Compliantly and Sensibly Structuring US Cash Healthcare Services
Avoiding the "Basic Instincts" Temptation
US private direct medical practices provide innovative services by charging patients (and sometimes employers) additional fees for services beyond what plan-reimbursed care delivers. With a motivated seller and willing buyer, can innovative practice models instinctively implement cash menus? Fortunately or unfortunately, depending on your point of view, US healthcare regulations are designed to remove all financial incentives from healthcare decision making — that means charging cash for US healthcare services runs into a variety of compliance challenges. Here is the good news: those compliance challenges are navigable. But because regulations are often counterintuitive (particularly in US healthcare), cash healthcare menus cannot be implemented simplistically. The basic instinct of healthcare professionals may be to flee healthcare insurance plans. For the reasons discussed below, that may not lead to a happy ending for anyone.
Jim Eischen started to lecture on private direct healthcare compliance solutions in 2010, and has since become a featured private direct healthcare conference speaker for a wide range of physician and healthcare innovation topics. Since 2019 Jim has served on the board of WMD Foundation, a San Diego non-profit dedicated to creating community-based and social media projects to provide healing and reconciliation as alternatives to conflict.
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