Who's paying the bills?
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For all the talk of cash, concierge, and cosmetics, it turns out the majority of dermatologists make most of their living by providing care for patients with government or private insurance. As more practices consider offering cosmetic services or concierge programs to supplement income in a time of shrinking reimbursement, the results of the AAD’s 2014 Dermatology Practice Profile Survey indicate that payment return from these new strategies have not yet caught up with the hype.

Despite buzz about the potential lucrativeness of cash-only payment models, these sources of revenue still only make up a small part of the larger reimbursement picture. Those surveyed reported that over half of their patients, on average, use some form of government insurance, while a third of patients are covered by private insurance. Even so, a portion of those using private insurance may be utilizing government subsidies. As enrollment in insurance exchanges under the Affordable Care Act makes more potential Medicaid recipients aware of their eligibility and baby boomers begin to age into Medicare, it is likely that the prominence of government payers will continue to expand in the future.

Refer to the chart below for a defined breakdown of payer source by prevalence.