Navigating Self-Pay

Strathspey Crown’s mission is to make MDs independent

Chairman Robert Grant says company helps them achieve self-pay success.

By René Luthe, Senior Associate Editor

Ophthalmology Management: Two years ago, Strathspey Crown established Alphaeon Corporation to promote the benefits of self-pay procedures for patients and medical practices. What need do you think it fills in the medical marketplace?

Robert Grant, chairman: Health care is upside down. The focus is on the payer, then the products used. Then it’s about the physicians who provide the care; the patients are focused on last. We saw the opportunity to rebalance the deck in favor of the physicians who provide the care to their patients.

Strathspey Crown’s Robert Grant

OM: Any areas where you are seeing a greater interest among physicians in growing self-pay? Oculoplastics, dermatology, for example?

Mr. Grant: We see self-pay elements in those, and more. Oculoplastics for sure, but premium cataract surgery too, and dry eye are areas I think will be growing quickly in the future. I believe LASIK is due for a revival. The number of LASIK procedures last year was about 600,000, and that’s much lower than at its peak, 1.4 million to 1.5 million per year in 1999 and 2000. The percentage of the population who have had LASIK is a fraction of what it could be.

LASIK has fantastic outcomes and very high patient satisfaction, greater than 95%. So we believe LASIK has a wonderful future, as does vision correction in general.

OM: What options do you offer doctors to grow self-pay?

Mr. Grant: Our offerings pivot around a suite of services we call ALPHAEONMD. The first service is EngageMD. It is a customer-relationship management program that includes consultation tracking; lead capture, management and analysis; and automated patient communication.

Additionally, we have TouchMD. It’s a patient consultation tool that significantly increases conversion toward procedures and allows patients to access their profile before, during and following their consultation. It’s on a HIPAA-secure site. Patients track their own progress and see things like before-and-after photos in plastic surgery, as well as their different vision outcomes using our proprietary technology such as iTrace.

ALPHAEON Credit is our patient financing program. Physicians told us they wanted an alternative; since it launched last year, almost 1,000 practices have adopted it. We don’t impose severe retroactive penalties if patients miss a payment.

And there’s our social commerce platform, ShoutMD. That’s our mobile app. It’s the most important approach to driving success in the self-pay sector. Doctors need a forum to share best practices. It has thousands of keyword-accessible surveys. Often, doctors take pictures of clinical challenges or business issues and ask the community for input. Within 30 minutes, they can have 30 to 40 responses from peers, KOLs, giving them perspective.

That creates what we call “crowd intelligence,” so doctors can make smarter decisions in virtually every aspect of their practice.

And it’s not limited to ophthalmology. Any board-certified specialist can join the ShoutMD community, of any specialty we serve. They don’t have to be an ALPHAEON customer nor Strathspey Crown owner. We have 4,000 members on ShoutMD right now. This cross-pollination is fantastic. These physicians are all facing the same challenges: how to grow their cash-pay revenue base and decrease their dependence on falling reimbursements.

Through Strathspey Crown and ownership in the company, doctors can influence and guide its direction.

OM: Do many doctors want to go totally self-pay? Or do they aim to create a hybrid model?

Mr. Grant: A survey recently taken on ShoutMD revealed that about 30% of participants were considering opting out of Medicare altogether if SGR wasn’t fixed (See Figure).

Figure: ShoutMD Survey

So no, doctors want to stay in, generally, and I believe the government should allow means and mechanisms so that doctors can stay in the Medicare system, but also augment their revenue system. As it is, doctors are paid through the Sustainable Growth Rate; the package for SGR will cost $230 billion to fix, and the government has to figure out where to find that money.

Doctors shouldn’t depend on third parties to make their incomes or build their practices for them. Physicians should look for ways to augment their revenue streams with cash-pay procedures that patients will value. And it’s a free-market system, so if you can’t deliver value, patients aren’t going to be willing to pay out of pocket.

But if you do deliver value, patients will pay for these elective procedures. That’s where ALPHAEON has focused its effort to help to optimize the cash-pay side of a physician’s practice, so that it can remain an independent practice.

OM: How does ALPHAEON incorporate the new realities of online commerce and social media and their effects on markets?

Mr. Grant: We’ve created an ecosystem based 100% on peer-to-peer influence. We ask our community to review the products we offer.

Every time a doctor posts on ShoutMD, he gets rewarded as part of the frequent flyer program. When members purchase products from us through the site, they earn points. They also earn points by posting shouts, commenting on their peers’ shouts and polls, or conducting their own polls.

We see new doctors from multiple specialties and countries join every day. We expect our community to grow to 10,000 practices by year’s end, which will make us the world’s largest independent practitioners’ group. We don’t want to own any practices or businesses. Rather, we want them to own us, or participate with us. OM