Earlier in my career, I used my data skills to advise practices on AR and collection results.  One of the most compelling stories from that time involved a practice, desperate for insights because even though they were seeing more patients than ever and decreasing operating expenses, they were still bringing in less revenue.  My review did not find problems with their collections billing, or data intake.  The billing team and front desk were doing solid work.  What the reports revealed was a change in patient/payer mix.

Over 36 months the mix changed from more than 60% commercial insurance to over 60% Medicaid.  This shift caused an overall 15% reduction in revenue for the same amount of hard work by practice staff.  They had always been proud of their relationship with the less privileged part of their community, but they previously relied on the rest of the patient mix to help cover those costs.  They needed to attract more of the commercial insurance share in their region. But how?

Reputation management: Reviews aren’t just for movies anymore

The patient/payer mix continues to change—especially with the rise of high deductible insurance plans—and the impact on the bottom line can be significant.  The new force, though, is social media and, more specifically, social reputation.  More than 3 out of 4 patients will research a provider’s or a practice’s social reputation on-line before they become a new patient.  The most educated and well-employed patients are beating that statistic—closer to 90% of them check on-line reputation and reviews prior to selecting a practice.  And these are some of the most mobile people in our population, moving to follow careers, etc., which means they change practices more often, too.

And these mobile, well-educated and social-savvy patients often have the best payment rates for physicians because their employers provide commercial insurance! So not only do you want to attract them to your practice, you want to make sure you are enabling them to interact with you on their terms, and to your benefit. Is your portal mobile-optimized and token-less for sign-up? Can they pay a bill 24/7 on your website—even without logging in? Do you allow them to self-schedule routine appointments—cutting down on phone traffic and filling schedule gaps? You see, your reputation is about a lot more than just what happens in the exam room.

What you don’t manage, is likely hurting you

Here’s the point.  While your practice may always have more new patients than you can handle, the vital question is about the payer mix.  Are you getting your share of the commercial insurance population so you can afford to handle the important work you do for other parts of your community?

Going forward, the strongest lever on changes in your payer mix could well be your social reputation, and you need to manage it proactively.  There are tools your practice can use to know when your reputation is at risk, when patients are not satisfied with something, when you need to respond, or act.  Those same tools can also inform patient opinion and influence your public social media reviews, as well.  Because you can’t act on things you don’t know about. And it’s surprisingly easy to start using these tools. Happy patients…happy practice!


Medfusion now offers a quick-start patient satisfaction measurement tool that triggers patient surveys during the check-out process. No extra clicks, checkboxes or actions for your staff. And responses to the surveys can be routed to specific staff based on sentiment—making it easy to respond quickly, when needed. To learn more about Medfusion’s reputation management offering, Medfusion Measure, you can request a demo or learn more here https://www.medfusion.com/solutions/medfusion-measure/ .