Mar 16, 2022 | Dermatology Practice, Uncategorized
By Darren Whittemore, DO
To increase revenue and expand your patient base, you may have tried engaging with people on social media, advertising special service packages, or even parking a dancing balloon guy on the curb by your derm practice to drum up business. Nothing seems to work.
Serious change requires serious strategies. By tracking changes in billing and health insurance requirements and offering your resources and expertise to support pharmaceutical companies as they use technology to gather research data, you can uncover additional ways to help your practice grow. So give the dancing balloon guy the day off, and let’s explore four hidden revenue-building opportunities that can help point your derm practice in the right direction.
Outsource Medical Billing
Unless your accounts team has expertise in ever-changing CPT codes, AFA policies, and other Medicare, value-based care reimbursement guidelines, outsourcing medical billing is a popular and cost-effective option. Around 90 percent of healthcare leaders have considered outsourcing in both clinical and nonclinical functions to be more cost-efficient and better equipped to handle value-based care models. And here’s why:
A recent survey by Harmony Healthcare found that 33 percent of hospital executives reported the average claims denial rate hovering around 10 percent. In fact, across the nation, hospitals face average denial rates between 6 and 13 percent. When rejections occur, you need an experienced team that can respond quickly and are better equipped to handle changing requirements for medical reimbursements.
For example, board-certified dermatologist Dina Strachan, M.D., at Aglow Dermatology in New York, notes that every step needed to collect money from both patients and insurance comes with a cost attached. There is a huge time factor involved in understanding the fine print of the myriad high-deductible plans, and a lot of time is tied up in collecting and processing bills. By outsourcing billing, and placing a link on her website where payments can be made, a lot of time is recaptured.
“We don’t have to spend time opening and sorting mail, punching in, and processing credit card payments—it’s a time savings,” she said.
Apply to Host a Clinical Trial
Emerging cloud technologies are helping pharmaceutical companies tap into innovative alternatives for collecting rich, segmented research data. ClinicalTrials.gov currently lists 404,694 studies with locations in all 50 States and in 220 countries.
With in-person testing sites no longer being the only option for research, pharma can use both virtual and hybrid models to collect data.
Depending on the length of the study and the interaction levels required by the clinical trial directors, pharmaceutical companies will often pay clinics willing to dedicate their time and resources to help facilitate a relevant clinical trial.
Along with the revenue potential, most healthcare providers enjoy the option to provide their patients with the most recent treatments available, particularly in skin cancer and other chronic cases. According to the Dermatology Learning Network, interviews with dermatologists that have participated in clinical research show they can be professionally, intellectually, and financially rewarding.
“It allows you to give your patients cutting-edge treatment at a severely discounted price or for free,” said Dr. Mitchel Goldman, medical director of La Jolla Spa MD, in La Jolla, California.
In addition to the excitement of being involved in the development of new products and offering patients new treatment options, Steven R. Feldman, M.D., Ph.D., of Wake Forest University Baptist Medical Center in Winston-Salem, NC, noted the potential financial benefit to practices as well.
“In an era where managed care is paying less for each office visit, you can charge your usual office rate,” Feldman said in reference to patients enrolled in trials.
Reexamine Health Insurance Partnerships
Over the past 20 years, health insurance companies have consolidated to cut costs, meet higher demands, and, in some cases, move toward the government and individual health insurance markets under the Affordable Healthcare Act. This transition has given health insurance companies an advantage over physicians.
“Most dermatology practices lack the scale to negotiate with large health insurance companies on an even playing field,” Todd Petersen, CEO of Vitalskin Dermatology, explains. “These terms set year-over-year reimbursement rates and allow the insurance company to set billing, coding and utilization management rules. Consequently, nominal year-over-year increases can be largely offset by increased denial rates and tighter billing and coding rules.”
Although dermatology costs aren’t a high price point for health insurance carriers (accounting for less than 2 percent of medical costs), Petersen points out that pharmaceutical spending for dermatology-related drugs, such as psoriasis-related treatments, accounts for 6.5 percent of total spending with signs of future increases.
“For dermatology practices with market share and a large psoriasis patient population, using this strategy at the negotiating table may prove beneficial and provide the practice with improved revenues,” he says.
