It’s official…Blue Cross sent the news that they are decreasing all reimbursement rates to mental health professionals staring in September 2010. I am looking at an 11.4% decrease in my salary in 2 months.
Crap.
Econ 101
This isn’t just happening to me or mental health in general, it’s happening across health care here in Massachusetts (for more on my state’s role as the health care reform canary in the coal mine, you can read “If You’re Relying on Managed Care for Reimbursement You’re Screwed“)
And these decreases will be coming to your state soon. Remember, in health care reform we are
a) covering more people
b) decreasing costs
leaving providers with c) making much less money.
And, no, the insurers won’t cut their own salary. That’s just fantasy silly talk. So don’t start shouting that reforming health insurers is the solution. Congress had that chance and blew it, so we need to move on.
No whining = winning
OK–so the reality we are faced with is lower salaries over the next many years. I’ll give you a day or two to feel bad about this, but when you are ready to stand up and brush yourself off, read the rest of this post. Just because one income stream sucks, doesn’t mean your future is a black hole of misery. In fact, it opens up lots of opportunities, as the public begins to realize that paying less for more isn’t all it’s cracked up to be.
As expected, when the psychologists I know got this bad news, they started a petition to some governmetn official somewhere in the state. That’s good, but how soon do you think this issue is going to be addressed? Government moves slowly and my salary is being cut nearly 12% in less than 3 months. I don’t have that kind of time to wait for someone else to solve this problem for me..
[And, big government reality alert--they will only pick this up if it negatively impacts the public's access to care. The government does not exist to protect anyone's income. You can't make the case that a lower reimbursement rate isn't fair or prevents you from paying your rent. You CAN say that you will leave the panel and limit people's access to quality care. Then they can do something. Just saying.]
So, we need a solution that is more immediate than a big government solution. The reality is that in the amount of time it take to write a petition, you can draft a whole new business plan with multiple income streams and a streamlined marketing plan to get the word out all over the world.
That’s what I did today. I sat down for 2 hours and sketched out a new plan. It includes online workshops, virtual coaching, bringing in contract employees to do some of the work I can’t get to. There are a minimum of 4 income streams, all with different price points. It leverages technology in a big way minimizing my overhead and maximizing my accessibility. In fact, I plan to increase the availability of my services to people of different financial backgrounds. ‘Cause 100 people paying me $19 is $1900 in income vs trying to find 19 people to pay me $100/hr. Right?
Don’t wait for someone else to solve this problem for you. There is no solution. Global and national economics are going to make health care a difficult profession to leverage into big incomes over the next few years, unless we innovate. People running around talking to people in power are going to get polite nods and handshakes with a “I’ll look into it” smile, while sitting on double digit salary gaps.
This sucks but it doesn’t have to be a crisis. Do yourself a huge favor and take 2-3 hours this week or over the weekend to sketch out a new plan. Start to familiarize yourself with new technologies and get used to the idea of online therapy. Those of us who do this work now will be saved a world of pain when these cuts become reality. Those who try to stand their ground and hold out for a force to save the status quo are in a mess of trouble. In Massachusetts those who are putting all sorts of energy into protest, rather than innovation will be 12% down in income starting in September. I just report the facts, folks.
The letter from BCBS came yesterday. The tide officially shifted. We’re in a new era. Don’t get stuck being the newspapers, magazines and music producers of health care. All are broke and nearly irrelevant because they did not pay attention to change and tried to hold on to the old ways of doing things. They got passed by as the HuffingtonPost.com, DrudgeReport.com, Amazon.com and iTunes leveraged technology and left them in the dust.
You will see colleagues stand firm and protest. Encourage them to shift their mindset along with yours, but don’t get stuck in a collective “group think” that the more people complain the more things will improve. Keep your head down and keep innovating. If you get lonely, we’re here to support you!
Which gives me an idea…if you are interested in forming a mastermind group to support one another in developing innovative practices, please leave a comment below saying “I’m in!” (more words are welcome, too.) I’ll contact anyone who has interest in this idea next week to see what we can pull together. You are under no obligation to participate in any innovative scheme I dream up. But if you have even a inkling of interest, I encourage you to raise your hand and be curious. You never know what opportunities await.
Maybe our moto can be “Innovate or bust!” 
Susan is a licensed psychologist, business consultant and marketer for health care professionals who want to diversify their income streams and utilize online tools to provide services and market their practices. She teaches providers how to leverage social media to educate about health care while growing profitable practices.
I’m in!
Whoo hoo, DeeAnna! You are already on the cutting edge, my friend!
Count me in Susan! I’m ready to learn more.
It’s scary and at the same time a call for action. Here in NY the Department of Health who oversees all early intervention services, after 12 years of not raising hourly fees, just cut each session rate by approximately 20%. This at a time when there’s a huge shortage of early intervention providers across the board.
