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Con's of Working With Employers
Here are some potential disadvantages to working with employers:
1) EMPLOYERS ARE A MIDDLEMAN: Even if employers pay you directly (without going through a Patient Care Management Organization, broker, or third party administrators) they still are paying you instead of the patient paying you. That's someone in between you and your patient. That “someone” can remove the “directness” of DPC leading to less power for patients.
2) EMPLOYERS MAY TRY TO INFLUENCE YOU: Employers could try to strong-arm you into doing something you don't want to do. If you don't lower your rates, provide time-consuming unproven data metrics, take chronic pain patients, etc. they could dump you and you lose a large number of members and income overnight. Preventing this requires lots of legal expenses to write protective contracts, which are even more expensive to enforce in case of a breach. Be very careful not to compromise significantly just to land a big client. It is a slippery slope. Diversification also helps this (get one-hundred 5-employee companies, instead of one 500-employee company) but then you have to deal with 100 employer contracts and a small legion of HR people.
3) HIGHER TURNOVER POTENTIAL: Many times employees have much less DPC buy-in than patients who directly contract with their DPC doc. They often see their membership as a random benefit that comes with the job, not as something in which they've made an investment. For this reason, they don't often see the value in your services, and if they leave the employer, you lose them as a patient. You can try to keep them but the retention rate is VERY low. Also, you find yourself with new patients daily and doing a never-ending stream of establishing care visits.
4) PROBLEM PATIENTS: Since employee-patients get you by default, you can get patients who might not be a good fit for you for some reason (drug-seeking, abusive, etc.). You can still refuse them care or fire them with good cause, but because you have a deal with the employer and the patient has HIPAA rights, this becomes a challenging path to navigate, often leaving you mismatched with some patients.
5) LOSS OF AUTONOMY: Even though you'll strive to contractually protect yourself, if your patients don't find and invest in your services on their own, at some level, you can't help but realize that you are beholden to the company that's paying the bills. You feel less in control of your practice. Employers will often use some type of insurance plan that you will be forced to work with. If you are not careful you'll be right back into the Fee-For-Service style of practice--prior authorizations, limiting referrals, medication step therapy, ghost coding, and time wasted on unproven data metric reporting.
Learn about the Pro's of Working With Employers.
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Con's of Working With Employers
Here are some potential disadvantages to working with employers:
1) EMPLOYERS ARE A MIDDLEMAN: Even if employers pay you directly (without going through a Patient Care Management Organization, broker, or third party administrators) they still are paying you instead of the patient paying you. That's someone in between you and your patient. That “someone” can remove the “directness” of DPC leading to less power for patients.
2) EMPLOYERS MAY TRY TO INFLUENCE YOU: Employers could try to strong-arm you into doing something you don't want to do. If you don't lower your rates, provide time-consuming unproven data metrics, take chronic pain patients, etc. they could dump you and you lose a large number of members and income overnight. Preventing this requires lots of legal expenses to write protective contracts, which are even more expensive to enforce in case of a breach. Be very careful not to compromise significantly just to land a big client. It is a slippery slope. Diversification also helps this (get one-hundred 5-employee companies, instead of one 500-employee company) but then you have to deal with 100 employer contracts and a small legion of HR people.
3) HIGHER TURNOVER POTENTIAL: Many times employees have much less DPC buy-in than patients who directly contract with their DPC doc. They often see their membership as a random benefit that comes with the job, not as something in which they've made an investment. For this reason, they don't often see the value in your services, and if they leave the employer, you lose them as a patient. You can try to keep them but the retention rate is VERY low. Also, you find yourself with new patients daily and doing a never-ending stream of establishing care visits.
4) PROBLEM PATIENTS: Since employee-patients get you by default, you can get patients who might not be a good fit for you for some reason (drug-seeking, abusive, etc.). You can still refuse them care or fire them with good cause, but because you have a deal with the employer and the patient has HIPAA rights, this becomes a challenging path to navigate, often leaving you mismatched with some patients.
5) LOSS OF AUTONOMY: Even though you'll strive to contractually protect yourself, if your patients don't find and invest in your services on their own, at some level, you can't help but realize that you are beholden to the company that's paying the bills. You feel less in control of your practice. Employers will often use some type of insurance plan that you will be forced to work with. If you are not careful you'll be right back into the Fee-For-Service style of practice--prior authorizations, limiting referrals, medication step therapy, ghost coding, and time wasted on unproven data metric reporting.
Learn about the Pro's of Working With Employers.