Increase Clinic Revenue with Targeted Payer-Based Marketing

Looking for a smarter way to market your services—and find new patients that not only increase your volume, but your revenue per visit? Rather than following the typical mass marketing to your region with brochures, digital avenues, or billboards (and wondering if it works), try a more precise marketing approach.

Market to patients with payers that yield higher reimbursement  per visit instead.

How to Find Patients with Higher Payer Reimbursement

Step 1. Analyze Which Payers Pay You Best

By this, I don’t mean the payers with the largest volume of patients you serve—rather, I mean the payers who give you the best reimbursement per visit. To make this possible, the first thing you need to do is find the patients and payers to target.

Tracking your best payers may or may not be a simple process depending on what data access you have. This is typically done through your EMR or PM system. Knowing the average revenue per visit (ARPV) by payer is critical to the success of this type of marketing. ARPV is the amount paid by visit once the visit has been completely paid by the payer and the patient (with write-offs and adjustments completed, leaving a zeroed out A/R balance on the visit.)

This method of target marketing makes most sense for urgent cares that have been in business for a few years, and have a strong archive of A/R data. Here’s an example of a DocuTAP report showing payers, visit counts, and average revenue per visit.

Report Color Key:

Bright red = Low $
Black = Med $
Bright green = High $
Box size = Volume

Step 2. Research Employers with High Paying Plans

Now that you know which payers pay you the best, find the employers in your region who offer those plans to their employees. You can then market to these employers in a targeted approach. Most PM software doesn’t track this variable, and health plans can’t tell you because of legal confidentiality.

However, there are various ways to find which payers employers use. You can start by manually tracking patients’ employers with certain plans. It’s recommended you do this for the first quarter of each year, as many employers will switch payer plans at the beginning of the year.

Other ways to track employer plans are to work with a trusted broker, or check listings in local publications like those distributed by human resource associations, business journals, and the local chamber of commerce. Or you can ask regional employers directly who their payers are if all other methods are unsuccessful.

Step 3. Narrow Your Market, and Know Each Employer

Once you’ve found the top five employers in your area with the best paying payers, research each employer further. Before you market to employers, you’ll want to understand who they are. Learn more about the industry they serve, and what their employee demographic is like. Are their employees typically families, single workers, blue collar, or corporations?

Each industry type will have its own niche of patient appeal to urgent care—such as workers’ compensation services, treatment for all ages, or after-hours care for busy employees. Understanding the dynamics of the employees working for these employers will allow you to focus your marketing presentation specifically to the needs of the employees.

Step 4. Understand Each Employer’s Payer Plan

Many employers offer the same health plan, but the specific benefits they purchase for their employees can vary widely. For example, one employer may have a $50 co-pay with Cigna for urgent care visits, while another employer with Cigna as their health plan has chosen a less expensive premium with a higher $75 co-pay. Keep this often misunderstood fact in mind as you study your target employers’ benefit plans.

To familiarize yourself with specific employer benefits, you can review the EOBs of any of their employees that have used your center in the past. This will help you determine co-pays, deductible amounts, and covered services based on payer.

As you investigate specific plan designs, be sure to look for benefits covering a free physical or flu shots, and include those in your presentation. Make sure your contracts with each relevant health plan does not have any restrictions on what services you can provide.

And, because you will want to maximize the time you have with the employer decision makers, you will need to not only understand their health plan design, but also know who their worker’s compensation carrier is so you can speak to those benefits as well.

Step 5. Market to Each Employer’s Employees

It’s time to market! You can start with a generic presentation that outlines the services offered and insurances accepted, featuring what separates you from your competitors. Putting this presentation on your website is a great way to generate more interest. You can also use this presentation when you go to chamber meetings or for presenting at local human resources association meetings.

Then, based on the information you have on each of the specific employers, make variations of the generic presentation—and call out specific offerings to those employees. And finally, designate a face of your urgent care, whether that’s your owner or a lead physician. Make sure this is a dynamic person who can easily and comfortably present your clinic information. Having a specific go-to person at the clinic for employers to follow-up with is very important.

Getting your presentation in front of the right audiences will involve your face person attending functions that either get them in front of decision makers or directly in front of the employees.  This can be accomplished by being invited to their workplace for employee staff meetings, employee benefit fairs, or other similar events. You can also offer to include your clinic info in employer newsletters or materials, or sponsor employee activities.

Final Thoughts

After you’ve researched your best paying plans, you’ll know your worse paying payers, too. Use the information you’ve gathered to help with contract re-negotiations with these payers. Take advantage of all you’ve learned, and increase your bottom line by working smarter, not harder.

While urgent care does rely heavily on patient volume for success (and always will), you also increase overhead costs for staffing and resources as you increase volume of patients served. It makes more sense to increase—and market more precisely to—patients from the payers who pay you the best.

ABOUT THE AUTHOR:
Tammy Mallow is the Director of Contracting and Credentialing Services at Experity and has over a decade of experience with helping urgent care clinics as an advisor and consultant. From hospital systems to independent start-ups, Tammy supports clinic development with hands-on analysis in workflow, revenue cycles, health plan contracts, and other practice management areas.