The bottom line is that that those who fund are only concerned with their bottom line.
Thanks for rallying the masses.
M. Yes, the big corporations will make a profit no matter what. They are business people, not helping professionals. This is why health care providers have always been in a weak position from a reimbursement standpoint. The people who provide our income view their work as a business that happens to be about people’s health. It could just as easily be a business that makes cars or widgets or drills oil. Their CEOs don’t think about the little people, because that is not their job. Their job is to make a profit for their investors. I’m very persistent in talking about this. I started discussing it ag 2 yeao rs and keep getting blank stares, like I’m talking gibberish. I put it out there, not to be “right” or smart, but because I care about our professions and our ability to help all the people out there who need us to be strong, available and focused on our work, not beaten down, demoralized and humiliated. This is a crisis only if we let it be.
Count me in!!! Although the shifting climate is scary, I also think the possibilities are endless and exciting!
I’m not in health care, but would like to be included. We’ve already been at this point, but are always looking for new ideas. The State of CA began furloughing over a year ago, which accounted for a 15% decrease in my husband’s gross income, then took away a health care benefit program that allowed us to afford the cost of traveling the 150 miles round-trip each time we have doctor’s appts. or hospitals tests or need to refill a prescription. Now they’re attempting to take what will amount to another 5%. My position went away 4 years ago when my non-profit employer closed offices. We’re in a rural, isolated area with no industry and almost no available jobs in any form. We continuously look at the big picture to prioritize what we must have, what we can do without, and what we can do differently to fill in the gaps. We found new ways to generate income, cut costs, use what we have in different ways, etc.
Welcome, Hunter! We’re always happy to hear from other like-minded innovators!
I’m in! Online I go!
Count me in. We as clinicians own the means of production, seems sensible that we should then profit from it.
@Nancy, That is a great way to put it. We do own the means of production, have the training and expertise. Why should a 3rd party dictate our value and means of making a living?
Count me in!
I’m in
Oh, and btw, I’m totally in. I always found it absurd that people in suits making millions of dollars pushing paper decide the treatment trajectory for people in need of help.
Not that there’s anything wrong with suits.
You’re point regarding itunes, amazon, etc. is brilliant; innovation is the future.
Count me in.
Hello Susan,
I want to be part of this. Please add me to your list. By helping each other we also help our profession and our clients.
Thank you.
I’m definiely in!!!!!!! I do not take insurance in my private practice, but I am tired of living on a povety level. When peole hear I don’t take insurance, they find someone else who does. I need to change my marketing pitch and I would love to be involved in a mastermind group! Thanks so much!
Saralee
Of Course I’m In!
I’m in!! I’m just opening my private practice. Got my business license yesterday
I want to make this work and I’m very open to innovative ideas. Let’s brainstorm!
count me in
thanks
Jean
Count me in. I find using the technology daunting, to say the least. But I am growing in acceptance that this is really necessary.
It’s so exciting to have a group coming together! Count me in for sure!
I’m in – keep me posted!
I am going to begin working in a private practice for the first time very soon. I hope to avoid being on insurance panels altogether, so I would love to be a part of this group!
Thanks!
Count me in. I’ve been in private practice less than 2 years and also got certified as a Distance Counselor. I love the idea of being part of a mastermind group!
I’m in!
I’m in!
I’m in!
Count me in!
I just got back from a 6 day intensive workshop learning hypnotherapy because I ..
1. believe in it.
2. know that people won’t expect their insurance to pay for it, so will be more open to private pay.
Between that and EMDR, I’m working to make myself stand out from the sea of therapists in town.
And, I just heard the mastermind group concept for the first time in my training and then here it is again..that was enough to make me pay attention.
Great idea
Hi Susan,
I have successfully had my own business since 2002 without being on any insurance panels at all! It absolutely can be done. I love the freedom it gives me and my clients to collaborate together on what really works. I also do hypnotherapy, healing touch, dreamwork and sandtray therapy as needed when my clients ask for it. I believe I must always stay on the cutting edge in order to keep my business healthy. So, please count me in. I have masterminded before with good results!
Thank you for starting this for all of us.
I’d love to be a part of this. Count me in!
count me in!
I am in the UK and always looking for new ideas
john
Wow! Look at all of the “I’m in.” This is going to be fantastic! Thank you for getting it together for fellow therapists around the world. Look forward to hearing from you!
Laura Beth
I’m in! I’m going to be the token “future therapist with marketing saavy” of the group. I have lots of ideas and it would be awesome to share them, see how therapists do with the ideas and learn from them
I am curious to know what’s on the radar. I am growing my pratice (where I specialize and don’t take insurance) much much faster than the group practice I work for taking insurance (and the pay really does hurt). Soon I want to explore options, and my own practice is growing…
Hi Susan!
