free at the point of delivery

Re: free at the point of delivery

J G Wray — Thu, 07 Oct 2010 22:56:11 GMT

[quote user="Gareth C."]Martin- your savings club idea could have legs though. The other big plus is that if they have £200 or so built up and need something like a dental or proper cardiac work up rather than just the minimum, they are more likley to go for it as the money is there. It would be a bit like self insurance, but instead of the owenr spending the dog's savings account on a new telly...[/quote]

Dear Mr Gareth-C,

Have you ever heard of human cash benefit schemes?

These originated in Victorian times and are still going strong today. The BVA even has one, which members can join, run by a third party.

The Leeds Hospital Fund has a 140 year history - www.simplyhealth.co.uk

I was a director of a company which looked into this in 2000-2001, even adding in insurance elements.

We also had a platform and PMS independent desktop IT solution for settlement. A client would have gone to reception, asked to settle their account with a cash benefit and the reception would have drawn down settlement from an automated and direct claim system there and then, using direct credit ( as opposed to direct debit - did you know it exists?) as used by the cash benefits schemes even today.

The stunningly expensive actuaries commissioned to study the viability of the scheme came up with some discouraging figures. The only way we could have made it work was to have had massive, almost universal adoption by UK vet practices recruiting clients in the tens of thousands within 2-3 years.

The FSA issues were minimal because cash benefits schemes only pay out to the maximum benefit available, so the requirements for multiples of possible liability to be held as for insurance schemes didn't apply.

Isn't it absolutely amazing that vets over forty could possibly have had these ideas and prosecuted them all that time ago?

JGW

Re: free at the point of delivery

Laurence Webb — Thu, 07 Oct 2010 22:00:42 GMT

[quote user="Bob Russell"]

There should be no problem with the FSA if clients chose to 'put money on their card' but if they set up a direct debit it is a budget scheme and I suspect the FSA may want to get involved. his would mean registration, insurance etc etc etc.

[/quote]

I think that this does not apply if it is done via standing order rather than DD. A standing order is set up by the client and the amounts paid and the date of payment are entirely controlled by the payee but if you ran a direct debit scheme you would have control over the amounts that clients pay to you and could change them at will which is why you are subject to FSA regulations under the direct debit guarantee scheme.

I wait to be corrected though!

Re: free at the point of delivery

Bob Russell — Wed, 06 Oct 2010 09:17:42 GMT

Gas and electricity companies will be registered to provide credit facilities, will be monitored by the FSA. Even savings clubs come under regulation after the fiasco of the Christmas hamper company collapse.

Anyone thinking of setting up a scheme should take legal advice to prevent problems.

I think the FSA is going to disappear but regulation will continue!

Re: free at the point of delivery

Andre Escudeiro-Vieites — Tue, 05 Oct 2010 20:07:46 GMT

What about something like the gas and electricity billing,but with some adjustments as the pattern of spending isn't normally as steady in our business. You sign for a Monthly direct debit for a year. Say you put £10 a month and start spending. For that you get for example£150 to spend in the year. If you go over your yearly credit by the end of the period then you need to pay like everybody else. Could even negociate increasing the monthly DD or decreasing it at the end of the year. If major expending (say over a certain amount) is needed you could have a clause saying thar the full amount needs to be payed or an arrangement so the client could pay in stalments (with an iterest added).

Re: free at the point of delivery

Bob Russell — Tue, 05 Oct 2010 16:22:35 GMT

Re: free at the point of delivery

Gareth C. — Mon, 04 Oct 2010 12:24:50 GMT

I think I have had my "free at the point of delivery" scheme pretty much panned now so maybe you have the right idea. I think the free scheme could only work with a startup practice run as a co-operative with owners, with a backup insurance for referrals only.

Martin- your savings club idea could have legs though. The other big plus is that if they have £200 or so built up and need something like a dental or proper cardiac work up rather than just the minimum, they are more likley to go for it as the money is there. It would be a bit like self insurance, but instead of the owenr spending the dog's savings account on a new telly...

