4. Kareo Confidential 44
Fee-for-Service to Value-Based Care
MACRA
• Replaces the sustainable growth rate and moves CMS payments
towards quality
• Quality Payment Program has two pieces: MIPS and Advanced APMs
• Goal is to increasingly push practices towards the Advanced APMs
Commercial Payers
• Also increasing value-based programs and payments
These programs can create more complexity for practices
5. Kareo Confidential 55
Changing Patient Expectations
Patients looking for more consumer experience
• Using social media and online reputation to
choose providers
• Online scheduling
• Text and email reminders
• Email communication with providers
• Access to medical records and online bill pay
through a portal
• More involvements in care and treatment planning
6. Kareo Confidential 66
Increasing Physician Burnout
Recent studies show increasing physician burnout
• 2014 study from AMA and Mayo showed that over 54% of all
physicians had at least one sign of burnout
• In 2011 the same study showed 45% (increase of 9%)
• Medscape Lifestyle Report 2016 also showed an increase in signs
of burnout and put the average at about 50%
7. Kareo Confidential 77
Growing Demand
• Healthcare demand is growing and there may be a shortage of
physicians to support this demand
• By 2020 demand for healthcare services will increase by 22%
• AMA says there will be a shortage of 130,000 physicians
• The entire industry is looking for ways to improve access and
reduce costs
9. Kareo Confidential 99
Survey Methodology
• 766 respondents
• Providers in private practice (MD, DO, PA, NP)
• Practice Managers
• Other Practice Owners
• 29 Specialties
• Evenly distributed across men and women
• Same questions used to compare those in traditional fee-for-
service and those in private pay (membership, concierge, direct
primary care, etc.)
13. Kareo Confidential 1313
Reasons for Change
Reasons for
Change
Already Using
Private
Pay/Membership
Models
Considering a
Change from
Traditional FFS
Spend more time
with patients
66% 43%
Improve work/life
balance
41% 43%
Separate from
insurance payer
system
40% 44%
16. Kareo Confidential 1616
Provider Hours & Patient Visits
Physicians Using
Private
Pay/Membership
Models
Physicians Using
Traditional Fee-
for-Service
Average Hours
Worked/Week
41 47
Hours Spent on
Admin Tasks
10.5 11.25
Length of Patient
Visit
79% have visits of
30 mins or more
75% have visits of
30 mins or less
Number of
Patients Seen/Day
63% see 15
patients or less
65% see 20 or
more patients
17. Prior to transitioning to concierge medicine I was seeing 40 patients a day and unable to get home
before 9 PM each evening. My wife and I decided to pursue the private medicine model to benefit
our patients and our marriage.
Now, 2 years into this "experiment" I have never been happier. Our patients are thrilled with the
care they receive and I am look forward to "creating health" each day I head to the office. I am now
seeing 10-12 patients each day which allows me to intensively manage chronic diseases such as
diabetes, hypertension, mental illness and even substance abuse.
Medicine has become fun. I spend my time listening to people and touching them. I am no longer
concerned about EMR and reporting data to the government. Our patient members are considered
"family" and are treated with utmost respect and dignity.”
Jeff Unger, MD, ABFM, FACE
18. Kareo Confidential 1818
Technology Use
• Practices using concierge, direct pay, membership
models more likely to use:
• Telemedicine (23% vs. 8%)
• Practice marketing and patient engagement (17% vs.
12%)
• Patient Portals (53% vs. 43%)
• 84% of all respondents use an EHR/EMR (no difference
in use based on practice type)
19. Kareo Confidential 1919
Biggest Challenges
35% 38%
Traditional docs say
staying financially viable is
biggest challenge
35%
Private
pay/membership docs
say recruiting new
patients is top
challenge
38%
20. Kareo Confidential 2020
Similarities
Showing a trend around a new understanding in the value of patient
retention, all types of practices were equally likely to:
1. List one of their challenges as retaining patients
2. Be accepting new patients
3. And, be investing in marketing tools
21. Kareo Confidential 2121
Similarities
Another similarity across all practices was involvement in ACOs.
Surprisingly, all practices were almost equally likely to be in an ACO
already or to be considering joining an ACO.
