What’s the Worst That Can Happen with Ancillary Services? Plenty.

Doctor walks a tightrope

March 28, 2017 by Ideal Business Partners

The American Health Care Act is dead, and the Affordable Care act remains the law of the land. For now.

But anyone who has a solid idea of if or how the embattled Obamacare will survive into the future, or in what form, better own a DeLorean and have a clear plan on how to generate 1.21 gigawatts of power.

This increasing uncertainty is, unfortunately, just part of the current healthcare landscape. Along with decreasing reimbursements from both government and private payors, this leaves healthcare practitioners often looking to in-office ancillary services to help out the bottom line.

The market may now be mature, but it's littered on all sides with fraud and shady players promising big money, but usually delivering headaches. It's hard to know what to do when the promise of found money comes knocking, but industry experts are providing consistent advice to private practitioners considering bolt-on services in their office.

The first step is to get a lawyer. Don't just take our word for it. The latest issue of Medical Economics advises: "Consulting an experienced attorney is a must for avoiding legal problem associated with ancillaries, including possible Stark violations, experts say." And it's not just Stark - anti-kickback, CPOM, HIPAA and other less-prominent laws and regulations can come into play. You don't want to find out about this for first time via an audit letter. This is especially true for joint ventures with third-party consultants - many of whom come from out of state, where the rules are often substantially different. Ideal Business Partners has a special team dedicated to vetting these offers and contracts - but even if you don't use our lawyers, be sure to use a healthcare lawyer.

The next thing you need to do is to do the math. Just because you can do something, doesn't mean you should. Many ancillary service models are perfectly legal, but won't make you a dime, and could end up costing you dearly. The bottom line is that any modification to your healthcare business should include, at a minimum, both a compliance and a feasibility study. Because if it doesn't make you dollars, it doesn't make sense. This is the primary reason IBP integrates both legal and financial professionals, and why our clients' ancillary service models are consistently the most profitable in the market. If your own accounting professionals can't develop forward-looking financials that conservatively estimate the value of ancillaries you're considering, find ones that can.

The bane of many failed ancillary services is what we call the Field of Dreams model, where physicians either assume or are sold the idea that if they build their ancillary service, the patients and referrals will come. Of course, this is absolutely not the case. Like any mature market, the ancillary market is insanely competitive, and if you don't actively market your ancillary services (even to your own patients) someone else will. An essential component of any successful ancillary service strategy is how you're going to successfully market it.

Successful planning and execution takes work and a dedicated team of professionals to pull it off. If you're considering ancillary services or just want to know what all the hubbub is about, give us a call.