Meet the Member M
Q: What is the outlook for your business and industry? A: Unfortunately, the outlook for health care business is not good. Health care businesses have a challenging income situation that is dependent on the government and commercial insurances willingness to pay us. It is unlike any other business model in the US. We are no longer able to negotiate reimbursement and we must take what they will pay us if we want to continue to contract to provide care to their members. We are challenged by continuous reductions to our pay. In fact, congress just passed another cut of more than 3% to all rehabilitation providers in the US to our reimbursement rate without asking us what it costs to deliver care. And this is not isolated to Medicare or Medicaid. As your commercial premiums increase, our pay decreases from commercial insurers as well since they follow Medicare’s lead. The increased rates are not being passed to providers. Since 2020, EA has seen a $12 dollar reduction in our per hour reimbursement. This was preceded by several years of cuts as well. As the founder and CEO, I have seen a $30 drop in the amount per hour that we are reimbursed since opening our doors in 2011.
will have no choice but to consolidate with larger providers, turn nonprofit, or close their doors. Fortunately, we collectively have the potential to change this trajectory through advocacy. I am a strong supporter of advocacy work through our chamber and professional associations. However, I heard yesterday that representatives from the Centers for Medicare and Medicaid Services stated that health care providers reimbursement for services will continue to drop until constituents start to complain. Your help to spread the word at the grass roots level is needed. It cannot just come from health care providers. It must come from the public. Have you asked your insurance what they paid the provider for your last medical care. You will be shocked how little it is for rehabilitation or other health improvement service. To learn more about EA Therapeutic Health, visit them online at www.chooseea.org.
Despite this reduction, the financial demand on our company to keep up with growing salary expectations, increasing administrative requirements, and growing expenses including the need to pay for more digital apps to manage the day to day operations. As a nonprofit, we are able to provide some offset of the impact and continue to pay our staff competitively while provided equitable care to all, no matter how they are paying for services. However, if these cuts continue, you will see private practice and small business healthcare become a thing of the past. Groups
EA Therapeutic Health serves children to adults and seniors needing physical, occupational, or speech therapy.
Advantage Magazine | 13
January 2023
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