Reimbursement Cuts: Texas Doctors Using Personal Resources


Small private practices struggle to survive, even as Texas Medical Association (TMA) President reported a significant worsening of the practice environment with various physicians using money from their personal reserves or secured bank loans to keep their practices going. According to AMA news nearly 51% of Texas doctors dug into personal funds. Various national reports also suggest a large number of doctors quitting private practice due to financial pressures caused by health system reforms.

Challenges facing physicians in Texas & other states

According to a TMA survey reports, the biggest challenge to physician practices:

  • 18% surveyed was the Patient Protection and Affordable Care Act and 59% had a very unfavorable opinion of the act.
  • Moreover 11% cited third-party interference as the major challenge
  • 33% reported continuously declining low reimbursements as a critical challenge.

TMA is using survey results to advocate against the Medicaid cuts, Texas, like many other states are facing.

Concerns among experts are high that these cuts along with other factors will push physicians in restricting the number of Medicare and Medicaid patients they treat. Due to declining insurance reimbursements and changing regulations that an increasing number of doctors in America are going bankrupt, including family physicians, cardiologists and oncologist.

Borrowing from yourself

Physicians unable to build or maintain a practice reserve access other options, the most common being tapping into personal reserves of defer salary – which is a form of lending to the practice. However, linking personal and professional funds in this way is very risky for the practice as most practices have some type of structure to protect personal assets, but merging personal and professional funds leads to loss in the protection.

Due to the reasons elaborated above, taking its toll on the physicians, an increasing number of physicians are contemplating changes in their practice – cutting back on hours, selling their practices to accept hospital jobs, etc, according to a survey released by The Physicians Foundation.

Tackling the challenge:

In this versatile healthcare scenario physician to remain afloat can – enhance their knowledge on how to navigate federal reimbursement laws, appeal all wrongful insurance denials and delays. Moreover experts recommend auditing of practices to determine cash flows, address cash shortfalls and prevention of those shortfalls by reviewing billing, collection and denial-management procedures. Doctors pressed for time can make optimum use of outsourcing to external experts as the need of the hour to streamline their practice and revenue cycle management, cost of running the practice is brought down and experts appropriate that the payback too is significant.

Sharing the same insight, practicing revenue cycle management for more than a decade now in Texas and all the other US States, with proven credentials in Revenue Cycle Management for clinical and operational efficiency are an ideal choice for bringing about the strategic-alignment and revenue-maximization to physician practices.

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