Invest in EMR Technology
Moving to digital-based technology, such as EMR or EHR, creates more efficient and profitable processes in a few ways:
- Participates in the Medicare Merit-based Incentive Payment System (MIPS)
Values-based care and reimbursements are growing and allow for additional revenue streams. EMR technology is required for billing compliance and patient dashboard access and to collect data and submit electronic data to CMS. According to Petersen, the initial investment cost of EHR technology will pay itself off down the road. “When considering whether to make the investment of complying with MIPS, consider the following: value-based reimbursement is not going away, and many practices have found the implementation of EHRs has helped them improve their billing compliance,” he writes. - Enables faster turnaround times for lab test results
For Allen-Taintor Dermatology, not only did partnering with a lab that specializes in digital dermatopathology provide a faster turnaround time for lab results (turnaround time is now 75 percent faster, with results often received within two days of submission), but it also enabled their dermatologists to use a digital slide to encourage a conversation about the patient’s biopsy results and possible cancer care. As faster turnaround time increases the speed of business, more patients can flow through the practice with increased revenue as a result. - Expands access to care
Digital-based patient files mean doctors aren’t limited by location to reach out for expertise on a patient’s case. With digital technology, a specialist in Boston or Switzerland can securely review a patient file and discuss a diagnosis in real time with the dermatologist. That leads to quicker results and prompt patient care, which again improves revenue.
With the dermatology field expected to grow by almost 11.4 percent by 2026, dermatologists can leverage revenue-building strategies by reducing overhead costs through outsourced billing services, research reimbursement rates with health insurance and government health program partnerships, participate in clinical trials, and expand digital patient care services. By tapping into these revenue outlets, you can help to prepare your derm practice for a future of growth.
Jan 27, 2022 | Dermatology Practice
By Eva Vertes George, MD
If you’ve toyed with the idea of starting your own dermatology clinic, you are not alone. In an industry worth almost $8.5 trillion with marked growth exceeding $800 billion by 2021, approximately 31.4 percent of physicians are independent practice owners.
Innovations in healthcare technology will likely trigger a new batch of medical startups utilizing emerging digital technologies to fill the growing need for dermatological care. The problem is that physicians have spent the majority of their time learning how to serve patients as dermatologists, not how to run businesses. That lack of business savvy may prevent many talented healthcare professionals from going into business for themselves.
Experts estimate over 5,000 dermatology businesses operate in the US, with indicators showing a consistent 1 percent growth in the dermatology industry since 2020. Cost, culture, and the customer determine whether a new practice is dialed in for future success as a solo practice or as part of a group practice.
Based on these factors, let’s discuss the advantages of (and a few of the possible deterrents to) joining an existing dermatology group practice based on cost, culture, and the targeted customer base.
Cost
Estimating the total cost to open and maintain a new clinic is likely the biggest obstacle for dermatologists planning to take the next step toward ownership. When you consider overhead costs associated with property, lab equipment, staff, marketing, and billing software, it’s no wonder that new clinic owners often underestimate the amount of money it takes to keep the doors open.
Because it often takes at least two years to turn a profit, Jerome Obed, DO of Broward Dermatology and Cosmetic Specialists in Florida, recommends having at least two years’ worth of money to live on when first opening a private dermatology practice.
If cash flow isn’t reliable, joining an existing practice is a strategic option. This is mainly because access to an active revenue stream, insurance credentials, and a robust client base is immediate. Another advantage of joining an existing practice is that you don’t have to put limited funds toward marketing, nor do you need business experience.
Culture
A trusting patient relationship needs a positive work culture to thrive. “Positive work culture will always support the healthcare professional-patient relationship. It will build patient trust and gain confidence among staff who provide patient care,” an NIH report concludes. “It will allow them to feel that other than the goal of working to cure their diseases, they receive care.”
The NIH study found that when patients see doctors and nurses who are satisfied in doing their work and providing services, it encourages patients to follow instructions. “When they feel teamwork is active among staff and stable leadership exists from their managers, these patients may be more than willing to allow themselves to seek medical advice and treatment.”
The advantages of joining an existing dermatology group practice have a considerable impact on your success. But the ease of stepping into an established practice can also interfere with the long-term benefits. For instance, joining an established practice means someone else decides who you will treat, the billing software you will use, and the length of your appointments.
By comparison, when you open your practice—and on the condition that your financing is secure—you have more control over your patient volume. You’re also in charge of your office hours, appointment times, services, billing, and lab partnerships.