• 15% of FFS and 12% of private pay practices in an ACO
• 9% of FFS and 13% of private pay practices plan to join and ACO
in the next year
23. Kareo Confidential 2323
Awards and Rankings
Growth awards
The speed at which
medical practices are
moving to Kareo and
referring it to other
providers.
Best places to work
Happy, engaged
employees stay longer,
have more experience and
offer better customer
service
Analyst reviews
3rd party recognition,
driven by direct
customer feedback,
equals trust and
credibility
24. @GoKareo 2424
Kareo Platform
Kareo Marketing
• Marketing and front office
automation
• Online visibility and SEO
• Online appt. scheduling
• Email, text & voice recording
appt. reminders
• Post visit patient reviews
• Practice analytics for ROI
• Patient communications
28. Connect with Kareo
Stop by and say hi!
Kareo @GoKareo GoKareo Kareo
3353 Michelson Drive, Suite 400
Irvine, CA 92612
(888) 775-2736
Notes de l'éditeur
Number in a direct pay, concierge or membership model has gone up just slightly from 24 to 25%
Studies have shown that providers like practicing medicine but they are frustrated with the complexity of healthcare and increasing third-party interference. As a result, many are looking at alternative approaches to help them reduce reliance on government and commercial payers.
25% have already switched to or added a direct primary care, concierge or other membership model in their practice
Another 34% are considering a similar change in the next three years
The makeup of the providers who are already switching shows a greater appeal for those in solo practice or in smaller practices of two to five providers.
If you have an idea to do this a visual and not text I am open to ideas
Majority of those using these alternate models are solo or less than 5 providers (89%)
77% solo or 2-5 (12% fewer than in private pay)
33% of practices in traditional FFS say they might transition their practice in the next 3 years. Reasons are consistent whether they already switched or are considering a switch. This reflects what we see in the challenges. Too much admin work, not enough face time with patients, working too many hours
One of the most interesting results of the study is the change to a new model doesn’t have to be a complete one. The largest group of respondents, 33%, only have 25% or fewer patients from their entire patient panel on a concierge, direct primary care or other membership program. And only 30% have all of their patient panel on one of these programs. The rest fall somewhere in between.
They are also not all totally opting out of insurance. There is a wide range of types of participation in both commercial and government insurance.
The benefits can be seen even when only a portion of the practice’s patients are moved to a new model. And the benefits that these providers experience show that some of their key goals can be achieved.
Making this change does impact time with patients, hours worked and time spent on admin tasks
The survey also shows that physicians who are trying concierge, direct pay, and other membership models are more open to trying other approaches as well. Twenty-three percent of providers in these practices are using telemedicine and 42 percent of those are planning to expend use of telemedicine in the next year. This is in stark contrast to traditional FFS practices where only eight percent are currently using telemedicine.
There is also an increased use of other patient-centered technology. Private physicians were more like to use practice marketing and patient engagement solutions as well as patient portals. And while they are equally likely to have an EHR, they are far more likely to prioritize features like a patient portal.
The added focus on being patient-centered may help them tackle their biggest challenge—recruiting new patients. Thirty-eight percent of respondents said this was the top challenge for their practice. The next biggest concern was staying financially viable at 24%.
For traditional FFS practices, it was the opposite with 35 percent saying financial viability was their top challenge followed by only 20% at t next highest response of recruiting new patients. This makes sense since to be financially viable, a FFS provider needs to see more patients each day and have a larger patient panel.
Another similarity across all practices was involvements in ACOs. Surprisingly, all practice were almost equally likely to be in an ACO already or to be considering joining an ACO.
15% of FFS and 12% of private pay practices in an ACO
9% of FFS and 13% of private pay practices plan to join and ACO in the next year
This may be an early indicator that more and more physicians are seeing the growing shift to value-based care and are open to participating in models that will help them get paid. This may position these practices for more success under MACRA’s Quality Payment Program and any similar commercial payer programs that may be on the horizon.
Kareo has received extensive industry recognition, including the Deloitte Technology Fast 500, Inc. 5000 and Black Book’s #1 Integrated EHR, Practice Management and Billing Vendor.
