Date post: | 13-Apr-2017 |
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Health & Medicine |
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Private Practice Model Perspectives 2015 Survey
Conducted by Kareo & AAPP
Agenda
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Agenda
2
• Methodology• Respondents• Motivations & Realities of
Practice Models• Key Trends in Private
Pay/Membership Medicine
33
• Approximately 100,000 physicians surveyed yielding 862 respondents• 206 Private Physicians
• 477 Conventional or Fee-for-service Providers
• 179 other
• Compared private physician respondents to conventional, insurance-based practice respondents across all common questions, and used statistical testing to determine where significant differences existed
• Reported on questions specific to either private physician practice respondents or insurance-based practice respondents
Methodology
4
About Respondents
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Gender
Conventional Private
40%47%
60%53%
FemaleMale
6
Age
21-29 30-39* 40-49 50-59 60 or older
7%
21%
24%26%
21%
4%
14%
29%
32%
20%
ConventionalPrivate
* Denotes statistically significant at a minimum 95% confidence level
7
Professional Designation
DO MD NP PA
10%
74%
14%
2%
8%
80%
10%
2%
ConventionalPrivate
8
Board Certification (MD/DO)
Conventional Private
14% 12%
86% 88% YesNo
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• Conventional physicians: 19.6 years• Private physicians: 19.9 years
Years in Practice
10
Group Size
Solo practitioner*
2-5 practitioners*
6-10 practitioners
11+ practitioners
Health system or academic medical
center
40%
36%
10%
7%
7%
55%
26%
8%
8%
3%
PrivateConventional
* Denotes statistically significant at a minimum 95% confidence level
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Comparing Motivations & Realities Between Private and Conventional Physicians
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Are you currently using a concierge, direct pay, or other membership model in your
practice?24%
76%
Yes No
13
What is the likelihood you will transition to a concierge, direct pay, or other membership
model in the next 3 years?
54%32%
14%
Not likelySomewhat likelyHighly likely
Primary care MDs and DOs
14
Top 2 Motivations for Transitioning to Private Medicine
Earn more money*
Spend more time with patients*
Improve work-life balance
Practice lifestyle, functional, or integrative medicine*
To separate from the insurance payer system
Other
39%
42%
35%
22%
41%
4%
26%
65%
42%
38%
46%
8% PrivateConventional
* Denotes statistically significant at a minimum 95% confidence level
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Average Length of a Patient Visit
15-20 minutes* 30 minutes* 45-60 minutes* Other (please specify)
49%
27%
18%
5%
19%
39%
33%
9%
Conventional
Private
* Denotes statistically significant at a minimum 95% confidence level
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How many days of the week do you see patients in the office?
Once a week 2 days a week 3 days a week 4 days a week 5 days a week 6 days a week* 7 days a week*
2%4%
10%
23%
61%
0% 0%2%
10%8%
19%
52%
8%
1%
ConventionalPrivate
* Denotes statistically significant at a minimum 95% confidence level
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What is your maximum daily visit volume?
* Denotes statistically significant at a minimum 95% confidence level Graph distributes “Other” respondents from previous question into “< 10” and “> 30” categories
<10* 10* 15* 20* 25* 30* > 30
1%
12% 13%
21%
17%
23%
13%
9%
39%
25%
9%
4% 5%
8%
Conventional
Private
Patient Panel Size
Conventional
< 500 501-1000 1001-1500 1501-2000 >2000
24%
14%
12% 11%
39%
Private
< 100 101-200 201-300 301-400 401-500 >500
26%
13% 13%12%
7%
29%
The average private medicine provider
works 42 hours a week while the average traditional provider works
47 hours per week.
20
% Clinical Time vs. Administrative
Conventional Private
71.8
76.0% Clinical Time
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Sources of New Patients Ranked by Importance
word of mouth physician* online* advertising employer* other
1.7
2.3
3.3
4.1 4.1
4.8
1.5
3.12.8
3.9
4.5 4.5ConventionalPrivate
* Denotes statistically significant at a minimum 95% confidence level
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20% of practices—conventional or private—spend less than $800 a month on
marketing.
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Top Challenge Faced by Practice
Choosing and implementing new technology
Finding and keeping qualified staff*
Managing regulatory compliance
Recruiting new patients*
Retaining existing patients
Staying financially viable
11%
19%
18%
16%
2%
33%
10%
7%
15%
39%
2%
27%
PrivateConventional
* Denotes statistically significant at a minimum 95% confidence level
Private Pay Practice Trends
The average practice has been concierge or direct pay for 8 years.
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How did you start your concierge or direct pay practice?
47%
53%
Converted from an in-surance-based practice
Started the membership practice from scratch
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How do you describe your practice?
37%
33%
30%Cash Practice
Concierge
Direct Primary Care (DPC)
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Billing models for cash-based fee for service practices
29%
71%
Based on visit time (i.e., # of minutes)Fixed fee by service type
The average annual membership fee is $2,025.
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What membership packages or payment plans do you offer? Check all that apply.
Monthly payment plan Quarterly payment plan Annual payment plan Discounts for couples/families
Discounts for children
65%
44%
61%
42%36%
Note: categories are not mutually exclusive and will not sum to 100%
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Of your total patient panel, what percentage are members?
37%
10% 6%
19%
28% <25
26-50%
50-75%
75-99%
All patients are members
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If you accept insurance, please check all that apply to the status you have with the following payer types:
Medicare non-participating
Medicare opt-out
Out of network with health plans
17%
23%
45%
Note: categories are not mutually exclusive and will not sum to 100%
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Services Offered (Select all that apply.)
Remote monitoring - Sleep tracking (i.e. using a FitBit, or other sleep monitoring device)Carotid IMT
Remote monitoring of activity (i.e. using a FitBit or similar device)Remote monitoring of biometrics (i.e. blood pressure, weight, glucose) using a monitoring device
Home sleep testingHospital admission
Mobile apps for patient managementNutritional supplement dispensing using an online dispensary and direct shipping
Nutritional supplement dispensing in the officeGenetic testing (e.g., 23andMe)
Body Composition Assessment (BIA)Exercise program design
Pharmacogenomics testingHormone replacement therapy
Patient education using seminarsHospital visitation
Weight loss programHouse calls
Nutrition assessmentPersonalized, documented health management plan for the year
Nutrition consultationNavigation and coordination of care with specialists
On-site lab drawingHealth Coaching
Virtual consultations via phone, text, email, and/or video chatPre-negotiated cash prices for office services and/or labs
Annual health evaluationOngoing Management of acute and other primary care needs
7%8%
10%13%
15%17%18%
22%23%24%
27%28%29%30%
32%36%
38%39%40%
45%46%47%48%
53%55%
59%68%
72%
Technology
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Private pay practices are more likely to use telemedicine, kiosks, and practice
marketing platforms.
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Top Software Features• When asked about top software features…
• Private pay practices were more likely to want online scheduling, patient portals, online billing & payments, and credit card on file.
• Traditional practices were more likely to want improved claims management, financial reporting, and specialty EHR features.
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In conclusion…There are challenges and benefits for both private and conventional practice models. However, despite varying workflows and
processes, a common need for all independent practices is the right technology, tools, and
support.
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