This article was originally posted here on November 8, 2019. 


Why do patient’s not complete their plan of care?


According to the clinics who responded to a recent survey, the number one reason was insurance limits and/or denials (73.3%), followed by scheduling difficulties, time commitment, cost of treatment & unrealistic expectations. (you can check out the summary of the survey here)


Now let’s set the insurance denials or limits off to the side. While you can make the argument that this whole problem would go away (and more patients would complete their course of care) if you simply went out of network or cash-based, that’s hard step to take.


On top of that, the next three reasons (time, cost, and expectations) need to be addressed before you consider leaving the insurance world behind. That’s because those three issues revolve around your ability to effectively communicate the value of the services you provide.


The Need to Communicate Value


Now, for decades, clinics and clinicians have relied on being “in network” to avoid having to talk about value. And, in reality, they didn’t have to. Patients simply went where their doctor sent them. But, as mentioned above, patients are beginning to be more picky about which provider they go to for therapy.


Rising healthcare costs (deductibles, coinsurance, etc.) combined with the access of the internet means that patients now have a choice in who they see. And they’re beginning to use it. This change means you have to be able to effectively communicate the value you bring to the table.


Time Commitment & Scheduling Difficulties


So let’s look at the first of the factors: the Time Commitment & Scheduling Difficulties. On the surface, this may seem like a legitamate factor, and in some cases, there may actually be scheduling conflicts that prevent a patient from completing their plan of care. However, more often this not, this is a priority problem, not a true scheduling conflict.


Why is it a priority problem, because the patients don’t see coming to treatment as more valuable than whatever else they have to do. Patients are busy. They’ve got jobs, families, & other commitments. If your services aren’t seen as truly valuable, there will always be a “scheduling conflict” that keeps patients from showing up.


Unrealistic Expectations


Then there’s Unrealistic Expectations. Usually a patient has unrealistic expectations for a couple of reasons. First, they may have been given unrealistic expectations from the provider that referred them. Other times, it results from a miscommunication or lack of communciation between your clinic and the patient.


Either way, you need to address expectations with patients at the first appointment. You do this by both educating the patient on their condition/diagnosis, the prognosis, and possible treatment options & by having a value discussion with the patient. You need to explain what the treatment options are, what their anticipated results are, and then how you (or your clinic) fit into that outcome.


Addressing expectations early prevents any misunderstandings and also gives you a chance to demonstrate and explain your value.


The Cost of Treatment


And lastly The Cost of Treatment. Whenever someone brings up price or cost as an objection or reason they can’t complete treatment, there’s often a deeper reason. Some patients have legitimate financial limitations and can’t afford treatment. In those instances, you should work with them to make sure they can still receive as much treatment as possible, given their limited resources.


Most of the time, however, cost is a smokescreen for something else. Usually, it’s value. The patient doesn’t value the treatment you provide, and therefore is not willing to pay for it. This is related to the priority problem mentioned above.


So what can you do to help these patients prioritize both the time commitment and the cost of treatment? You need to have the value discussion with them. You need to sit down with the patient and have them identify their desired goals or outcomes. Then, you need to attach objective metrics to those goals or outcomes. After that, you frame the cost of treatment as the price to achieve those outcomes or goals.


By having the value discussion with patients, you help them prioritize both coming to and paying for treatment.


If you’d like to talk with me about your clinic, and how Rehab U can help you improve your clinic’s patient retention and engagement. Schedule a FREE 15-minute call with me.


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How do you communicate value to your patients and prospective patients?  Share any additional resources that you found helpful in the comments below!

For more informational reads, check out our Insights Page to see all the articles we’ve published to date. Click here to head over to our resources section and check out our variety of clinical and professional resources aimed at increasing your knowledge and skills. If you’d like to make some changes in your clinic or health center, and would like some help, check out our consulting and advisement services or contact us to see how we can help you break out of the norm and provide a truly impactful patient experience.

Rafael E. Salazar II, MHS, OTR/L is the principal owner of Rehab U Practice Solutions. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. He worked as the lead clinician in an outpatient specialty clinic at his local VA Medical center, where he worked on a team to implement a relationship-based care model to increase employee and patient engagement. He also has experience as an assistant professor at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, has served on several committees for the national OT Board (NBCOT), and as a consultant working for the State of Georgia’s DBHDD. He is also on the Board of Directors for NBCOT. He works to help healthcare clinics and organizations increase revenue by delivering uniquely impactful patient experiences to increase patient engagement. Rehab U Practice Solutions: training & advisement services

Read his full bio Here. Read about Rehab U Here.

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