Inspired by numerous medical integration consultants and coaching organizations, chiropractors have increasingly pursued the integration of medical services into their practices over the past few years. Driven by the dual goals of providing comprehensive healthcare solutions and tapping into the broader healthcare spending of their patients, chiropractors are wise to approach this integration cautiously. Too often, chiropractors, excited and perhaps pressured at integration seminars, sign agreements only to later regret it due to several issues: (1) their lawyers disapprove of the advice they received, (2) they underestimated the complexities and risks involved in expanding their practice, (3) they think integration lone will fix fundamental business issues in their practice (e.g., lack of effective marketing and sales), and (4) the integration ultimately fails due to business needs of their practice that are actually intensified by adding the “weight” of an additional service line. What are some of the most significant areas of disappointment for those whose integrations did not go smoothly?
Addressing Underlying Business Problems
Using integration to solve an existing business problem can be problematic. For instance, if you’re pursuing medical integration because your chiropractic patient volume has decreased, you should first understand why your core business is suffering. Evaluate your marketing efforts – are they effective? Do you have a dedicated sales team comfortable discussing your services and fees with potential clients? Since medical integration patients typically come from your core chiropractic business, a decline in chiropractic patients will undermine the success of any new medical services you offer. Fewer chiropractic patients will likely mean fewer integration patients.
Navigating Legal Complexities
Many chiropractors are drawn to the promise of medical integration but often overlook the legal intricacies involved. Are you aware of the self-referral issues related to creating a second Tax Identification Number (TIN) for the medical entity? Do you understand the state and federal requirements for physician supervision? It is illegal for a newly formed entity to refer patients to itself for certain specific services. Chiropractors often find themselves following a “one-size-fits-all” model touted as standard practice with consultants and “their lawyers” who just flow the deal instead of making sure their clients understand the laws, risks and options. It’s common for practitioners to reconsider medical integration when informed about state and federal self-referral restrictions. Additionally, not all states require a complex “management model”; some, like Florida and approximately 12 other states, permit simpler direct services models. Chiropractic leaders must do two important things here: (1) accept that one size fits none, and (2) measure twice; cut once!
Clients who work with the Florida Healthcare Law Firm benefit from deep industry (both business and legal!) experience and dedicated legal support. Our team doesn’t merely dabble in healthcare law; we specialize in comprehensive representation of healthcare providers and almost every type of healthcare business. Whether you’re a new physician starting a practice or a chiropractor looking to integrate your practice, our attorneys are aligned with your success and committed to navigating the complexities of healthcare regulations to protect your interests.
By: Jeff Cohen
Founder, Florida Healthcare Law Firm
