Cost-saving tips from your colleagues

Allergy practices are feeling squeezed on all sides, with reductions in reimbursement, potential penalties from MIPS and challenges collecting from patients with high-deductible health plans. So it’s no wonder allergy practices are looking for ways to reduce expenses without impacting patient care – or allergist and staff well-being!

Read what some of your Practice Management Committee members say are their best practice cost-saving tips. Some suggestions are easy to implement and others take a little more effort, but we’re certain you’ll find a few ways to save your practice money!

Alnoor Malick, MD, FACAAI

• Sign up with a group purchasing organization to get discounts on office and medical practice supplies.
• Create your own group of local allergists or physicians to do bulk purchasing or get better discounts from vendors.
• Negotiate free shipping on the purchase of high-dollar items like extracts.
• Negotiate a waiver of bank service fees for business operating accounts tied to your personal accounts.

Mike Tankersley, MD, MBA, FACAAI

• Use a free EHR. I switched to a free one and was happier with it after just seven weeks.
• Use billing software that charges a fixed amount rather than a percentage of collectibles. I use one that integrates with my EHR and only costs $169 a month.
• Don’t outsource your website. Without any prior experience, I built my website using a free website builder. I can make changes myself anytime at no cost.

Michael Rupp, MD, FACAAI

• Review and/or renegotiate your medical waste contract. It saved us a bundle! (ACAAI note: Get several bids from medical waste vendors and review contracts carefully. Some companies are known for lengthy contracts and substantial cost increases mid-contract. Don’t get caught unaware.)
• Move business cards, letterhead, etc. to online companies like Vistaprint to save money. Limiting printed items to one ink color can also save a lot.
• Save postage by sending regular letters, rather than registered letters, to non-compliant patients with serious diseases. Check with your malpractice company to confirm; ours told us registered letters are not required. (ACAAI note: You may also be able to use regular mail when terminating patients from your practice. Check with your malpractice carrier first.)

John Tole, DO, FACAAI

• Compare liability insurance costs and benefits and ask if extra coverage, such as cyber security coverage, is available at no additional cost. (ACAAI note: Some malpractice carriers offer substantial multi-year discounts to practices completing a successful risk assessment. This is definitely worth exploring. Another option: consider working with an insurance broker to negotiate malpractice rates. You may be surprised at the savings they are able to negotiate on your behalf.)

Kelly Davis, BS, CMPE, Practice Manager

• Where possible, order a year’s supply of extract at one time to keep shipping costs down and to maximize discounts. Extract costs go up every year.
• Scrutinize medical suppliers and individual products for deals. Our syringe distributor has a special pricing deal in the spring and fall. It lowers my syringe costs by close to 30%. I look at about how many cases a month we use and buy six months’ worth at a time. Fortunately, we have the storage space we need for all the additional supply.
• Implement a credit card (CC) on file policy. We ask new patients (and increasingly follow-up patients) to “pre-authorize” a CC for their visit. Our merchant service provider allows us to pre-authorize an account for a set amount; say $600. The CC number is captured and stored on the processor’s website. Then after we receive the remittance, we process the CC for the patient responsibility portion up to the amount that has been pre-authorized. We bill the patient for any amount greater than the pre-authorized amount.
  • For immunotherapy patients, we try to keep a CC on file for recurring charges. We process any outstanding balances monthly. We call patients ahead of time before billing for additional vials as these tend to be a few hundred dollars. We’re not 100% successful with getting all patients to participate, but we try to set that as the expectation. (ACAAI note: Check out our new Allergy Office Essentials educational modules, at education.acaai.org/allergyofficeessentials, which provide key practice management advice on specific topics – including how to implement a credit card on file program.)

James Tracy, DO, FACAAI

• Consider reducing offsite medical record storage fees by scanning old medical records into a scanning solution.
• Use purchasing programs in your area to help reduce the cost of clinical and office supplies.

Laura Meadows, Practice Manager

• Shop around to find favorable rates on supplies. Costco, Walmart and Sam’s Club sometimes have the best deals.
• Ask your main supplier to match the prices of competing vendors. When I find a better deal on medical supplies, I ask my main supplier to match the price – and they do.
• Patronize your patients’ companies when possible. They will often give you discounts and it’s a good way to thank them for choosing you.

Some other suggestions:

• Look at your profit and loss and identify your biggest expenses. Get competing bids on those line items every two to three years to confirm you’re getting the best rates.
• Network with others in your state or local allergy society to find out what vendors they’re using and what their experience has been. You might find opportunities for cost savings or better customer service.

We’ve pointed out several ways to reduce expenses, but notice which area was NOT mentioned by any of our members as an opportunity for savings – despite being one of the largest costs: staff expenses.

The results of a recent Medical Group Management Association survey indicate that higher-performing practices have more total support staff per full-time equivalent physician. Don’t skimp on clinical support staff, since clinical staff can take on tasks delegated by providers that can improve provider productivity. Your practice’s most critical resource is provider time, so it’s worth spending a little more on clinical staff to maximize provider productivity.