In a group practice, the bottom line is the main focus. It’s part of the motivation to maintain a fast pace and see as many patients as possible. It can also mean a lower pay rate for you. It’s no wonder almost half (42 percent) of physicians experience burnout. And that’s something to be mindful of when making long-term business decisions.
Customer
It’s important to establish the type of patient care you want to offer. Those decisions can help you prioritize resources, possible clinic locations, and equipment purchases. For example, does your area report high incidences of skin cancers? How many dermatology clinics presently specialize in the services you hope to promote? One phone call can help you establish the wait time for new patients. Addressing these questions can guide your professional goals for your patients. But there are other factors to consider.
Your customer base includes more than your patients: It includes billing partners, insurance companies, lab partnerships, marketing firms, other healthcare providers, and more. When you own your clinic, you get to select and nurture those valued relationships.
Strategic partnerships, such as your dermpath lab, can help streamline your workflow process and reduce overhead costs. For example, working with a lab with expertise in digital pathology means you don’t need to invest in expensive lab and testing equipment. Partnering with a lab that integrates with your EMR technology and offers locum tenens services may open up new opportunities to expand your services without investing in an expanded staff.
By working with innovative, digital-based companies like PathologyWatch, it’s easier to see the possibilities of opening your own practice.
The healthcare industry will show plenty of opportunities for dermatology services in 2022. Choosing the best way to promote your expertise with optimal patient care can be a rewarding next step in your career. Improve your chances of long-term success by weighing the pros and cons of a group practice versus starting your own dermatology clinic (your financial strength, work culture, and customer relationships) and chart your new path forward.
Jan 21, 2022 | Digital Pathology, Pathology Business
Things are changing fast in the dermatology field. As more dermatologists turn to digital-based services, the options for expanding patient care services, accelerating turnaround times on diagnoses, facilitating interoperability among health services agencies, and streamlining workflow processes to better control overhead costs are transforming the dermatological patient experience.
At the heart of some of those changes occurring in Utah’s pathology labs is PathologyWatch, a full-service dermpath lab that combines the dermpath expertise and cutting-edge technology of an academic center with the efficiency and customer service of a private lab.
Dan Lambert, CEO at PathologyWatch, met recently with Caitlin Hansen of Silicon Slopes to discuss the business side of running a series of digital pathology laboratories, the future of AI technology on patient care, and the vision Dan has for the future of PathologyWatch and digital dermatopathology.
Here are some of the highlights from that interview.
Caitlin Hansen: Can you give me a little more info about the technology?
Dan Lambert: Right now, you go into the dermatologist; then they take a biopsy, and that gets FedExed or couriered to a local lab where it’s cut into really thin slices and stained. A physician looks at that under a microscope, types up a report, and that report might be faxed somewhere.
For us, we’re taking that process, which is very manual, and we’ve streamlined it. We make the slide digital, so that, for the first time, the dermatologist can look at that slide as part of the process, much like a radiologist would show you an X-ray.
We’re enabling not only dermatologists but, down the road, other physicians as well to actually show you what your cancer looks like in the patient room. Also, the integration with EMR means it’s much faster for the dermatologist’s office. [This creates] a lot fewer errors, and it allows for multiple opinions on the same case, which has never been done before because it’s really just been glass slides. And so the transformation to digital across this industry is reducing costs, it’s making things faster, and it’s also drastically improving patient care.
CH: I’m curious how you feel like this is going to affect the accuracy of diagnosis as well.
DL: We see from major academic medical centers that, at the end of the day, recognizing cancer under a microscope or digital, it’s about pattern recognition, And computers, especially with deep learning, have gotten better and better at recognizing these patterns and will eventually greatly improve the diagnostic accuracy.
It will help doctors for a long time. And then, at some point in the future, it will probably be accurate enough that we can start phasing out the human review of some of these cases. This stands to take out major costs from what is almost a $17-billion-a-year industry, which is pathology. And it’s one of the few innovations that I think can take out the true costs for a very overburdened healthcare system. . . .
CH: I’m curious about your specific focus as the CEO. . . . What does the day-to-day look like for you, and what do you put most of your focus on?
DL: So we just raised the $25 million Series B. With that funding, now it’s going from the point where you have a product that has proven product market fit, but moving into scale means that you need a lot of really highly qualified people to build the business. I’m spending about 50 percent of my time just on straight recruiting; trying to bring in engineers. . . .
CH: You mentioned you just moved facilities. Where did you relocate to?
