Over the past year Pacific Rim Headache Center has had no choice but to apply several new austerity measures in order to stay in business. This is despite the overwhelming demand for our services and us working extremely hard to care for that demand. We have also run a tight ship, cutting our expenses to the bare bones and paying our providers far below what typical providers earn. However, these austerity measures have also included requiring patients to pay their deductibles at the time of service, no longer accepting insurance plans that reimburse us below the actual cost of collecting that reimbursement and, the most recent one, no longer doing Botox treatment on Medicare patients. We understand that this has been at least inconvenient if not painful for some of our patients. We understand that pain and frustration and we share that pain with you.
We live in an age where it is becoming almost impossible for small, independent practices to stay in business. Already headache sufferers are disproportionately under-served and headache clinics, because of societal discrimination against our patients’ needs, are some of the hardest hit. The only choice today for small clinics to survive is to sell out to large systems. However, large system do not want headache clinics because they are time-consuming, if done right, and are not lucrative. Additionally I don’t think those large systems understand what incredible people our patients really are. To large systems, unfortunately, headache patients are often seen as fakers, drug seekers and trouble makers whereas nothing could be further from the truth.
This perfect storm is the result of the added financial burdens under the Affordable Care Act (ACA) and insurance company requirements. To comply with these changes we now have to pay an additional $2,000/ month in required software expenses alone. The second part related to this storm is that insurance companies, in the age of ACA, have raised deductibles to catastrophic levels, cut reimbursements to small practices (but not to large hospital systems) and made the collection of those reimbursements extremely difficult. It now takes two full time billers per provider to fight with insurance companies when ten years ago it took only one biller per five providers. Now we have to charge high rates for our services to break even because of these high expenses and because 60% of our care that we give is now for free.
I am grateful that the vast majority of our patients who understand the stress that small medical practices are under these days and have expressed their support. I appreciate patients who rightly direct their frustrations towards those who have created this mess and not towards us who are in this difficult place with them and come to work every day because we have a passion for helping headache sufferers get well.
J. Michael Jones, MPAS-C