Seven ancillary services that can boost profitability at spine and pain practices:
1. Urine testing — The practice can do dipstick urine screenings to generate additional revenue. Capital purchases to add urine testing include a mass spectrometer for analyzing the samples. The screenings' reimbursement ranges from $20 to a few hundred dollars and currently have fair Medicare reimbursement.
"It's a good investment now, but Medicare could change the rules for physician-owned labs," says Kevin Henry, MD, founder of Regional Pain Institute in Arizona and Illinois. His group sees a return on investment after around 300 urine tests per month.
Physicians unable to own a urine testing lab or who are more risk-adverse are purchasing stock in urine testing companies. The physicians can join at a standard share price and amount — not based on potential business.
"The companies can often provide investors a dividend depending on the company's financial performance and that's beneficial for physicians who deal with narcotics and other controlled substances," says Dr. Henry.
2. Physical therapy — While physical therapy services aren't a huge revenue generator, they can boost the services provided to make the practice more comprehensive.
3. Psychotherapy — There are psychological issues associated with pain patients, and bringing these specialists onboard provides better care as well as another billable service. "For a psychologist that's relatively busy, there are revenue opportunities available and it makes the practice more comprehensive," says Dr. Henry.
4. Ambulatory surgery center — ASCs are the biggest revenue-generating ownership opportunities available to physicians. They aren't easy to develop in every region or state, especially those with a certificate-of-need law, but they can make a huge difference in patient care. "Spine surgery is going more outpatient and there are shorter stays associated with it," says Dr. Henry. "Pain management is also a lucrative specialty for ASCs."
5. Medication gels and topical creams — In the past, providing medication gel and topical creams for patients have been lucrative, but their reimbursement was cut significantly in the recent months. Still, they offer another revenue generation opportunity.
6. Cash-pay pain procedures — Stem cell injections and platelet-rich plasma injections can be lucrative with the right clientele. "You can add these services as cash pay to your practice," says Dr. Henry. "There isn't a significant amount of literature behind them, but there are people willing to try them and who can afford them. Many of my patients have experienced great improvement through their use."
7. Telemedicine — There are new ways for physicians to connect with patients remotely and provide care, which could be a huge opportunity for spine and pain practices. "In general, I think this will catch on, and more patients will be seen from home on the computer. It will be convenient for patients," says Dr. Henry. "If you want to see a physician from home or do your follow up from your computer, it can now be done."