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Re: Patient Cancellations

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Hiten-

They're not necessarily canceling; they are hesitating to even schedule in the

first place!

There seems to be a shift going on from the family practice physician being the

gate keeper of the medical care to the wallet of the customer becoming the gate

keeper. By increasing the co-pays (so the medical insurers argue) the patient

will think twice before accessing medical care. It seems to be working!

How do we respond? We need to advocate (advertise) to our patients the value of

our service and that the $20 to $40 is more than worth it!

Rene van Doorn, PT, MTC

Seattle

From: hitendave@...

Sent: Thursday, September 09, 2010 11:36 AM

To: PTManager

Subject: Patient Cancellations

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays have been

in the neighborhood of $20 to $40. In the 25 years of my practise I am seeing it

more lately. Would like to know from PTs country-wide.

Thanks.

Hiten Dave' PT

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Hi Dave,

Definitely. This has been happening more since the recession took hold but

also remember that co-pays by design were probably instituted so patients

self-limited rehab services.

As a small practice we can be flexible at offering payment options, which

has helped. We also educate clients on the consequences of limiting PT

(when needed). We do more instruction in home programs for those limiting

their care due to cost. We do the best we can to get clients to stay and

the best we can when they decide they can't afford to continue. That is all

that we can do.

Tom Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, ID

thowell@...

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From: PTManager [mailto:PTManager ] On Behalf

Of hitendave@...

Sent: Thursday, September 09, 2010 12:37 PM

To: PTManager

Subject: Patient Cancellations

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays have

been in the neighborhood of $20 to $40. In the 25 years of my practise I am

seeing it more lately. Would like to know from PTs country-wide.

Thanks.

Hiten Dave' PT

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We aim to achieve an immediate change on the first visit so that the patient

appreciates the value of PT.  Getting the patient in the door to start with is

the bigger problem, especially given the prevalence of sky high deductibles. 

Karl Bebendorf PT, OCS

Denver, CO

Subject: Patient Cancellations

To: " PTManager " <PTManager >

Date: Thursday, September 9, 2010, 1:36 PM

 

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays have been

in the neighborhood of $20 to $40. In the 25 years of my practise I am seeing it

more lately. Would like to know from PTs country-wide.

Thanks.

Hiten Dave' PT

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Group,

I appreciated the latest posting on this topic, giving patients a quality

experience makes the difference - for their treatment attendance AND for getting

the next patient (their circle of friends/family) to schedule with you or even

another PT when referred.

See the latest ADVANCE PT/Rehab issue (there is an article on this topic). I

have been touting the need for a value-added experience in each PT session for

some time and even teach a con-ed course on minimizing cancellations/maximizing

efficiency.

Mike Studer,PT,MHS,NCS, CEEAA

President, Northwest Rehabilitation Associates Inc. Serving You With

Specialist Care and a Personal Touch 

Phone:

Fax:

mike@...

www.northwestrehab.com

 

We aim to achieve an immediate change on the first visit so

that the patient appreciates the value of PT.  Getting the patient in

the door to start with is the bigger problem, especially given the

prevalence of sky high deductibles. 

Karl Bebendorf PT, OCS

Denver, CO

Subject: Patient Cancellations

To: " PTManager " <PTManager >

Date: Thursday, September 9, 2010, 1:36 PM

 

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays

have been in the neighborhood of $20 to $40. In the 25 years of my

practise I am seeing it more lately. Would like to know from PTs

country-wide.

Thanks.

Hiten Dave' PT

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Dave:

It is happening more and more at our outpatient hospital based clinic in

Colorado as well. Some of our HMO clients are paying up to $60 copays.

Sperry, PT, OCS

From: hitendave@...

Sent: Thursday, September 09, 2010 12:37 PM

To: PTManager

Subject: Patient Cancellations

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays have

been in the neighborhood of $20 to $40. In the 25 years of my practise I am

seeing it more lately. Would like to know from PTs country-wide.

Thanks.

Hiten Dave' PT

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Seems like I got a lot of responses from PTs around the country and yes....we do

have a problem with higher co-pays and lesser patient visits This is insurance

company's tactics of " making the patient responsible for ther care " . Anyone has

suggestions how we can deal with this problem or is it hopeless?

Hiten Dave' PT

Patient Cancellations

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays have

been in the neighborhood of $20 to $40. In the 25 years of my practise I am

seeing it more lately. Would like to know from PTs country-wide.

Thanks.

Hiten Dave' PT

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The current trend is definitely to shift more cost to the patient as

demonstrated in the Kaiser Family Foundation and Health Research and Educational

Trust 2010 Employer Health Benefit Survey located here ==> http://ehbs.kff.org/.

You can see another article about that study at Health Affairs here ==>

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0725.

Both point out what we have all experienced in that employers are passing more

of the cost of coverage on to their employees in the form of higher premiums.

The amount of cost sharing for health care services consumed is also rising in

the form of higher co-pays and deductibles.

