Tweak the DIGMA model for your practice
Strategy can be adapted for small organizations
When Edward B. Noffsinger, PhD, conceived of the drop-in group medical appointment (DIGMA) model, he envisioned it for a large capitated practice that is fully or largely at risk for patient care. However, the model can be adapted for smaller practices and for those that are largely fee for service, he says.
If you want to start a DIGMA in a small practice that is largely fee for service, you may need to be creative. For instance, third-party payers don’t have any payment codes that allow you to bill multiple patients for the same block of time.
Noffsinger recommends medical groups that are not capitated contact their third-party payers and ask for suggestions on how they can bill for the services.
"It won’t take long for third-party payers to see that seeing 10 to 15 patients in a group setting saves everybody time and money," he says.
Other options might include billing for patients that are actually examined or charging fee-for-service patients nominal fees for the additional service.
If your offices aren’t big enough to have a conference room for your DIGMAs, considering holding DIGMAs after hours in your waiting room.
The behavioral health professional who co-leads the DIGMA could be a person with whom the physician has worked in the past and who attends the group sessions on a contract basis. Another suggestion would be for a nurse who knows the patients to take over the role.
Oncologists, nephrologists, and other specialists whose patients have a high incidence of emotional and psychosocial needs should consider enlisting the aid of a psychologist to work with their groups, Noffsinger suggests.
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