ABOUT JOE FLORES Joe Flores has been an
ABOUT JOE FLORES � Joe Flores has been an RN 28 years with the first 10 years in ICU and obtained his CCRN in 1996. Joe then obtained his FNP-MSN in 1998 and attended law school with an emphasis on studying health law and helping his fellow practitioners and to become a patient advocate. Joe has defended over 1000 nurses, pharmacists, physicians and health care entities. The Flores Law Firm is a source of information for shaping health law policy and for reforming health care and the medical treatment of prisoners, the poor and the elderly. Joe is also at the forefront of housecalls, telemedicine and is gaining an international presence in Mexico, Brazil and other areas of Latin America on telemedicine and housecall models. � Joe can be reached any time at joe@floreslawfirm. com or calling 361. 887. 8670. E-mail us and join our list and sign up for our newsletter and upcoming video and book series and free newsletters. WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 1
GOALS AND OUTCOMES �AT THE END OF THIS LEARNING OPPORTUNITY THE APRN WILL: �VERBALIZE INCREASED KNOWLEDGE REGARDING HOUSECALLS COMPANIES �LEARN ABOUT THE MAIN OBJECTIVES OF HOUSECALL BUSINESSES �THE BASICS OF TAXATION AND RUNNING YOUR OWN HOUSECALL BUSINESS �BUSINESS FORMATION AND MARKETING �WHETHER A HOUSECALL BUSINESS IS RIGHT FOR YOU AS AN APRN WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 2
HOUSE CALL PRACTICE FOR APRN’S: WHY NOW? � �WHY NOW? WHY HOUSE CALL BUSINESS FRANCHISES? �HOUSE CALL COMPANIES HAVE NOW EVOLVED AND HAVE BECOME A VIABLE, PROFITABLE AND MARKETABLE BUSINESS WHOSE TIME HAS COME NOT ONLY IN SOUTH TEXAS, BUT NATIONWIDE. �IN 2014 A COLLABORATION WITH A MANAGEMENT AND SOFTWARE COMPANY WAS MADE TO FURTHER ENHANCE THE EASE FOR THE PHYSICIAN AND MID LEVELS TO LAUNCH THEIR COMPANY IN A “TURNKEY” FASHION. WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 3
WHY HOUSECALLS? There a number of excellent reasons for a physician and mid level practitioners to collaborate and start their own medical house call practice. Among the top reasons that several MD’s/NP’s and P. A. ’s choose to change their practice include: WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 4
WHY HOUSE CALLS? (CONT’D) Freedom from HMO’s and Managed Care Plans if desired Over 80 percent reduction in overhead yielding higher profits Increased reimbursement rates Ability to better assist the escalating baby boomer and Generation X generation plagued by diabetes, strokes, pain management issues, occupational injury and the “sandwich generation problems of providing care to children, grandchildren and aging parents. Increase physician and mid-level practitioners flexible time and income Work at your pace and provide the teaching that can save lives and time for caregivers WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 5
WHY HOUSE CALLS? (CONT’D) Ability to maintain an office/clinic practice while augmenting the practice through deploying up to 7 mid-level practitioners in the rural area to drive more patients into the clinic and keep them compliant, healthy and engaged and above all to reduce morbidity and mortality. A 150 dollar house call can save a 1500 -15, 000 E. R. visit. Gaining a competitive edge in the post Affordable Care Act world Increasing marketing appeal and value to the patient The house call market is expected to boom in the next 5 years. By acting now the smart practitioner captures more of the market share and allows the practitioner to save lives and increase positive outcomes WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 6
Why Floreslawfirm. com is Educating APRN’S ON HOUSECALLS �Since 2014 FLORESLAWFIRM. COM has been educating MD’s, NP’s and PA’s on how to transition from office and institutional practice to house call practice. �Our goal is to provide valuable information for those seeking to have financial and professional freedom and seeking a realistic alternative to practicing medicine and healthcare delivery in a traditional setting while helping save lives and better understand patients. �In the model developed here physicians and NP’s become their own boss and serve their patients to the very best of their ability with minimal oversight and control by profit making institutions. WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 7
Know How To Market and Reach Your Customers �Good bedside manner and technical skills. Financial sophistication is needed. �Financial knowledge: Plan and control your business cash flow and prepare for tight periods without cash flow. �New medicine and technology collides with good old fashioned medicine. House calls are making a comeback. WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 8
SOURCES OF REFERRAL �Home Healths �Group Homes �Oilfield and Occupational Medicine �HMO’s using NP’s to perform home assessments (opportunity for vendor contracts) �Community �Assisted Living Centers (Nursing Home visits are not housecalls and are reimbursed differently) WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 9
