Could High Deductible Plans Save Small Practices?

Posted on October 8, 2013 I Written By

John Lynn is the Founder of the blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve had a number of really interesting conversations with EHR vendors around the future of small practices in healthcare. In fact, many EHR vendors are focusing their marketing efforts around saving the small practice (more on that in a future post). Although, one topic that’s come up multiple times recently is how the new high deductible plans might be a tremendous opportunity for small practices.

To give credit where credit is due, I first heard this idea from Dr. Tom Giannulli (Check out this Google Hangout I did with Dr. Tom), CMIO of Kareo.

The core concept I took from talking with Dr. Tom and have since morphed with other viewpoints is that patients with high deductible plans can be more selective about who they visit for their care. This presents an opportunity for small physician practices to provide a personalized service to those patients that a large group practice or hospital owned system can’t or won’t provide.

Of course, at the core of this question is whether the small practice does offer a more personalized service than a large group practice. There are many arguments to be made that a small practice can offer a better service. In some ways it’s the eternal battle between mom and pop vs big company. We all love the idea of mom and pop locations that know are name and know our needs. In many ways small practices can provide this same level of service and relationship which is hard to create in a large group practice that’s ruled by numbers.

However, I think one challenge to this idea is that large groups could provide some services which small practices can’t or won’t provide as well. Of course, this assumes that they aren’t too distracted and immovable to actually implement change. I expect that we’ll see some patient facing services that do much better in a large group practice and that would be nearly impossible in a small practice. For example, once telehealth visits become popular, a large group practice could implement a 24×7 telehealth service for patients with emergent needs. A small practice couldn’t do this (although, they could partner with someone to offer something close).

The point is that the battle for these high deductible patients is just beginning. I usually like to put my money on the faster, more nimble organization. The problem is that many small practices aren’t that nimble. In fact, healthcare isn’t nimble (see Mandi’s post today about Inflicting Agile on the Waterfall World of Healthcare). Although, small practice can be nimble if they chose to do so.

Coming full circle, does this present an opportunity for EHR vendors? Can the small practice focused EHR vendors offer a set of features to small practices that enable them to offer a more personalized service to patients? I think there is this opportunity starting with features as simple as e-communication with the clinic, online payments, and personalized care. The real challenge for these EHR vendors is how to balance customer service focused features that patients will love against the onslaught of government regulations which bog down their development teams.