DL: [We had to] move from one lab in Murray to a bigger lab in Murray. . . . It is exciting to grow. We employ about 50 people right now, and we’ll probably be at about 80 people by the end of next year, which is exciting to see the team [become] some of my close friends. It almost feels like family now. . . .
CH: What is on the horizon for you?
DL: The next phase for us is continuing development of AI. Learning to recognize cancer samples better, faster; finding those rare cases that frankly many, many physicians miss. Having gone through a couple of startups, I started this four years ago with the understanding of trying to leave something behind that’s like a true legacy or trying to make medicine truly better. It turns out that’s a hard journey. But so far it’s worked, and I’m really happy that I made that decision. . . .
CH: Are you in hospitals and clinics? How are you integrating to make sure that this technology is being used now?
DL: When we looked at the business early on, we could have gone two routes: We could have sold to hospitals, which is generally a longer sales cycle, or focus on outpatient clinics. They can make a decision usually in about a month. So we decided to go after the independent dermatology clinics that are primarily located in Utah.
We now have five labs in different states, so we’ve scaled up quite a bit. If you go to a dermatologist here in Utah, we process the majority of skin cancer samples in the state and so your sample is probably going through our laboratories. And I’m really proud of that because I genuinely believe it’s a higher standard of care than what has existed in the past.
CH: So switching back to you being the CEO and running your company. I think that culture and motivation comes from the top down and leading by example. What is the kind of culture that you inspire your employees to abide by and how do you keep them motivated?
DL: I think in any company, you have to pick a set of values. That also means making sometimes hard decisions about what you prioritize. And I think, in this company, the culture of truth, transparency, and accuracy of the diagnostic process is more important than anything. . . .
I want our company to be the kind of place that you would send your family member samples to, and that means enforcing a really high standard of care.
To view the full interview, click here.
Jan 6, 2022 | Dermatopathology Lab, Pathology Business, Press Release, Uncategorized
The Series B funding round will help PathologyWatch digitize biopsies, increase access to top skincare physicians and further AI research.
SALT LAKE CITY, November 16, 2021—PathologyWatch, the leading digital lab and pathology platform for dermatologists, announced today that it has raised $25M in Series B financing with participation from Ceros Capital Markets, Rock Creek Capital, SpringTide, Spark Growth Ventures, Blueprint Health, Blackbrook Management Group and existing investors.
With the new funding, PathologyWatch will broaden its outreach to dermatologists and conduct further research into skincare diagnostics and AI – allowing patients to receive faster diagnoses and more equitable access to dermatopathology services while enabling labs to work more efficiently and cost-effectively. Additionally, the funding will support operations as the business expands across the country, adding new labs in Texas, Florida and Arizona.
“We are honored that of all the digital dermpath labs available, dermatologists are increasingly choosing to partner with us,” said Dan Lambert, PathologyWatch CEO and cofounder. “As digital dermatopathology continues to grow, it has the potential to reduce the costs of pathology by billions while creating better patient care for everyone across the country. We’re thrilled to be winning so much volume so quickly.”
PathologyWatch provides fully interfaced EMR reporting and 24/7 access to digital slides for dermatology clinics. For their clients, this means more-efficient workflows and direct access to leading dermatopathologists across the country, with broad insurance coverage. PathologyWatch has successfully integrated laboratory information systems, scanners, digital viewer technology and EMRs into an end-to-end solution for dermatologists.
“PathologyWatch has been disruptive to the market and is digitally transforming the industry in unprecedented ways,” said Mark Goldwasser, CEO of Ceros. “With the need for remote health services during COVID, the distributed network of top-tier dermatopathologists alongside a digital viewer that can be accessed anytime and anywhere could not have come at a more fortuitous time.”
“For a dermatology practice to send nearly all skin biopsy volume for cancer diagnosis to PathologyWatch is a no-brainer,” said Austin Walters, founder and managing partner at SpringTide. “The company has worked hard to create a service that outperforms every other from both cost and quality perspectives.”
“Dan is a driven entrepreneur with social good in mind,” said Ryan Brooks, principal at Blackbrook Management Group. “We are part of a cause, not just an investment capital endeavor. In the past, I have been a patient waiting for pathology to come back. When you are waiting for results that could change your life dramatically, you want doctors and tech you can depend on. PathologyWatch will enhance the human experience and enable dermatopathologists to do a better job.”
