

= high overhead

anyplace with very high overhead.

rent, malpractice, staff or other expense

or low reimbursement like only medicaid unless you are a

rural health clinic with better reimbursement.

From: drsof99

Subject: micropractice " dead zones "

To:

Date: Tuesday, August 26, 2008, 4:21 PM

After reading the article

that posted, I was wondering what are

the micropractice " dead zones " . I was looking on the site but would

not

find any listing? I am wondering if my location is one of them! Anyone

know where I can find the info?

[Guest guest]

Sharon:

CMS has done this already and yearly. The information you are looking at would be individually based and not always able to be replicated.

CMS puts out hourly expense estimates for each specialty. Someone then takes these and massages them into the locality specific fee schedules.

Except for procedures, all E & M coding is time based. Take the reimbursement from CMS for your area a typical visit 99213, 99214, 99215 etc and back calculate into reimbursement per hour. MY locale is about $135/hour. CMS average overhead runs $56/hour. My salary in CMS eyes is $69times the number of hours I want to work.

They do not take into account dead time ie no patients scheduled. They do not care how you alot your overhead.

Really a complex issue. Enough patients and any location works if you spend the right amount of time with the patients.

For IMPs it becomes total yearl reimbursement/ clinical hours for the rate. When reimbursement falls below $135/hour then I either work more hours or see more patients in fewer hours.

Conciegre practices allow for setting reimbursement rate per year and thus offer stability in business once a critical number are massed. Then you don't worry about the down time, the extra time,the headaches, because you know you have been paid and won't be in the cardboard box unted the bridge.

Hope this helps

PS My time is worth $2/minute if I could line them up I would.

Subject: RE: micropractice "dead zones" = high overheadTo: Date: Wednesday, August 27, 2008, 11:15 AM

We haven¢t really come up with a way to map these yet; it is a project worth working on though. So far, anecdotal. I have considered trying to look at this with average reimbursement, percent insured, cost of living, cost of malpractice, etc, but haven¢t had the time yet. Anybody interested in a little project??

Sharon

From: Practiceimprovement 1yahoogroups (DOT) com [mailto:Practiceimp rovement1@ yahoogroups. com] On Behalf Of EglySent: Tuesday, August 26, 2008 2:26 PMTo: Practiceimprovement 1yahoogroups (DOT) comSubject: Re: [Practiceimprovemen t1] micropractice "dead zones" = high overhead

anyplace with very high overhead.

rent, malpractice, staff or other expense

or low reimbursement like only medicaid unless you are a rural health clinic with better reimbursement.

From: drsof99 <drsofhotmail (DOT) com>Subject: [Practiceimprovemen t1] micropractice "dead zones"To: Practiceimprovement 1yahoogroups (DOT) comDate: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice "dead zones". I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone know where I can find the info?

[Guest guest]

I'm waiting to see how Appointment Quest works out now that I've opened it up to patients, but "Receptionist?" I'm thinking AQ + Onebox.

[Practiceimprovemen t1] micropractice "dead zones"To: Practiceimprovement 1yahoogroups (DOT) comDate: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice "dead zones". I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone know where I can find the info?-- If you are a patient please allow up to 12 hours for a reply by email/please note the new email address.Remember that e-mail may not be entirely secure/ MD ph fax

[Guest guest]

Speaking as a resident of an official Dead Zone, I think a glut of physicians is a key variable. On BestPlaces.com, one of the parameters compared under healthcare is the number of physicians per unit population. Lexington KY has almost four times the national average, which is almost certainly why our insurers are not at all interested in negotiating fees. I take what they offer or I take a hike. Thank God my overhead is under control.

2010 cannot get here soon enough!Annie

anyplace with very high overhead.

rent, malpractice, staff or other expense

or low reimbursement like only medicaid unless you are a rural health clinic with better reimbursement.

Subject: micropractice " dead zones "

To: Date: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice " dead zones " . I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone

know where I can find the info?

-- Annie SkaggsLexington, KY

[Guest guest]

One would think we could list out the variables and weight them for what makes a dead zone.

Poor insurance rates

Too much medicare, medicaid - above a certain percentage

Too many docs

Not enough people

High cost of living and/or overhead

etc

I would think that is the first place to develop the equation.

I believe we have listed more of these features before.

Perhaps we should come up with a master list that would be included in the Equation for...

IMP Dead Zone = a + b + c + ...

Locke, MD

From: [mailto: ] On Behalf Of SkaggsSent: Wednesday, August 27, 2008 5:13 PMTo: Subject: Re: micropractice "dead zones" = high overhead

Speaking as a resident of an official Dead Zone, I think a glut of physicians is a key variable. On BestPlaces.com, one of the parameters compared under healthcare is the number of physicians per unit population. Lexington KY has almost four times the national average, which is almost certainly why our insurers are not at all interested in negotiating fees. I take what they offer or I take a hike. Thank God my overhead is under control.2010 cannot get here soon enough!Annie

anyplace with very high overhead.

rent, malpractice, staff or other expense

or low reimbursement like only medicaid unless you are a rural health clinic with better reimbursement.

Subject: micropractice "dead zones"To: Date: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice "dead zones". I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone know where I can find the info?-- Annie SkaggsLexington, KY

[Guest guest]

One of the things to look at is also who is the best payor.

In NJ, one of the reasons it’s a “dead zone”

is that Medicare is the best payor and all other insurance plans pay less.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Locke's in

Colorado

Sent: Wednesday, August 27, 2008 8:57 PM

To:

Subject: RE: micropractice " dead zones "

= high overhead

One would think we

could list out the variables and weight them for what makes a dead zone.

Poor insurance

rates

Too much medicare,

medicaid - above a certain percentage

Too many docs

Not enough people

High cost of

living and/or overhead

etc

I would think that

is the first place to develop the equation.

I believe we have

listed more of these features before.

Perhaps we should

come up with a master list that would be included in the Equation for...

IMP Dead Zone = a

+ b + c + ...

Locke, MD

From:

[mailto: ] On Behalf Of Skaggs

Sent: Wednesday, August 27, 2008 5:13 PM

To:

Subject: Re: micropractice " dead zones "

= high overhead

Speaking as a resident of an

official Dead Zone, I think a glut of physicians is a key variable. On

BestPlaces.com, one of the parameters compared under healthcare is the number

of physicians per unit population. Lexington KY has almost four times the

national average, which is almost certainly why our insurers are not at all

interested in negotiating fees. I take what they offer or I take a

hike. Thank God my overhead is under control.

2010 cannot get here soon enough!

Annie

anyplace with

very high overhead.

rent,

malpractice, staff or other expense

or low

reimbursement like only medicaid unless you are a rural health clinic with

better reimbursement.

Subject: micropractice " dead zones "

To:

Date: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was

wondering what are

the micropractice " dead zones " . I was looking on the site but would

not

find any listing? I am wondering if my location is one of them! Anyone

know where I can find the info?

--

Annie Skaggs

Lexington, KY

[Guest guest]

maybe thats why that new practice folded a couple years ago in South Orange NJ.

[Practiceimprovemen t1] micropractice "dead zones"To: Practiceimprovement 1yahoogroups (DOT) comDate: Tuesday, August 26, 2008, 4:21 PM

After reading the article that posted, I was wondering what are the micropractice "dead zones". I was looking on the site but would not find any listing? I am wondering if my location is one of them! Anyone know where I can find the info?

-- Annie SkaggsLexington, KY