May 21: Flexibility in Healthcare Business Models

On May 21, 2019, Kasie and Shennice welcomed new show sponsor Flex Chiropractic into the studio. Here are the show notes from our visit with Dr. Angela Larson:

Introductions:

Kasie Whitener, Clemson Road Consulting, DMSB

Shennice Cleckley, Smart Cookie Coaching

Dr. Angela Larson, Flex Chiropractic

Theme for the day:

Healthcare Practitioner Business Models

Agenda review:

• More about Dr. Larson and how she became a Chiropractor
• The Healthcare Business Model for Practitioners
• Alternative Streams of Income
• New segment: Being Flexible in Your Business

Segment 1:

We’re welcoming into the studio today Dr. Angela Larson, owner and practitioner at Flex Chiropractic. Two locations, Columbia and Lexington. You’re in the Bull Street office. You’re from Michigan, a Spartan for undergrad and Northwestern for grad school. Moved to South Carolina to be near family (and get out of the cold?).

Tell us about transitioning from there to here. You’ve been here 12 years now, should be feeling like home by now, yeah? What do you love about SC? What do you miss about Michigan?

This is a business show, so we’re going to focus on the business model for most of the show. But before we get to that, help our audience understand Chiropractic medicine, your philosophy of preventative care and alternative medicine.

What do you wish people knew about Chiropractic care?

What myths would you like to dispel while you’ve got their ear?

What has surprised you the most about being a practitioner and business owner?

Segment 2

We typically ask entrepreneurs, “What problem are you solving?” Medical practitioners are providing healthcare services to individuals. Why establish a solo practice? Why not be part of a health system? Or work in a hospital or therapy center? What was it about independent practice that convinced you this was the way you wanted to practice?

Let’s get some healthcare business terms defined for our audience (link to glossary):

• Payers: insurance companies and medicare/medicaid
• Service providers: laboratories, medical imaging, therapy centers, surgery centers, pharmacies
• Care provider: trained medical professionals including doctors, nurse practitioners, nurses, and therapists
• Practice: the office or business model wherein a care provider works to assess and treat patients
• Patient: individual receiving services from the care provider

The definitions are mostly “volume-based” and “value-based” with the latter being the latest trend in the industry.

Volume-based is a “fee-for-service” model that sets pricing for care activities and then practitioners bill payers for the services they provide to subscribers, or patients. Professional governance organizations like the American College of Radiology, for example, establish care guidelines and then payers negotiate rates per-service for care providers.

Volume-based pricing requires a business to consider its inventory as the number of patients it can treat, the number of maladies it can address. There is software that enables this balancing practice — appointment types that limit the number of low-value appointments in a given period. Well-child exams, for example, in your pediatrician’s office.

The move toward value-based service is motivated in part by the frustration felt in practitioner offices around the limited inventory they have available for preventative care and routine maintenance. Value-based pricing is meant to hold providers accountable for the care they provide, meaning the patient’s condition improves, reducing the long-term costs for medical intervention.

Like our exploration of the publishing industry, this look at Healthcare was prompted by the seismic change that has been occurring in the industry. And, of course, by our new sponsor Flex Chiropractic.

So what is the Flex Chiro model? What are your sources of revenue? (services, products)

Segment 3

There is a tremendous amount of entrepreneurship and innovation in healthcare right now. A lot of it is around technology but even more of it is around business models. The words driving these disruptive efforts are “access” and “sustainability” and “patient-centered care.”

We’re seeing, worldwide, efforts to empower providers to treat patients with a focus on wellness. Whether that manifests in preventative care, holistic approaches, or single-payer is yet to be determined.

This article talks about six models disrupting healthcare right now including these three:

1. Mobile devices to enable payment for preventative health services (in Kenya) — reduces administrative costs and makes paying for service immediate, improving the accessibility of care to, specifically, expectant mothers
2. Health records registry enables patients to share their medical records with providers (or not) and speeds care in new environments by allowing the patient to render the historical data a provider needs
3. Remote healthcare consultations via phone and video; 24-hour accessibility globally to health professionals who can render advice and address patient questions

This article talks about the industry itself and the fatigue patients have for the healthcare industry as-is: delays, lack of transparency, lack of choice, one-size approaches, etc. Some moves toward consumer-driven, demand-side models noted here include:

• Personalized health solutions – combination preventative and acute treatments
• Telehealth – use of mobile devices and 24-hour accessibility
• Care-anywhere networks – automation of scheduling & access to digital health records
• Patient experience benchmarks – ratings, ranks, and reviews
• Information on request – audio/visual consultations

What does the industry need to do to adjust the technology available for better care?

What do providers need to do to prepare for more demanding (and discerning) patients?

Some hurdles to these innovative models and technologies: trust, validation, risk & accountability, legality and ethics

Segment 4

We usually chat so much we don’t get to the Segment 4 topic, so if we’ve been conversing and miss this last supplement, it’s fine.

We are introducing a new segment to Start Something, Columbia! The named-segment as part of Flex Chiro’s support of the program: Be Flexible in Your Business brought to you by Flex Chiropractic.

This week’s “flexible” tip is about knowing your industry. As we’ve seen in publishing and now healthcare, technology can create massive disruption. When you know your industry, you are aware of the technology under development and deployment. You can visualize its impact and consider how best to engage it to build your business.

We know businesses that stick with old models, that refuse to innovate, that are unaware of trends in their industries, struggle to remain competitive and effective. Don’t be that business! Learn your industry through events, trade publications, blogs, videos, whatever other resources you can access. Make time to keep up with your industry. It’s just as much work as serving your customers.

How does Dr. Larson keep up with trends in her industry? How do you stay connected to the field of chiropractic care and also the healthcare industry? How do you stay informed of innovative technologies and the possible introduction of those technologies into your practice?

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