We Asked: If you have worked within a managed-care network, what are the benefits and/or disadvantages of doing so?
Here is what you told us...
Benefits of being a managed-care provider are the inclusion of your name in the network directory, and possible introduction of new clients to your work or specialty. One disadvantage is with the current trend of discount programs, where the client self-refers but pays out-of-pocket, at a discount. The clients seem more concerned with the discount than with the work. In my experience, they are often abrupt and arrogant on the telephone, and don't take their appointments seriously, frequently canceling their first appointment or two on short notice and never re-scheduling. Participation did not increase physician referrals at all.
The benefits of managed care would be that they make all the arrangements, they call you and tell you where to go (I work with hospice patients). They create the client base for you, they provide the structure and support. The disadvantage is that you have to wait at least three weeks to get paid - it's a large corporation and a bureaucracy.
As a full-time massage therapist who has been married to and employed by a chiropractor for over 12 years, I have been directly affected by managed care and have seen managed-care networks slowly and steadily erode the care received by the patient and the ability of the doctor to provide adequate and conscientious care. The network tells the doctor what can and cannot be treated, and for how long, and what will be paid for that care. Decisions to give or withhold payment or to require rebilling are made by young and inexperienced persons of questionable education who know very little about chiropractic care. Ultimately, the loser is the patient. Good and highly qualified doctors are leaving the profession in increasing numbers because of what has happened as a result of managed care. Those are the disadvantages of managed care. The only advantages and benefits of managed care belong to the managed-care companies, whose first and major concern is profitability. Managed care is not managed and it is not care.
I think if you are starting out it's a great network for getting referrals. So it can really boost your practice if you are low on clients. If you are an experienced practitioner it is a great way to not lose clients when they get massage as a benefit in their insurance plan. The disadvantage is that often you contract at a lower rate than your normal rate, so you have to weigh the costs and the benefits of whether you will get more referrals and a fuller practice to offset the lower rate.
Managed care is not really good for anybody who has enough clients that come in on a cash basis, because in general the rate at which they are going to pay you is a reduced rate. So you are trading: They will refer clients to you if you will accept a reduced rate. They call it a percentage discount that they are getting because then they refer people. The only advantage is for people who want to make more connections with doctors and the public, those who couldn't afford massage on their own on a cash basis. Also, people might come in under a managed-care plan and then continue to see you as a cash client later after their benefits run out.
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