You will need to jump through various FSA type hoops though

Re: free at the point of delivery

Martin Atkinson — Mon, 04 Oct 2010 09:38:12 GMT

Looking at this totally cynically, the point of the payment plan in the end is not to help clients to budget, even though it will and that is the advantage to them, but to bring in a steady and potentially greater stream of money. Unlike insurance, the premiums for which are lost to the client if they don't claim, with my scheme they get the money back if they don't spend it (minus an administration fee) although the idea is that they will so it doesn't matter if they want to put in £1or £100 per month but it's money sitting in my account not theirs. We haven't started this yet but any comments are helpful to assess the viability of it.

Re: free at the point of delivery

Rob Loxley — Sun, 03 Oct 2010 12:45:44 GMT

[quote user="Gareth C."]This would need a good insurer and a careful calculation of the excess waiver element.[/quote]

AFAIK only M&S has ever had a zero excess insurance policy, and withdrew that after not long, which suggests it doesn't work?

Re: free at the point of delivery

Michael Woodhouse — Fri, 01 Oct 2010 22:56:34 GMT

[quote user="Gareth C."]so maybe it is perfectly possible but just would be too expensive, but on average thats what our clients between them are spending. [/quote]

Do you not find you have some clients that you seem to see almost every week often with the mildest ailments? They are the people I think who would be more likely to sign up - the bigger spenders. Your sums are becoming increasingly confusing - you would almost have to give an individual price, like with farm client contracts - maybe based on past use?

I can't see you getting enough people who turn up once a year for a booster or only if they really need you to sign up and basically subsidise the bigger spenders. I know what I am trying to say, but not verbalising well tonight.

Re: free at the point of delivery

Gareth C. — Fri, 01 Oct 2010 22:48:25 GMT

[quote user="Michael Woodhouse"]

[quote user="Gareth C."]also I did a quick mental calculation thus: annual turnover divided by active clients divided by 12= about £25. so if you could get all your active clients to throw in £25 a month (?and get their pets insured).... not that much is it?[/quote]

I think it's a hell of a lot! Just done an online quote for my 5y/o FN Patterdale and Petplan quote £25-36/month. Add onto that your £25 means I would be paying £50 - 65/month.

The only Veterinary attention she's had in our ownership are boosters, worming tablets and flea treatment only when she catches them off a rabbit or a hedgehog!

So it's cost me probably less than £50/year at normal vet fees to keep her - not £300 - 432/year!

[/quote]

so maybe it is perfectly possible but just would be too expensive, but on average thats what our clients between them are spending.

the calculation for clients on the scheme would need to take into account insurance, as a sig proportion of the turnover is from the insurers, so the £25 plus insurance is misleading, as its doubling up on practice income. you would need to guestimate the turnover from non-insurance revenue divided by active clients divided by 12 for your monthly subs, then add the ins premium.

maybe martin's savings club type option is easier, or the above idea plus some refund...

keep the thoughts coming, even negative ones

Re: free at the point of delivery

Michael Woodhouse — Fri, 01 Oct 2010 20:52:01 GMT

I think it's a hell of a lot! Just done an online quote for my 5y/o FN Patterdale and Petplan quote £25-36/month. Add onto that your £25 means I would be paying £50 - 65/month.

The only Veterinary attention she's had in our ownership are boosters, worming tablets and flea treatment only when she catches them off a rabbit or a hedgehog!

So it's cost me probably less than £50/year at normal vet fees to keep her - not £300 - 432/year!

Re: free at the point of delivery

Gareth C. — Fri, 01 Oct 2010 20:42:22 GMT

re martins post:

a savings scheme would help keep things simple and avoid the problems of lots of uneccessary visits. if you got them to insure as well the "pot" would only have to cover up to an excess and you would then distance yourself from the insurers.

also I did a quick mental calculation thus: annual turnover divided by active clients divided by 12= about £25. so if you could get all your active clients to throw in £25 a month (?and get their pets insured).... not that much is it?

many kiwi farm animal clinics operate like this: as a co operative where all the clients (farms) pitch in a set amount per month

