Medicare reimbursement for RO services down 20% in inflation adjusted terms from 2010

[dieABRdie]

Yep, we have a formalized process for patients without insurance. We look into their financial information and charge only what they can afford. If they can't afford anything then we can write off the entire treatment.

It's simply a smart business choice. You want your referrings to think "I'll send this patient to OTN's practice, as I know no matter what he's going to make sure they're treated." I don't want referrings to ever have to think about who the patient's payor is and whether we will be able to treat. Gotta grease the slide as much as possible to get consults in.

Does the practice ever get to write any of it off as a "loss" for tax deduction; or something of the sort?

I am happy to provide my services for free. We really don't have that many uninsured at any given time that I can't do that and still make good money.

But.... the practice will stick them with a bill for the treatments. I hate it and wish there was a way to have a certain "charity fund" or something. But their argument is that it ends up being a complete loss.

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[thecarbonionangle]

To me it’s not as much about them getting that funding.

It’s about who is at the table and influencing the powers that be about big issues related to the field. Those PPS exempt centers should not be there. They do not have the same skin in the game as 95% of the rest of us. At best they don’t have a realistic sense of challenges, and (?more likely?) there are perverse incentives.

MDA faculty getting any where near an APM policy steering meeting (that doesn’t apply to them) is flat criminal.

I would love to know how this even happened that Ben Smith was able to pimp the brocade grift and what did eileen chen have to do with writing APM?

 

[OTN]

Does the practice ever get to write any of it off as a "loss" for tax deduction; or something of the sort?

I am happy to provide my services for free. We really don't have that many uninsured at any given time that I can't do that and still make good money.

But.... the practice will stick them with a bill for the treatments. I hate it and wish there was a way to have a certain "charity fund" or something. But their argument is that it ends up being a complete loss.

My understanding is that we considered a write-off, but decided in the end it wasn't worth it, given the relatively small change to our overall revenue and tax bill. The patients don't receive bills, fortunately.

 

[grenz]

My understanding is that we considered a write-off, but decided in the end it wasn't worth it, given the relatively small change to our overall revenue and tax bill. The patients don't receive bills, fortunately.

Yea seems like it would just open you up to an audit

 

[medgator]

Yea seems like it would just open you up to an audit

Unless you're a "non-profit"

 

[Lamount]

Unless you're a "non-profit"

Could one just create a non-profit that pays for the treatments for indigent patients… and simply have your practice donate money to the non-profit and write off the donation?

(Asking as someone who has a very rudimentary understanding of taxes)

 

[Reaganite]

View attachment 361696

If anyone at "Institution 69.2" specializes in financial toxicity or affordability of health care... please look into this and let us know your thoughts.

Maybe that doc is attending an orgy party!

How much you wanna bet the parking costs at institution 69.2 are also the highest on this list?

 

[thesauce]

Could one just create a non-profit that pays for the treatments for indigent patients… and simply have your practice donate money to the non-profit and write off the donation?

(Asking as someone who has a very rudimentary understanding of taxes)

My understanding is yes, you can. But it may be state dependent. I’d like to hear other’s opinions on this.

 

[elementaryschooleconomics]

Could one just create a non-profit that pays for the treatments for indigent patients… and simply have your practice donate money to the non-profit and write off the donation?

(Asking as someone who has a very rudimentary understanding of taxes)

Yes. Anything is possible...

...if you have the right lawyers.

Thinking out loud, you'd have to choose the most advantageous 501(c) status, of which there are actually 7. We're most familiar with 501(c)3, but maybe it's "easier" to go a different route, because we can't forget that the main benefit is not the tax write-off that someone gets from donating, it's the tax exempt status the organization itself attains.

So I think the easiest thing to do would be the treat your non-profit like it's "health insurance" and "enroll" your indigent patients.

Let's say someone comes in with prostate cancer and meets the qualifications to be deemed "indigent". You have your patient "enroll" in your non-profit, which is a technically independent organization from your practice. You'd want to do some filing trickery to make this bullet proof, maybe have an LLC holding company be the owner.

Anyway, your practice treats the patient like normal and "charges" the "insurance" the regular chargemaster rate. Magically, the "adjustments" and "credits" happen like normal, your patient doesn't pay a cent, and your practice can go and claim the chargemaster amount as a loss/donation.

...that would be my guess.