WHY HOUSE CALLS MAKE DOLLARS AND SENSE � Although half the states still have not accepted the full measure of the ACA including Medicaid reimbursement dollars it is likely that this may soon change with billions on the table � Although there are no guarantees it is up to you to succeed. We can help you by informing you of how to increase your chance of success. � Reimbursement ranges from INITIAL VISIT OF 125 to 175 on average with CMS to 50 -125 for followups and the same reimbursement for cash payments can be obtained. HMO’s are more difficult to work with. Physicians is recommended to do the initial visit followed by an NP and then periodically thereafter. 8 -10 visits a day is not hard if done per zip code and a tablet and good software is used. � Technology is advancing and collaborating physician roles are evolving to expedite visits and to optimize profits while achieving the goals of health promotion and saving lives. WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 10
BUSINESS BASICS: APRN’S Need to learn how to run a business �Pros and Cons of opening your own practice �Overhead, Overhead and Overhead �Location, Location �Market Analysis and Research �Business Plans and Organization WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 11
EMPLOYMENT LAW 101 �Hiring employees �Tips from those who have been there �The worst employees you will ever hire �The best type of employees you ever hire �Partnerships: There can be only one Queenbee/King Pin �Regulations and Insurance �Hidden Price of Owning Your Business �How to Fire Someone Who Is Not Producing �It’s a Business, Repeat After Me… �Contract versus Employee NP’s and M. D. s WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 12
Where’s My Office? There’s No Place Like Home �Low or No Overhead �Remember Overhead, Overhead? �Leasing or Buying a Building After you start making money �Office equipment and furniture basics (For Mid-Levels: You Don’t work for someone else, you now pay the bills) �Purchasing New Versus Pre-Owned/Used Equipment �Dealing with Contractors and Suppliers and Contracts �Staying in Compliance with the Law �Technology-How Much is Enough? WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 13
LEGAL BOOTCAMP FOR THE HOUSCALL APRN ON THEIR OWN �Partnerships, Solo, S Corp, C Corp, LLC, PC, LMNOP? Pros and Cons of each �Choosing a name and checking with Secretary of State �Trademark and Copyright Basics �Licenses, permits, and inspections �CMS Basics on Medicare and Medicaid �Which Attorney is right for me? (YES, CONTRARY TO EVERYTHING YOU HAVE HEARD, YOU NEED TO BE ON FRIENDLY TERMS WITH LAWYERS) �Risk and Compliance Issues WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 14
DEATH AND TAXES �Taxation Issues and Record Keeping Issues �Basic Record Keeping Issues �Get an Accountant �Financial Management 101 �Capital �Death and Taxes �Deductions �Retirement Planning WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 15
GUERRILLA MARKETING FOR APRN’S: WHAT YOU DON’T LEARN IN SCHOOL � What is a Marketing Strategy � TV, TV � Phone Books May Not Be Dead but they are trying to die � Radio Ga. Ga � Direct Mailers � Penny Savers, Ad sacks and the Pickle… � Social Media and HIPAA � Brochures and Web Sites � Video Production: You Don’t Have to Be Oliver Stone or Spend Like Him � How to Promote Your Business in the Community � Health Fairs � Home Health and Physician Office referrals � HMO health assessment business � Private sector � Occupational Medicine and Workers Compensation � Making a Commercial: Lights, Camera and Auscultate WANT MORE INFORMATON ON THE HOUSE � BRANDING Your Practice CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 16
PUTTING IT ALL TOGETHER: THE GOOD, THE BAD AND THE UGLY �Some people like working for themselves and some don’t �Some Need a Partner, Some Don’t �What It Takes to Compete and not just survive…but thrive �Collaboration Agreements, Billing, and Physician/NP agreements- Don’t hang out your shingle without backup and good referral networking WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 17
ETHICAL CONSIDERATIONS �MARKETING WITH HOME HEALTHS �BEWARE OF MARKETERS �WATCH YOUR CODING �HOW TO KEEP AWAY FROM THE CROSSHAIRS OF OIG, FBI, HHS AND OTHERS �DOING THE RIGHT THING AND KNOWING WHEN TO REFER OUT �CONTROLLED SUBSTANCE ISSUES WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 18
FUTURE CONSIDERATIONS �AGING POPULATION �TELEMEDICINE �UNDERSERVED POPULATIONS �MEDICAID �VETERANS �INTEGRETATING HOME CARE �APRN’S AS CHANGE AGENTS WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 19
WANT TO START YOUR OWN PRACTICE? �SIGN UP FOR OUR FREE NEWSLETTER ON HOME AND HOUSE CALL ISSUES joe@floreslawfirm. com �LEARN MORE BUY VISITING THE CMS WEB SITE �CONTACT US ABOUT TELEMEDICINE PRACTICE �KEEP ON THE LOOKOUT FOR OUR NEW PUBLICATION AND VIDEO SERIES IN 2017 �SPECIAL THANKS TO SCHARMAINE BAKER DNP THE PIONEER IN HOUSE CALLS SINCE 2005 -A Mentor and Pioneer WANT MORE INFORMATON ON THE HOUSE CALL BUSINESS FOR APRN'S? VISIT US AT FLORESLAWFIRM. COM ALL RIGHTS RESERVED 2016 20
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