Evan Dumas 

You’re listening to Group Practice Tech, a podcast by Person Centered Tech, where we help mental health group practice owners ethically and effectively leverage tech to improve their practices. I’m your co-host, Evan Dumas.

 

Liath Dalton 

And I’m Liath Dalton, and we are Person Centered Tech.

 

Liath Dalton 

This episode is brought to you by Therapy Notes. Therapy Notes is a robust online practice management and electronic health record system to support you in growing your thriving practice. Therapy Notes is a complete practice management system with all the functionality you need to manage client records, meet with clients remotely, create rich documentation, schedule appointments and bill insurance all right at your fingertips. To get two free months of Therapy Notes as a new Therapy Notes user go to therapynotes.com and use promo code PCT.

 

Evan Dumas 

Hello and welcome to Episode 539: What Are Practice Management Companies?

 

Liath Dalton 

This question has been coming up more and more as practice management companies are getting sort of more and more prevalent, and also like rapidly proliferating. The list of practice management companies has grown like exponentially over the last year in particular, and Kelly and Miranda from Zynnyme, and Eric Strom, the therapist attorney that PCT regularly collaborates with and that co-facilitates office hour sessions for our members on a regular basis, the four of us collaborated yesterday, at the time of recording to do a free webinar on these different platforms and what folks need to understand about their contracts, and in the process of both preparing for the presentation, and then the sort of deluge of questions that we received around it, a couple things became clear.

 

Liath Dalton 

One is that there is often a question of, okay, what’s the difference between a practice management company one of these platforms, like Headway, Alma, Grow therapy, Ruler, Sondermind, the sort of first ones on the scene were like Talkspace and Betterhelp. These platforms are offering more than just what Talkspace and Betterhelp did. But what is the difference between these platforms that are sort of marketing and positioning themselves as practice management companies and what we classically refer to as practice management systems, which are actually Electronic Health Record systems, but they have more feature and functionality than purely the record maintenance, right?

 

Evan Dumas 

Yeah.

 

Liath Dalton 

And the distinctions are really impactful, but I think it’s not something that sort of newly licensed, new to professional practice clinicians are aware of.

 

Evan Dumas 

Oh, not at all.

 

Liath Dalton 

Right? And so, the, if they’re evaluating platforms, just looking at, sort of, what do I get out of it, as it’s marketed or presented, these practice management companies understandably have appeal. Because they say they’ll take care of all the dealing with credentialing, and getting insurance reimbursement and even marketing and so on.

 

Liath Dalton 

So they’re presenting a greater feature list and often touting that they have higher reimbursement rates than folks who are in solo practice or even group practice. And so a clinician who’s just starting out is understandably going to think, wow, this sounds better than just signing up for a conventional EHR practice management system.

 

Evan Dumas 

Mhm, yeah.

 

Liath Dalton 

But, Evan, if something sounds too good to be true, it often is,right?

 

Evan Dumas 

Yeah, yeah, yeah. There’s, there’s a touch of exploitation going on and lack of transparency, for sure.

 

Liath Dalton 

Yes, and in in ways that are significant to a clinician’s ability to meet their legal and ethical responsibilities in in a lot of instances, when it comes to things like informed consent and AI utilization and who owns the data, who can release the data, like the actual client records, and also in terms of clinical decision making as well.

 

Liath Dalton 

Because essentially, and we’re going to be referencing this great study that the Psychotherapy Action Network conducted this year to basically get into what the experience does with and attitudes towards these different practice management companies are, and the findings from that are really insightful. And I think what help just alone, just skimming through the study itself and what the findings are, is something that any practitioner who’s considering one of these practice management companies versus a practice management slash EHR system should examine.

 

Liath Dalton 

And also in the show notes, we’ll put a link to the free webinar that we did with Eric, Kelly, and Miranda yesterday.

 

Liath Dalton 

But some of the you know, big key findings are that these companies are really marketed as practice management solutions, but they’re operating as large scale, investor backed group practices, but without the conventional benefits of a clinician working in a group practice where they’re an employee, where they get collegial support and training, and there’s a practice culture, and they get the protections of employment, right?

 

Evan Dumas 

Yeah.

 

Liath Dalton 

There are a lot of protections and benefits that come with being in an employee status. So when it’s flipped to being a 1099, independent contractor, they’re not getting those protections and benefits, but are then, by virtue of that independent contractor status, being positioned to take on HIPAA responsibility and liability in ways that can be kind of murky, depending on on the platform and how they have things set up, right?

