Fascinating discussion. I think you should stop taking new patients when the average number of patient visits requested per day exceeds the number you offer per day. I work using a slightly modified open access schedule. Most of the patients I see called that day requesting the visit.
Medicaid in my county used to pay me $30 for adults and $36 for children. Now all the children have 'mandatory managed medicaid' which enrolls them with fee for service HMOs. Those HMOs are no worse than any other plan and in some cases pay better so I'm in a better place than I was a few years ago.
I recently had an inquiry from a new managed medicaid provider, Fidelis who will provide insurance in our county. They offered me 90% of Medicare's fee schedule. I emailed back that I was already getting 110% of Medicare from their main competitor GHI and so, didn't see any reason to join. Much to my surprise, the representative took it to her committee and in a few days they offered to match the 110% rate. I was AMAZED. I guess it comes down to supply, demand and the insurance company's situation. I would never again hesitate to at least ask for a raise!
Jay
