Combining the two to fuel wellness care for higher profits, practice valuations
Are you taking advantage of the greatest marketing opportunity that has been available to chiropractors in its 127 years of practice? It is called the No Surprises Act (NSA), and here is something that might surprise you: This regulatory act is, in fact, a huge chance to turn personal injury patients into long-term wellness care patients.
That’s right: Injury care can work as a feeder to wellness care. If you approach this correctly, you have a huge profit advantage before you. Patients entering your practice through injury care, and especially through personal injury (PI), are more likely to enter into, commit, and see through longer-term wellness care plans. You profit more, and your business is worth more as a result.
Let’s start by considering the problem with the business of chiropractic.
What lowers patient visits, business valuation
Most people who seek chiropractic care do so when they have back or neck pain. They come in for an adjustment here and there. And many others still consider chiropractic care to be quackery.
But we all know chiropractic care has much more to offer, addressing adrenal fatigue, headaches, gut problems, stress, insomnia and other maladies. Chiropractic is science-based, noninvasive injury and preventive wellness care, helping relieve (if not remove) pain, leading to a healthier life.
And yet, rare is the person who includes chiropractic care as part of a long-term wellness plan. They go to the gym, get massages and pluck their eyebrows on a routine basis, but chiropractic care is sought out on an as-needed basis, if at all.
Whether they realize it or not, most chiropractors fuel that perception by seeing patients on a “per visit” model. Under this model, you, the chiropractor, see the patient today, and then determine if you will see them again. You repeat the cycle at each visit.
The problem, then, is that a chiropractor must hustle continuously to fill those daily and weekly patient slots. Instead of having a steady stream of wellness patients already committed to a visit regimen, the business chases one-off patients, hoping they come back. And this lowers the business valuation because it has no roster of long-term care patients who have already committed to care over months, if not years.
Much like personal-injury patients who are traditionally slotted in advance for 15-30 visits, so, too, are “term” wellness care patients. If you can find more of these patients, your upcoming patient visit slots will already be filling up, which is great for you now, and also when you want to sell your practice.
A term-care model solution
The foundation for success, then, is transitioning your chiropractic office to one that has a healthy stream of patients who see you for a “term” of care, not just one or a few visits. These patients have committed to a treatment plan over time, in advance, which is a far more profitable and value-driven business model.
Having a loyal, pre-committed client base as a business asset increases the value of your business, which is important when it comes time to exit your business and sell it. Rather than simply being valued for the treatment beds and medical equipment owned by your business, plus gross annual revenues, your business valuation increases when you have patients committed to treatment over time.
That increase can be quite substantial. After all, you have a proven business that is not reliant upon that day’s walk-ins. Indeed, walks-ins should end up being 20% of your daily patient flow, if that.
This is a doable goal over time, and both the synergy between injury care and wellness care, along with the effects of the No Surprises Act, can rocket your practice to another level.
To be sure, great business owners start with the end in mind. They think like chess players, considering how they will establish a profitable business they can sell for the highest amount possible, and they know the moves it takes to get there.
Whether you realize it or not, every PI patient starts off as a term-care-plan patient. The secret is turning those term PI patients into term-wellness-care-plan patients. In fact, any practice focusing only on injury care is missing the synergy and gold of wellness care.
Injury care and wellness care go hand-in-hand. Those injured at some point heal, but need further care for maintenance and prevention of further injury. Those undergoing wellness care, like it or not, get into PI or other injury care situations. Each exists alongside the other, in a wonderful symbiotic dance.
When you combine injury care and the No Surprises Act, you can get a true business advantage that can fuel your term-care-plan wellness patients to the advantage of both your patients, your practice and your pockets.
The NSA, PI and wellness care conversion
In January of 2022, Congress passed the No Surprises Act (NSA) to curtail surprise billings. The meat of the NSA is something called a “good faith estimate,” or a GFE. Essentially, the NSA wants patients to be given a GFE before treatment begins so their medical bill does not surprise them, and so they have an opportunity to shop for alternative treaters, should they believe the GFE is too high.
Here’s how it fits into personal injury and chiropractic care. The No Surprises Act mandates term-care plan estimates. When any uninsured or self-pay patient — personal injury, cash or otherwise — schedules a visit for treatment, you should (and generally must) provide a GFE that covers your anticipated medical care up to a full year’s worth. And that GFE must be provided in advance of care depending upon when the appointment was scheduled.
The NSA is intended to apply to all uninsured and all self-pay patients, which includes your PI patients, even if they have insurance and even if they have medical expense or personal injury protection (MedPay or PIP) as part of their auto policy coverage. “Self-pay” essentially means the patient “may” have to pull money out of their own pocket. Given there is no guarantee a PI patient will win a claim or lawsuit, or that MedPay or PIP will for sure cover your bill, the NSA likely will be deemed to apply to your PI patients.
And guess what a GFE is? Essentially, it is a long-term-care plan — just a very detailed one, having all the “what, when and how much” fully laid out so there are no “surprises.”
Before the NSA was passed, at best, you likely provided a fee schedule to your patient. Now, you are required to detail all diagnosis codes, treatment codes, frequency of treatment and cost. You are also required to include any co-providers or co-facilities, such as imaging, into your GFE if you are the primary provider — and in PI cases, the chiropractor usually is.
That GFE needs to be provided in advance of care or by the second visit, depending upon when the first appointment was scheduled. And this is to your advantage.
Consider, for instance, how you are training your patients. Estimates can change, which means you will likely issue updated GFEs throughout treatment for the patients to sign off on. This puts you and your patients in the habit of thinking long-term.
Even better, the attorney, upon seeing the price tag of your GFE, will shout, “Yes! Do that!”
The patient benefits, too, through exposure to chiropractic care — the No. 1 specialty in PI cases in most regions. All too often, though, it is also the first time that patient has ever been to a chiropractor. Even if they think chiropractic care is a bit unorthodox, they get treated, given that the value of their PI case increases as their medical bills increase.
And PI patients show up as scheduled and comply with a longer treatment plan because of that potential financial gain. If they fail to comply with your treatment plan, their PI recovery can be negatively impacted. This is why PI patients generally have a higher percentage of positive health outcomes, which makes sense. If the patient shows up as the doctor advises, he or she gets healthier, faster.
As a result, your patient also is going to walk away from chiropractic care with the positive impression that your treatment made them healthier — perhaps even significantly better. That creates loyal patients who are going to be more likely to move from “injury care” to “maintenance care” by becoming wellness patients.
Presenting long-term care
Now, when you present a term care plan to a post-PI patient, that patient is far more likely to both agree and comply. What a wonderful thing for both the patient’s physical health and your business’s financial health.
Now, more patient visits are filled in advance, you have more contracted term patients, and as a result, life is easier and your business is worth more.
Long story short: Don’t be afraid of PI or the No Surprises Act. Embrace both. Use the symbiotic relationship between injury and wellness care to the advantage of your patients, your practice and your profits.
MICHAEL COATES, ESQ, is a national authority on personal injury medical lien recovery and the founder of PIMadeEasy.com, which educates, coaches and trains medical providers and their staff to accelerate their success in personal injury. For more information, go to Facebook.com/groups/pimadeeasy.