 

Liath Dalton 

So, so that’s one area where this is problematic and requires that you really be evaluating what the contract details are. Do they meet your legal, ethical needs? Do they provide the protections you want? And is it going to actually lead to the kind of practice that someone wants to to have and run right?

 

Evan Dumas 

Yeah.

 

Liath Dalton 

Now going back to the data piece, Evan, who owns these companies, and why are they doing what they’re doing, like at the bigger, like more existential level?

 

Evan Dumas 

Yeah, what a good question to ask that not a lot of people do ask or know. Turns out many of them are backed or owned by insurance companies.

 

Liath Dalton 

Exactly.

 

Liath Dalton 

So this is a situation where then, and again, this is just taking the data from this study done by the Psychotherapy Action Network, that the companies are presenting themselves to clinicians as a solution to the pain points that they have with working with and accepting insurance, right? But there’s a big conflict of interest there then, because basically the same insurers that the therapists are struggling to work with are now controlling these intermediary platforms.

 

Evan Dumas 

Yeah, yeah, you’re just working for the insurance companies in a different way, and they’re not being transparent about it, about fee splitting, about that you’re even working for an insurance company like that just screams kind of sneaky to me.

 

Liath Dalton 

Right? So you’re giving away autonomy, but still maintaining legal, ethical responsibility. And then essentially giving client data to these companies that not only are they doing what they are with with regards to this sort of insurance dual relationship scenario, but are also really leveraging the data from all client sessions and all client communications to train AI models.

 

Liath Dalton 

And so, of course, that has implications for the professional field at large as well. So there are so many impactful considerations that must be entertained, undertaken when evaluating any one of these platforms, and if they are a fit for your needs as a clinician and as a business owner. And I think that this is something that group practice owners also want to be up to speed on, because in some ways, these are the platforms that you’re competing with for new hires, for clinicians new to the field.

 

Liath Dalton 

So for those of you listening to this who are group practice leaders, there’s an opportunity in this to, if you know what the, the risks, but also the promises of these platforms are, to then be able to, when you are sort of presenting why clinicians should come work for, for you and your practice is to emphasize the pieces around you, know, collegial support, clinical growth, culture practice or practice culture, what your values are as a practice, and how you know that aligns with a clinician looking to find a right fit and look at where those really key distinctions are, because I think that’s going to be really helpful in terms of effectively conveying kind of the value proposition of your practice versus one of these platforms.

 

Evan Dumas 

Mhm.

 

Liath Dalton 

So again, group practice owners, get informed on what these are, don’t just be concerned that they’re an existential threat and going to make it so you can never hire anybody again.

 

Evan Dumas 

Mhm.

 

Liath Dalton 

And those of you that are solo practitioners are new to the field, and you’re weighing the pros and cons of using one of these platforms, versus going into solo practice and using a traditional practice management slash EHR system or working for a group practice, look at the the details in the contracts, evaluate that and consider what really is, values aligned.

 

Liath Dalton 

Like the reality is that, yes, starting your own practice does have a heavy lift. There is investment of time, money, capacity, and it’s not possible for for any practice to just open its doors and have a full caseload on day one and not have to deal with any of the business pieces of things, right? That, that is a reality. But there are supports and alternatives available. Like it doesn’t have to be an either or sort of thing in terms of you either have to go it alone and do all of the hard parts on your own, or you have to work for one of these platforms.

 

Evan Dumas 

Yeah, yeah, there’s options.

 

Liath Dalton 

There are options. So the, knowledge is power

 

Evan Dumas 

Mhm.

 

Liath Dalton 

and do please check out the study results, because they’re really eye opening.

 

Evan Dumas 

Oh yeah.

 

Liath Dalton 

And also, the webinar that we did, the replay, is currently available, and we’ll have the link in the show notes, and in that we get into some of the deeper, specifics about how to evaluate 1099 versus W2 status, HIPAA implications and business associate versus covered entity relationships, etc, ethical considerations, cross jurisdictional practice considerations, and then expanding more into what the alternatives are. We want the profession as a whole to be able to, as Kelly put it, like reclaim sovereignty and and realize the value of each therapist’s labor and take responsibility and control of that not, not give that away.

 

Liath Dalton 

So that’s our PSA for the week. We hope you found it helpful, and stay tuned for next week.

 

Evan Dumas 

Yeah, talk to you next week, everybody.

 

Liath Dalton 

This has been Group Practice Tech. You can find us at personcenteredtech.com. For more podcast episodes, you can go to personcenteredtech.com/podcast or click podcast on the menu bar.