Anyone do a scholarship fund for folks who can’t afford it? How do you track money so there’s no chance of legal questions? How do you account for the money? Do you set up a separate non-profit or is it simpler than that?
Do you mean so that other people can donate to it? I thought about it but then one of my patients suggested something I like better and would do if I were that organized. He suggested having a separate membership level called “supporting” or something similar. Then people can choose that instead of the regular price. Kind of a “get a membership/give a membership”. And have a membership type for the free or discounted or whatever I’m choosing to do. The downside is losing flexibility. The bonus is that all I have to do is have the number of months of one type match with the number of months of the other type over time. Easy accounting.
It’s simple. We just don’t charge patients who can scarcely afford their medications. We don’t put a membership in Hint so there is nothing to track. The attorneys tell me this is completely legal since no insurance contract is involved or violated. And it feels great to help those who need a freebie.
The idea of a scholarship fund is to enable me to write off patients without taking a big financial hit. It also enables people who otherwise want to support my practice (and many have expressed the desire to do so) to be able to do so. The only reason to do a non-profit is to give people a tax write-off, and I’ve been told that’s too big of a hassle for too little of a benefit. We have done discounts for folks (you can write discounts into the monthly hint invoice - even to zero), but as the practice grows, that number becomes increasingly substantial and there is a benefit for people to know what my work is worth financially, and not give them lower cost and have them not value us as much. The other thing about scholarships is that they can be used for other things, such as x-rays or other tests people need to get done outside of my office. It would give us a way to possibly offset some of the cost where that would be prohibitive.
We have setup a ‘protocol’ where any discounts for memberships are actually passed through me (the CEO / manager), rather than offered through the physicians. They physicians can offer ‘scholarships’, which are basically discounts, but there are a limited number of them per physician (we limit to 1 per 100 patients). And we also try not to offer them perpetually, but reserve them for families or people that are going through financially hard times (we usually offer 3-6 months, letting them know that we’ll start billing normally after that).
We also say that our pricing is low enough that many people should be able to afford it - and rarely do we ever give a full discount to a member, because we believe it’s always best to have some ‘skin in the game.’
These excellent suggestions and insightful questions seem to be begging for a theological or philosophical treatise on poverty and medicine. However, I am neither a theologian nor a philosopher, but still feel inclined to offer a few points.
- What’s so cool about DPC is that any of these suggestions, and I’m sure, plenty more, can be adapted, implemented and fine tuned without worrying about insurance, Medicaid or Medicare regulations.
- It warms my heart to hear both DPC providers and administrators have concern for indigent or financially struggling patients.
- If your DPC is a 501©3 already, you’re off to the races. I suspect that not many, or any, are though.
- You could not “run” your non-for-profit scholarship organization and pass the funds on to yourself (DPC practice) me thinks. Better, maybe to consider approaching another charity or religious institution to run the scholarship fund, if you are looking to help donors with a tax right off.
- I think that it might be worth considering a 1/3,1/3, 1/3 approach. Have a conversation with the (potential) patient and let them know that you are willing to pay for 1/3 of the membership cost. They, however, must also contribute 1/3 of the cost and also find another individual (preferably family member or friend) to cover the last 1/3. I think this adds credence to their dire situation and also makes them responsible to solicit assistance from someone besides you. (I am usually a sucker for a sob story, so having some definitive verification by a close contact of the patient is helpful.)
- Poverty should hopefully be a transient situation (especially for the able-bodied) and so putting a time limit on the assistance program seems a good idea as Jason suggested.
Anyway, just a few quick thoughts that popped into my mind when scrolling through this thread.