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The Role of Patient Education in Reimbursement

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Under the premise that an active patient has the ability to become a healthier one, the role of patient education and “shared decision making” in reimbursement is more important than before. As mentioned by Brian Eastwood in a recent edition of Medical Economics, “Knowledge is power and in this new environment, means revenue.” What’s more, a patient tends to receive a better value with a better outcome at a lower cost.

As one may assume, a patient that is engaged in their healthcare is more likely to comply with treatment, as well as marketing and research. In the same way, if a patient feels supported in advancing their health, this produces a win for stakeholders on all sides. For example, consider a patient that needs to be placed in a diabetes prevention program, and his or her physician endorses this. While the payer agrees to cover it, the employer is also willing to pay for it. In this case, when all parties are united in their efforts to prevent a condition from occurring or worsening, everyone wins.

Aside from engaging a patient and developing a sense of cohesiveness in improving one’s health, communication between physician and patient not only establishes trust and loyalty—it could eliminate the need for additional visits. This is accomplished through case management software and patient portal applications. Adding value to the patient care process, this helps physicians and patients get around restrictions placed by certain procedural codes. For instance, if a code allows for 20 minutes each month for a non-office visit, new-age software enables providers to track these interactions. In addition, it allows Medicare to be billed. Thus, physicians can deliver care to patients and receive payment, while continuing to nurture the provider-patient relationship.

Chris Whybrew, principal of Whybrew Medical Management, devotes focused attention to supporting and improving physician practices and hospitals with experienced healthcare consulting. Mr. Whybrew understands the unique challenges relating to the healthcare industry, and how they impact every aspect of the business side of medicine.

To discuss specific strategies to maximize revenue for your medical practice or hospital, contact Whybrew Medical Management.

Posted on behalf of Whybrew Medical Management

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Chris Whybrew, FACHE


Whybrew Medical Management, LLC

Tulsa, Oklahoma, United States