“I am proud to support PathologyWatch’s mission to provide premier, accessible and affordable digital pathology services to the world,” said Rick Stratford, managing director of Rock Creek Capital. “The ability to provide top-tier pathology services to all communities regardless of location brings hope to patients in underserved areas and can save countless lives. PathologyWatch and other digital platforms like it are democratizing healthcare services and bringing hope and change to our healthcare systems.”
For more information about PathologyWatch, visit pathologywatch.com or contact [email protected].
About PathologyWatch
PathologyWatch is the groundbreaking leader of digital dermatopathology services. Through these services, dermatology clinics, hospitals and laboratories can improve operational efficiency by speeding up workflow and enhancing patient outcomes by utilizing the PathologyWatch expert professional team and in-house lab services. With an intuitive and easy-to-implement digital pathology solution that includes access to top-tier dermatopathologists and a streamlined clinical workflow that interfaces directly into the EMR, PathologyWatch brilliantly combines state-of-the-art technology and clinical decision-making to deliver unprecedented patient care.
Dec 3, 2021 | Dermatopathology Lab, Digital Pathology
By Darren Whittemore, DO
As one of the most feared types of cancer, melanoma accounts for about 1 percent of skin cancers while contributing to over 7,000 deaths in the United States every year. And those numbers are steadily increasing, with annual incidences rising up to 4–6 percent over the last several decades.
In the age of improved preventative measures, early detection, digital technologies, and better treatments, why are cases of melanoma continuing to rise? Is it our propensity for skin cancer? Or could it be the diagnosis? Are patients receiving the most accurate and reliable information possible? Some voices in the dermatopathology industry believe the pursuit of a “definitive” diagnosis—bolstered with advancements in digital pathology—sometimes leads to biopsies that are collected and tested too soon and ultimately come back with a negative result for malignancy.
However, others believe it is better to risk overdiagnosis than to miss cases before it is too late. As the industry-wide debate persists concerning melanoma diagnostic processes, let’s discuss points that support both sides of the argument.
Yes: There are indicators of melanoma overdiagnosis.
“From an epidemiologic perspective, the sharp rise in the incidence of melanoma in the face of stable mortality for the past 40 years [signifies] the epidemiologic signature of overdiagnosis,” says Jason B. Lee, MD, in an article for the American Academy Dermatology Association.
Lee echoed some of the concerns expressed by H. Gilbert Welch and his team’s research, which postulates that “the rapid rise in the incidence of melanoma is not due to a true rise in incidence, but it is the byproduct of increased scrutiny, which they refer to as the epidemic of inspection, surveillance, and biopsy of pigmented skin lesions.”
Welch’s team asserts that the rapid rise in the incidence of melanoma is due to the increasing skin cancer screening activities, low threshold to biopsy, and low threshold to diagnose melanoma by dermatopathologists fueled by heightened public awareness of melanoma, financial incentive, and fear of missing melanoma that has resulted in what they refer to as the “cycle of melanoma overdiagnosis.”
No: Testing for early detection—even if tests don’t result in malignancy—is good.
Opponents of this overdiagnosing argument—particularly Sancy A. Leachman, MD, PhD, and John D. Gray, an endowed chair in melanoma research—caution against rejecting new technologies for fear of diagnoses not resulting in malignant melanoma:
They suggest that we revert to not biopsying lesions less than 6 mm, rather than making an effort to better understand the biology (and clinical signs) that makes some 2 mm lesions deadly. Shouldn’t our call-to-action be to improve, rather than to decrease, our diagnostic scrutiny? Wouldn’t it be better to utilize the COVID “experiment of nature” to evaluate the true (data-based) impact of decreased melanoma screening, rather than keep all screening programs closed? . . . Should the SPOT Skin Cancer™ screening program be halted completely, as they suggest, or should we purposefully stratify risk and screen those with highest need?
The drive toward innovations in digital pathology and AI technology continues to improve the accuracy of tissue testing. Advances in digital pathology transform our view of the early stages of cellular behaviors.
But how are we best utilizing this information? At PathologyWatch, we combine state-of-the-art technology and clinical decision-making to deliver optimal patient care with accurate diagnosis. Our clinical team carries extensive experience in identifying and predicting the cellular behaviors of chronic conditions and skin cancers. One of the advantages of having access to this expertise is that dermatologists can collaborate with our clinical team to discuss those factors should there be concerns about early detection.
Call us to discuss the innovations in digital pathology that can help your practice diagnose with confidence.
