Opportunity: According to the National Alliance on Mental
Illness, 1 in 5 Americans suffer from mental illness. Currently, there aren’t
enough resources to solve the mental crisis in America.
Forces: Several forces that have created this
opportunity, is the lack of Psychiatrists and Psychologists in the industry. As
a result, many primary care doctors are carrying the “burden” of attempting to
treat illnesses outside of their expertise or discipline and failing. In
addition, with the economic crisis and a lot of individuals unemployed, there
are many uninsured patients that are unable to afford the out-of-pocket
expenses for services. Lastly, insurances are becoming extremely restrictive
with the services or medications they approve which in turn limits the care or
services the patient receives.
Market demographics: Individuals
(ages 7+) who need mental health services that can either not afford services
due to lack of insurance or are limited to the services they can receive
through their insurance. Also, I will monitor the
need in wealthier areas for the need of my services to make sure I am providing
more private care for professionals who fear judgement or the loss of a
position due to them seeking help.
Customers: Currently,
patients with insurance are seeing specialists in their network of coverage.
For uninsured patients however, many of them are most likely going to hospitals
and being Baker-Acted for services; this only provides a temporary solution,
not maintenance.
This opportunity is huge considering
the recent suicides of wealthy individuals who unfortunately, struggled with
mental illness and could not receive help.
The window of opportunity will
always be open as long as patients need a mental health institution where they
can be treated.
Innovation:
My organization will be multifaceted in
that it will offer services to pediatric patients, as well as, adults. In
addition, I will also have a drug and alcohol rehabilitation facility within
the practice. Most mental health institutions don’t combine the use of both
practices, but I believe these services go hand-in-hand for a successful
recovery.
o Self-Pay/Underinsured patients
will be placed on the sliding scale and will have a copay ranging from $20-$100
depending on where they fall on the sliding scale fee.
o Providers/Hospitals will
be able to refer their patients. In order to build relationships with both the
providers and hospitals, I will offer the first visit free to every new
patient.
o Insured patients
will be required to pay their copays. If there is a service that is not covered
by their insurance, they can apply for the sliding scale and pay for the
service at a discounted rate.
Venture Concept:
·
Patients are willing to
go anywhere necessary to receive proper care and attention. If they are currently at an organization that is
providing these services, they will go elsewhere. Even if patients don’t
completely abandon their current services, they might still benefit from
services offered in my organization.
·
For my organization, the
competitors will most likely be non-profit organizations that also offer
sliding-scale discounts to their uninsured/underinsured patients. One of the
weaknesses I can easily note is that such organizations will most likely have
longer waiting periods, which will direct patients to my organization. Also, if
their poverty guidelines are different, they may not be offering affordable
copays which again, will send more patients my way.
Location:
My organization will be placed in
low-income communities in order to meet the need for the underprivileged. Also,
it’ll have to be stationed in an area with local bus routes for those who don’t
have transportation.
§ Fundraise or generate funds to supply patients
with free bus passes for appointments.
§ Conducting research on possible partnerships with
Uber or Lyft to provide transportation services to patients who don’t have
access to local bus stations.
Price points:
The average office visit
for patients range from $110-$220 depending on diagnosis and services offered
at the time of the visit. My organization will offer a sliding-scale fee for
uninsured/underinsured patients which will allow patients to pay for services
at a discounted rate based on the household income. In order for patients to
qualify for the sliding scale fee discount, they must be at a poverty scale of
100%-200%. The slides will be projected as follows:
|
Household
Size
|
Annual
Household Income
|
|||||||||
|
Slide
Fee
|
$20 Copay
|
$40
Copay
|
$55
Copay
|
$70
Copay
|
$100
Copay
|
|||||
|
1
|
$0 - $ 12,140
|
$12,141 - $16,146
|
$16,147 - $20,152
|
$20,153 - $24,280
|
$24,281
|
and up
|
||||
|
2
|
$0 - $ 16,460
|
$16,461 - $21,892
|
$21,893 - $27,324
|
$27,325 - $32,920
|
$32,291 and up
|
|||||
|
3
|
$0 - $ 20,780
|
$20,781 - $27,637
|
$27,638 - $34,495
|
$34,496 - $41,560
|
$41,561
|
and up
|
||||
|
4
|
$0 - $ 25,100
|
$25,101 - $33,383
|
$33,384 -$41,666
|
$41,667 - $50,200
|
$50,201
|
and up
|
||||
|
5
|
$0 - $ 29,420
|
$29,421 - $39,129
|
$39,130 - $48,837
|
$48,838 - $58,840
|
$58,841
|
and up
|
||||
|
6
|
$0 - $ 33,740
|
$33,741 - $44,874
|
$44,875 - $56,008
|
$56,009 - $67,480
|
$67,481 and up
|
|||||
|
7
|
$0 - $ 38,060
|
$38,061 - $50,620
|
$50,621 - $63,180
|
$63,181 - $76,120
|
$76,121
|
and up
|
||||
|
8
|
$0 - $ 42,380
|
$42,381 - $56,365
|
$56,366 - $70,351
|
$70,352 - $84,760
|
$84,761 and up
|
|||||
Customer
Service:
Patient
care coordinators will be assigned to each patient to monitor patient progress
and ensure everything is running smoothly for the patient. Patient care
coordinators also follow up and maintain contact with patient once they leave
the office and schedule them as needed.
Employees:
Clinical/Medical
o Psychiatrists
o Psychologists
o Registered
Nurse/Licensed Practical Nurse
o Medical
Assistant
Clerical
o Patient
Service Representative
o
Patient Care Coordinator
o
Billing
o Case
Workers I removed the position of a case worker, because the
patient care coordinator will be responsible for the same duties and it is an
unnecessary expense.
Executive
o Medical
Director
o Executive
Director
o Human
Resources Director
§ Compliance Officer
§ Operations Director
o Accountant
I removed this position because I hope to be the CPA of my own business.
o IT
Unfair Advantage: As mentioned previously, my unfair advantage is
my social capital because I have a lot of people I can easily contact for
information or referrals. Also, I am well-versed in how the business operates
and how to apply for government funding to secure the funding I need to
maintain operations.
What’s next: After operating for five years, I am hoping to
expand my business. This will require me to start a budget, seek new
opportunities and conduct research on prospective areas I’d like to target.
With my expansion throughout Florida, I would also like to begin to offering in-patient
services.
For me: I hope that after my successful expansion, I can
partner up with a coffee shop or deli so that I can generate revenue without
solely depending on government funding. This would also allow in-patient visits
to have access to food while receiving treatment.
Unfortunately,
I did not receive much feedback from my peers as to what to change or other
developments. Most of my peers stated that they enjoyed the idea from the, “What’s
Next,” assignment to offer in-patient services. I did not go into detail, as
that would come eventually assuming my business was successful but I did make
minor changes to the services I would like to offer and the number of employees
I will hire. Above, I mentioned that I would like to be located in areas where
there are many bus stations for patients that struggle with transportation. One
of my ideas is to generate funds to provide patients with free bus passes for
their appointments. The other idea for patients that live in more rural areas
to have access to an Uber or Lyft, by a paid partnership. In addition, I removed
the accounting and case worker position. Because I plan on receiving my masters
in accounting and becoming a certified public accountant, I wouldn’t need
another accountant. Instead, I will just have to hire accounting associates for
accounts receivables and accounts payables which is a part of the billing
department above. I decided to remove the case worker position because their
duties are the same as that of a patient care coordinator, so I didn’t see it
fit to invest additional money into that position. Please feel free to provide
any feedback!
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