Cash Only Practice Ideas

David,

1. I resoundingly agree that a new grad should not even consider an
individual practice until they are sufficiently ready to provide good quality
patient care and be able to handle the volume of patients that he/she might
see during the course of the day and remain treading above water.

2. You should check out this guy's website who I found on the net surfing
about being practice owner: http://www.acchealth.com/ . I guess this
could be considered a boutique type of practice, but in the same regard, it
is reasonable if a patient were using HSA's as their primary source of
payment for healthcare. Using a mixed income model, I believe that profiting from business would not be much of a problem. Also, this is very dependent on the amount of overhead that would come from owning this type of practice including but not limited to property leases or ownership prices, one's own liability insurance, supplies and equipment, ancilliary staff, one's own health insurance, and coverage for days to be off so the practice could continue to run in your absence. I in no way intend to open my own practice right now, but am checking the weather on my community for the need and the demand of this type of practice in the future. If I can become sufficient enough to practice independently, it may one day be an option. Thanks for your insight, I always enjoy reading your posts to consider a different vernacular.

BabyLady,

I respect your point of view.

1. If a patient has the choice between seeing you and paying up front, or another NP that will bill the insurance, which one will they see?

Usually one seeing his/her is required to pay some sort of copay (ranging from 1$-50$). Many offices that I have seen require a patient to pay this upfront before they can be seen. Patients receiving a socialized form of healthcare would probably not be interested in receiving a cash only practice as their source of primary care. These people are not required to often pay any significant copays and would not be willing to pay more for service. Unfortunately for our current social state and socioeconomic status of these individuals, this may also eliminate seeing many patients who are drug seeking individuals which may infringe upon the environment of your practice.

2. Moral issues regarding people telling YOU what tests they think they need run, the care that they need, etc...based on their ability to pay. You'll be a writer of "estimates" rather than a provider of care. Can you live with yourself if you knew they needed something done and couldn't afford it and something happened to them...if they had insurance?

To answer in one word "Yes". As stated earlier, these individuals may qualify for some form of socialized medicine and be able to receive it. If the need is acute, the individual could most certainly be seen in the ED without having to pay at that time. If they could not reach the ED on their own, an ambulance could be arranged to pick up the patient and take them to the ED. The need to marginalize the cost of healthcare is just as important today as it has ever been. Competition is how we as nurses make ourselves affordable as is always stated as one of the examples of being a nurse practitioner. Oftentimes, we are only affordable to the institution who is hiring us, not to the people we are providing care for.

The moral benefits would be to help individuals without health insurance as well as those who have high priced premiums on their health insurance be able to receive primary care in an environment where cost was not a mistifying cascade of charges that insurance companies send you back on a bill everytime you go see your PCP and you are charged for each fee included.

I believe that one (the business owner) would have to continually be aware of the costs of certain procedures as well as referrals for individuals without health insurance. Perhaps if the business became successful, one could work out deals with specialists in the area or companies with specialty equipment to see these patients because they are cash paying individuals. Networking throughout the community would be very important. Patients could also use insurance if need be if the situation arose. Especially those with HSA's that included high priced premiums. Continual review of performance would also be important and the community could hopefully answer you by mail based surveys or telephone based interviews. This would be a cash for service type of business in the sense that I believe where one would receive their health care service need at a price. Like David said though, one would have to possess a great rapport with the community and be a highly competent provider.

ive never done this before, but bump