This is part of the theory that part of the reason for our runaway cost

inflation in healthcare is because the customer (patient) was insulated from the

cost in years past, so in order to control utilization the patient should have

more responsibility for the cost. Based on what I have seen in our clinics and

in other PTManager posts, it seems to be working in that patients are

questioning not only how many visits to consume but whether to come to therapy

at all.

We have responded in our outpatient clinics with the therapists having

conversations with patients on the first visit to be sure patients understand

the value of the PT/OT/SLP services they will be purchasing. So many people

still aren't fully aware of how we can help them, so it's up to us to tell them.

If they leave the eval appointment baffled then the probability of them being a

repeat customer with a $50 per visit co-pay is low. Then on every subsequent

visit we try to communicate to the patient what the patient will do in the next

visit that is different from what they did in this visit. That way the patient

hopefully sees a progression and not just the same thing from visit to visit.

Our assumption is that patients will be happy to pay for improvement, but will

become hostile to paying for the same thing done repeatedly.

Mark Dwyer, PT, MHA

Director of Rehabilitation Services

Olathe Medical Center

Olathe, KS

markdwyer87@...

Re: Patient Cancellations

Posted by: " hitendave@... " hitendave@...

Tue Sep 14, 2010 3:24 am (PDT)

Seems like I got a lot of responses from PTs around the country and yes....we do

have a problem with higher co-pays and lesser patient visits This is insurance

company's tactics of " making the patient responsible for ther care " . Anyone has

suggestions how we can deal with this problem or is it hopeless?

Hiten Dave' PT

Patient Cancellations

To the Group:

Was just wondering if any of you are seeing a very scary trend lately of

patients cancelling appointments as they cannot afford copays? Copays have

been in the neighborhood of $20 to $40. In the 25 years of my practise I am

seeing it more lately. Would like to know from PTs country-wide.

Thanks.

Hiten Dave' PT

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A quick follow-up to this thread on cancellations. There is a good article

about reducing cancellations by focusing on quality and value-added services in

the September 6, 2010 ADVANCE for Physical Therapy & Rehab Medicine by Mike

Studer, PT, MHS, NCS, CEEAA. It is on pages 18-22. You can also find it here

-->

http://physical-therapy.advanceweb.com/Archives/Article-Archives/Maximizing-Effi\

ciency.aspx.

Mark Dwyer, PT, MHA

Director of Rehabilitation Services

Olathe Medical Center

Olathe, KS

markdwyer87@...

>

> The current trend is definitely to shift more cost to the patient as

demonstrated in the Kaiser Family Foundation and Health Research and Educational

Trust 2010 Employer Health Benefit Survey located here ==> http://ehbs.kff.org/.

You can see another article about that study at Health Affairs here ==>

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.2010.0725.

>

> Both point out what we have all experienced in that employers are passing more

of the cost of coverage on to their employees in the form of higher premiums.

The amount of cost sharing for health care services consumed is also rising in

the form of higher co-pays and deductibles.

>

> This is part of the theory that part of the reason for our runaway cost

inflation in healthcare is because the customer (patient) was insulated from the

cost in years past, so in order to control utilization the patient should have

more responsibility for the cost. Based on what I have seen in our clinics and

in other PTManager posts, it seems to be working in that patients are

questioning not only how many visits to consume but whether to come to therapy

at all.

>

> We have responded in our outpatient clinics with the therapists having

conversations with patients on the first visit to be sure patients understand

the value of the PT/OT/SLP services they will be purchasing. So many people

still aren't fully aware of how we can help them, so it's up to us to tell them.

If they leave the eval appointment baffled then the probability of them being a

repeat customer with a $50 per visit co-pay is low. Then on every subsequent

visit we try to communicate to the patient what the patient will do in the next

visit that is different from what they did in this visit. That way the patient

hopefully sees a progression and not just the same thing from visit to visit.

Our assumption is that patients will be happy to pay for improvement, but will

become hostile to paying for the same thing done repeatedly.

>

> Mark Dwyer, PT, MHA

> Director of Rehabilitation Services

> Olathe Medical Center

> Olathe, KS

> markdwyer87@...

>

>

> Re: Patient Cancellations

> Posted by: " hitendave@... " hitendave@...

> Tue Sep 14, 2010 3:24 am (PDT)

>

> Seems like I got a lot of responses from PTs around the country and yes....we

do have a problem with higher co-pays and lesser patient visits This is

insurance company's tactics of " making the patient responsible for ther care " .

Anyone has suggestions how we can deal with this problem or is it hopeless?

>

> Hiten Dave' PT

> Patient Cancellations

>

> To the Group:

>

> Was just wondering if any of you are seeing a very scary trend lately of

> patients cancelling appointments as they cannot afford copays? Copays have

> been in the neighborhood of $20 to $40. In the 25 years of my practise I am

> seeing it more lately. Would like to know from PTs country-wide.

>

> Thanks.

>

> Hiten Dave' PT

>

>

>

>

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