Re: free at the point of delivery

Martin Atkinson — Fri, 01 Oct 2010 18:32:59 GMT

We were thinking of doing our own payment plan. The client pays in what they want monthly be it £10 or £50 and this can be used for what they want. If they want to blow it on wormers and vaccines thats their choice or they may wish to save it as an insurance for a major accident/illness. However once the sum I hold for them is exhausted they start to pay again up to the full amount. Things could be discounted a bit as well to encourage participation but in theory we will make more from the interest and increased sales (when sensible interest rates come back anyway!) because they won't want to continually exhaust the pot. If the pet dies or they leave before they'd used the pot then they would get the money back minus an admin. charge, either a fixed amount ot a percentage. It will need some bomb-proof paperwork but it could guarantee a steady income. I know some companies already run a similar scheme but this would be entirely in-house to avoid paying commission to a 3rd party.

Re: free at the point of delivery

Gareth C. — Fri, 01 Oct 2010 13:06:23 GMT

insurers defaulting...

Good point and you would have to go into it with an agreement with the insurers and a clause in the client-practice agreement that the client is liable if the insurers default. There is a company that produces bespoke insurance products for practices.

or just provide the sub-insurance part and get them to agree to sign up to pet plan and do direct claims, with client liability if insuers default.

...anyone got anything positive to chip in?!!!

Re: free at the point of delivery

Gareth C. — Fri, 01 Oct 2010 13:00:18 GMT

[quote user="Bob Russell"]

How often would a patient be presented for very minor ailments? How much of our (human) GP time is spent on consultations that are really not necessary?

The insurance company would take a hammering and the following year premiums would go through the roof.

Nice idea if someone could get it to work.

[/quote]

the insurers shouldn't "take a hammering" as they wouldn't be any more exposed than they are now. unecessary visits may occur but it would take the pressure off to prescribe something unless needed. although consult fees cover overheads etc, they dont actually incurr any expenditure for the practice. we would be more in the position of a human GP with fixed incomes per patient. Our liability would be the excess per condition.

i suppose you would need to take your average less-than-£60(ie excess) -transaction fee, see how many you would incurr on average per patient per year, divide by twelve and put that on the monthly fee (plus ins premium plus routine tx). It may end up looking too expensive for the client, but if anyone out there can have a stab at the calculation ....

Re: free at the point of delivery

Bob Russell — Fri, 01 Oct 2010 12:57:13 GMT

A significant number of people go to the GP for the slightest sniff/cold/cough - our clients will, I suspect take advantage of the 'free' consult to get value for money. I bet they would be no different about their pets than themselves or children.

I suspect our no show rate would go up as well!!!

Re: free at the point of delivery

mark bayliss — Fri, 01 Oct 2010 12:53:57 GMT

And who would take the financial hit if (or rather when) the insurance chooses to dispute or refuse a claim?

We all have had the experience where a clients hatred of an insurance company verges on the clinically insane - at those moments I am thankful that I can honestly claim no association with the insurance companies.

Re: free at the point of delivery

Gareth C. — Fri, 01 Oct 2010 12:51:58 GMT

[quote user="Hannah Wynne Richards"]

Nice idea, but I don't think it could work What about the non-registered animal that's brought in following a RTA as the owners have heard you don't charge !!!!!!!!!!!!!!!! You would need everyone compulsorily enrolled, whether or not they used the service i e NHS

Wynne

[/quote]

We already run a scheme where people pay by direct debit and get vaccines and flea and wormers and some cases food "free at point of delivery". These clients are enrolled and we so far have no one come in asking about free wormers etc. It would be something that people sign up and pay monthly for, and it would be a minority, but may well suit pensioners or people who like to budget. As for time wasting consults I dont think many people would go to the vets just for fun, but you may pick up more cases and once the bill excedes the excess for a condition the insurers pay. This is no different to the insurers position now.

Thanks for input so far, lets have some creative thinking on this!

Re: free at the point of delivery

Bob Russell — Fri, 01 Oct 2010 11:42:46 GMT

How often would a patient be presented for very minor ailments? How much of our (human) GP time is spent on consultations that are really not necessary?

The insurance company would take a hammering and the following year premiums would go through the roof.

Nice idea if someone could get it to work.

Re: free at the point of delivery

Hannah Wynne Richards — Fri, 01 Oct 2010 11:31:08 GMT

Wynne