The principle of putting patients first, along with ethical and legal practice, sits at the core of quality healthcare practice. Patients' needs, best practices, costs, and outcomes must be considered and each holds more weight than providers' needs in quality practice models. As audiologists and providers in the healthcare system, we too must focus on patient needs, best practices, costs, and outcomes.

There is no one universal answer to the question, "What's my time worth?" The answer is individual and dependent upon many variables. Certainly, worth or value must be considered when setting fees, and every audiologist must first define his or her practice's vision, values and quality standards. Variables such as whether you choose to be a generalist or a specialist, practice models and quality standards impact individual worth, value and fees. "Exceptional practices can and do charge more and do not lose patients because of fees!"¹However, consumers must not only recognize the value of an audiologist's care, but also desire it.

"Audiologists must be able to differentiate and articulate what makes audiology care unique if we expect consumers, legislators and payers to understand its value."²This starts with consideration for scope of practice as defined by our licenses, credentials (including degrees and state license), exemplary patient care based on research and fact versus experience, choice of practice models, third-party reimbursement (including direct access), and both individual and professional esteem. Every audiologist must understand how all of these variables and individual actions impact not only individual value, but also the perception and value of our profession overall.

Numbers reflected on a profit and loss (P&L) statement tell a story, and every audiologist must understand that story and how it relates to practice management. At minimum, gross charges, adjustments, returns, net income, expenses, and net profit should be tracked, analyzed and reviewed monthly.

When setting practice fees, it is important to complete a breakeven analysis that considers not only revenue generated and collected, but also expenses and desired profit. Time for patient appointments and total patient contact hours also must be considered. Define desired profit or professional quality of life either in dollars or percent of net revenue that will meet both personal and professional needs. Be aware of market influences and competition, but do not let the competition control your pricing. Your competition may have a very different business model or plan than you do.³

Audiologists should not set fees below the practice's breakeven rate or participate in contracts that pay below his or her breakeven rate. If you do, have a very compelling reason to do so. As an example, Medicare diagnostics may pay below your breakeven but, at least today, hearing aids purchased by Medicare beneficiaries are private pay, unless patients have a secondary policy that covers hearing aids.⁴sup>

Discounting services and products, matching competitor pricing and participating in contracts that pay meager fees can be tempting, especially during tough economic times, but offering services or products at pricing that erodes a practice's profit margin can be devastating. Seeing more patients at lower reimbursement levels typically means working harder and longer, but that does not necessarily equate to increased income or profit. Always consider the impact of all discounting on the net profit, not only the gross charge.

The profession of audiology started in allied health and has transitioned to a doctoral level profession. That transition alone has not and will not cause increased value or professional esteem. Audiologists must differentiate the care we provide and distinguish our uniqueness for consumers, physicians, third-party payers, networks, and regulators. The value of our time also ties to the public perception of audiology care. If we expect consumers, physicians, payers, regulators, and others to value audiology care, that value must be communicated in our words, actions, marketing, behaviors, pricing, and outcomes.

References

1. Foltner, K. (2009). What's My Time Worth? Part 1: Vision, Values, Quality. ADVANCE for Audiologists, 11(1): 47.

2. Foltner, K. (2009). What's My Time Worth? Part 2: Understand the Value of Audiology, Ibid, 11(2): 58.

3. Foltner, K. (2009). What's My Time Worth? Part 3: Breakeven Analysis, Ibid, 11(3): 44.

4. Foltner, K (2009) What's My Time Worth? Part 4: Setting Fees. Ibid, 11(4): 33.

Kathy Foltner, AuD, is CEO of AuDNet Inc. She also teaches courses in Practice Management and Basic Business at Rush University Medical Center and Salus University. Contact her at kfoltner@aud-net.com or 312-593-1787. Visit www.NowiHear.com or www.aud-net.com for more information.