Every day, I make a little “to do” list next to my mouse pad andabout 1/3 of the time, the word “blog” ends up without a line throughit.  Yesterday was one of those days.  I have ten minutes to make sureit gets a line.

Dr. Stoller has been particularly helpful lately as she passes me these two unrelated gems.

• The MGMA is running a payer survey that ends tomorrow, 10/24.  Folks have been talking about it on the MGMA lists a lot and I’ve generally ignored the discussion (the new MGMA forums are difficult, at best, and I didn’t see this having much traction).  However, I’ve changed my mind.  So, race here, and complete the survey for your state and payers.  I think the data will be fascinating afterall and I will report what I can!

• Over the past month or three, I have encouraged a number of practices to consider putting an annual administration fee into place.  I have worked with a handful of practice who have done this and none of them have regretted it…yet, the world of medicine is filled with nay-sayers and all I have heard in response is how, “At my practice, I could never do this because my situation is different…” blah blah blah.  If I had a dollar for everyone who told me they can’t do something, Lynn Cramer and I could retire.  So, Dr. Stoller was kind enough to share this admin fee vignette from the SOAPM list (names changed to protect the successful):

This is the second year we have charged such a fee, though it is voluntary and much smaller than the ones you cited. We call it our “Added Benefits Plan.” We charge $40 per child/ max $100 per family. We give all new patients/newborns a free one-year membership. Believe me - our patients checked with their insurance companies immediately. Because it is voluntary we had no problem with it. I am not sure that would be the case if we made it mandatory. I have found that many patients, especially with older children have chosen not to join because they are not in that often and don’t feel they benefit as much from our services. If they need a single form we charge $20. We have tried to explain to patients that the fee is for all the extras we do - taking our own call, having nights and weekends, in-house lab, clean, happy surroundings - but for the most part, they just weigh whether or not they need the forms.

There is a practice in Texas that has mandatory charges similar to the link you provided. http://www.pediatricassociates.netI have spoken with them and they are very happy with their choice and have not lost many patients.

A handful of patients left over it. We had patients tell us that at $100 for the family per year,that would be $1000 over 10 years. Some came back quickly. We continue to grow well with new families. We checked with our favorite OB referrals to make sure they had no objection, which they did not. We would be happy to share our introductory letter with you. Be prepared for very strong opinions. Many patients supported us, but many (some doctors’ wives and children) were very angry and not afraid to say so very loudly in our waiting room. Your staff needs to be very well trained and prepared. They will take the brunt of it. But the doctors have to support them.

The first year is the worst because patients will test you. The second year is easier.

I added boldface for emphasis. See, you can train your patients.Here are two practices who did it (and do the math for yourpractices…$100 per family? That’s a lot of money.).