Transition to IMP - Letter to Patients --> was RE: Your input please

[Guest guest]

Hi Gail,Good luck with your transition!I have a few comments. Take them for what they are worth - free.First off -- are you sure this is the best way to cull patients?Have you thought about doing this by a combination of natural atrition and getting rid of your worst paying insurances?That way, you would be improving your payments and likely lose some of the patients that are part of those low paying insurances.Off the top, it's a pretty high level readability in regards to words.I put it through this readability site and it said it was a 12th grade reading level -- which might be fine for your population, but just be aware that much of the population has a much lower reading level. http://www.linda-andrews.com/readability_tool.htm

Here is a google on readability calculators.

http://tinyurl.com/ytwo3xAt the bottom of this e-mail is the SMOG analysis for your current letter.

I would leave out the "fail to pay for my services competitively" -- whenever one talks about money, it can get difficult.Patients are dropping $20-40 copay for 15 minutes of our time, plus paying a lot monthly in premiums. I'm not sure they want to hear about how difficult it is for doctors to make it on what the insurance is paying.Just my opinion.My overall opinion is...

Consider decreasing patient load by not accepting new patients and dropping your lowest paying insurances.

You could then send a letter to only the patients that have those dropped insurances....no need to go into big details about why the insurances were dropped -- just say that XYZ clinic will no longer be accepting ABC insurance. We hope to continue to see you as a patient, but understand if you choose to changes providers -- and if you really want those patients to go elsewhere -- you could add -- and here are some docs in the area who take ABC insurance.

I think the technology fee is fine -- seems a little high -- $10/month would be $120/year.I'm not sure what others are charging out there.$120/year x 500-1000 patient panel would be $60-120,000 per hear just in that fee. A pretty good salary for some of the docs on the list -- and without even seeing a patient.You might have to rethink that.Also, there may be some issues about Tech Fees and insurances. Some insurances argue that the docs aren't allowed to charge anything beyond the E & M/CPT fees -- ie Malpractice surcharge, etc.You might get some flack from some patients who then report you to the insurer.I'll try to repost some Tech Fee info I found out in the past.

Lastly, I'd keep it very short and brief.Keep it solution focused (this is what I will do) and not problem focused (I can't see you if you have ABC insurance and it's because your insurance's reimbursement sucks).Best of luck and don't take any of this as criticism -- just requested feedback and how I might interpret a letter that I received like this one.

Detailed SMOG Analysis

Sunday, November 11, 2007 9:47:39 PM

SMOG Grade

12.02

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Words:

612

Numbers(off):

0

Total Tokens:

612

Syllables:

935

Sentences:

31

Basic Data

Sentences

31

Total Words

612

Letters

2793

Digits

0

Characters

3596

Lines

1

Derived Data

Words/Sentence

19.74

Syllables/Word

1.53

Syllables/Sentence

30.16

Letters/Syllable

2.99

Letters/Word

4.56

Letters/Sentence

90.1

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low-literate

Soap Opera Weekly

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junior high school

True Confessions

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junior high school

Ladies Home Journal

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some high school

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some high school

Newsweek

11

some high school

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12

high school graduate

Time Magazine

13 - 15

some college

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university degree

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post-graduate studies

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19+

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IRS Code

Locke, MD-----Original Message-----From: [mailto: ] On Behalf Of gail_dresslerSent: Sunday, November 11, 2007 9:42 PMTo: Subject: Your input pleaseI have been trying to compose a letter to my patients to explain that I am cutting back on my patient load (1700 or so) and instituting IMP ideals. My reason is honest: to spend more time with my family, especially my parents. I am also led by a desire to change the way medicine is practiced and all that, but I don't want to get too wordy, and I know that what really matters to them is if they are going to be "cut" or not.Honest feedback please:Dear________,Over the past year, I have been wrestling with some weighty issues regarding my priorities, my time commitments, and the current status of our healthcare system. This struggle has led me to make the choice to significantly alter my practice. In a nutshell, I plan to make it smaller and less hurried, following the "Ideal Micro Practice" model.You can read further about this model at www.idealmicropractice.org.I have been in either the pursuit or practice of medicine now for almost 30 years. I love it, I'm fascinated by it, I hope to be practicing for many more years. But if I continue on my current trajectory, I believe I will face many regrets once I finally do retire. The greatest is that I will have not been available to my aging parents in their later years of life. I could not bear to realize too late that I should have chosen time with them over working late. Consequently, I will be making changes that will unavoidably affect each of you. These changes may mean that you move to another practice that fits your needs. If that is so, please accept my thanks for the privilege of having been your physician, and my apologies for the disruption my choices create.The three main changes come in the areas of Insurance, Technology Fees, and Office Hours, as outlined below:Insurance As of 2/1/08, I will no longer be accepting any HMO insurance (this means I will not be a provider for Hill Physician Medical Group). I will continue to be a preferred provider for the following plans only: All Medicare Fee-for-Service (ie: non-HMO) plans Aetna PPO United Health Care PPO Great West PPO Most Labor Union Self-insurance plans Blue Cross Blue Shield All plans will be reviewed periodically with regard to reimbursement levels and "hassle factor". I will not guarantee ongoing participation in any plans that fail to pay for my services competitively. If your insurance is not listed here, you will have the option of paying at the time of the visit and submitting the bill to your insurance plan. Your insurance will reimburse you using its non-preferred provider rates. For those of you who already pay at the time of service, there will be no changes.Technology Fees The use of electronic records, email with patients, and other applications of technology is the way of the future. It can boost efficiency, provide important information at the point of care, improve communication between patients and physicians, and help prevent medication errors among other things. But it is not cheap.Its use is encouraged but not mandated by payors, consequently it is not rewarded financially either. I will be instituting a reasonable "user fee" for these non-covered services. It will be in the range of $10-15/month, paid quarterly.Families with children and the very elderly will have a sliding scale. Instead of charging for WebVisits on Relay Health, I think this fee will more fairly reimburse me for my time and likewise encourage more open communication online. This fee applies whether you use email with me or not, since it is not just for online communication but for all use of technology.Office Hours I plan to institute an "Open Access" schedule, which means that most times a patient can be seen within 24 hours of contacting me for a visit. Online visits will be available as well. However, I do expect that I will be out of the office most afternoons in order to tend to my family commitments. I will remain available by phone or email 24/7 however.