Awesome idea! I am in for sure! I am working now on creating a flexible business model emphasizing coaching and I have lots of questions … Would love to collaborate with folks!
Thanks.
Kate
WOW! I”m thrilled to see so many of you ready to mastermind! If you’ve never done it before, it is a great way to share ideas, and learn from others who may have different experiences and perspectives from you. Let me ponder how to make this useful and efficient. We have over 30 people “in” and I want to make sure we use a forum that is flexible enough to support out needs, ideas and sharing requirements. Stay tuned….I’ll probably have a plan by Tues or Wed next week….
I’m in!
As therapists, we are masters of collaboration and creative problem solving.
Game on!
Susan, what a response! Please add my name. I have an idea. . .
Susan,
I find managed care absolutely insulting to therapists. The fees they pay to me are less than one third of my regular fees, sometimes less than a fourth.
But when I have to get my car repaired, my hair done, dental work, doctor visits, web design, an air conditioner installed, my lock opened by a locksmith when I got locked out,an attorney, an accountant, etc., etc., etc. – I cannot plead with them to get such a ridiculously low fee. And many of them have much less education, do not pay to maintain the numerous licenses and certifications that I maintain. And many client slso feel that therapy should be almost gratis, a gift from a caring professional, not something they should have to spend a lot of money on – like the cruise they are planning for a week.
Thank you for creating this dialogue.
Can I play, too? I’ve been on my own for 18 months and feel quite lonely in my attempts to be innovative and resourceful. I’m soooo looking forward to this!
Wondering if you might be interested in doing an online event around this? Perhaps an interview on skype?
John
onlinevents.co.uk
John, are you the same Onlineevents from Twitter?? Yes, online events are up my ally and should be a part of this process at some point!
I’m in. Starting my M.A. in Counseling this fall. Owned a small business decades ago — not in the helping professions — but didn’t get very far into “guerrilla marketing,” as we called it back then. Am definitely curious to see how we can e-network on this. Thanks, Susan.
I’m in as well. Looks like this is going to be really fun & exciting! It’s late for me so I’m not sure how many ideas I have at the moment but am open to brainstorming with everyone! I have a private practice part time so I keep my clientele limited at the moment but this will help when I want to increase my caseload. Thanks!
I am in. I am from Mexico, we do not deal with insurance the way you deal in the US, but I am very interested in learning and creating new ways of living through the psychotherapy world. So many minds and cultures can open up a lot of possibilities.
I am a psychologist in Canada ~ after I was let go due to health care cuts in June 2009, I spent the year building/marketing my private practice! I have had some success! I am always open to ideas about how to move forward in the marketing area! Thanks Catherine
I’m in!
I’m in!
I’m in! But just so you know, I’m just beginning grad school, MS in Mental Health Counseling. It will be a few years before I’m licensed. I’ve not started my practice…yet…but want to be well prepared and knowledgeable by the time that day comes. Hope you don’t mind my “tagging along” on this one.
@ChanaCeceilia– we love students!! You are right to start learning about all these new ways of doing things from the beginning.
In a few years, you’ll be ready to hit the ground running with a great, profitable practice!
I’m in… started in private practice in Southern California last year and seeking new, innovative ways to work..
I am the John from Twitter @onlineventiveYive me a shout when you are in the mood for an event
you might want check out our next event to see if it suits you? http://truckertherapy.eventbrite.com/
John
I’d like to participate, so “I’m in.”
Please include me in this very important, innovative conversation. Susan, I love your attitude and style!
I’m in!
I’m in, raising hand and waving it
I’m in too!
Wow – I really came to the party late! Just got back from a nice long vacation of pondering life, the universe, and everything… I’m excited by the possibilities of working with a group like this – I am totally “in”!
I’m interested in being creative with like minded folks. Thanks for getting us organized.
I’m in. I’m also in Massachusetts, and I’m trying to get away from insurance based practice. I’ve been marketing myself as a Parent Coach, but I need to liven it up somehow.
Susan:
I’m in! I am a pretty old-school kind of clinician, but am getting tired of always trying to run faster and faster as the ground gets less firm under our feet. It really is time to take on a bit more control over our professional lives.
in
Great article/blog post! I’ve been studying for a year now how to market via internet, create other income streams, and about offering therapy and coaching online. I think there are many very exciting possibilities if people are willing to take time to learn how to make the shift to new ways of working and marketing. Definitely count me in for innovation!
I would be very interested.. also in MA
I’m in!
Love your perspective. I’m in , and also in MA
I’m very interested…and also in MA
I’m in and curious.
I’m listening (smile)
Months have passed since the original post, but if the group continues do count me in as well. Thanks!
If you are still meeting and are open I would like to join.
I’m in
Hey, Susan – check the link in this post. It’s broken tonight.
Wish I could have seen this sooner!
I would totally be in!