There are two significant factors that are driving the increase in cash as a method of payment in medical clinics and doctor’s offices. One is the Affordable Care Act. The other is the growth in Concierge Services, which are medical practices that have decided they no longer will accept insurance and accept cash as the exclusive method of payment. We’ll discuss both trends in more detail in this article, and we’ll then discuss why a smart safe makes sense for medical practices, given these recent trends.

The Affordable Care Act

A key driving factor for the Affordable Care Act, or ObamaCare, was to get more Americans insured. By all standards this legislation has succeeded in this effort. According to the RAND Corporation, 16.9 million people have newly enrolled in ObamaCare, through February 2015.

With the Affordable Care Act, the uninsured can purchase new policies in an open exchange market. Many of these policies are characterized by having high deductibles. Typically, health plans with higher deductibles have lower premiums. The growth in high deductible plans is putting more of the cost burden of managing health care in the hands of the consumer.

A key result of this trend is the growth in patients who are classified as “self-pay.” Self-pay means the patient is responsible for medical services rendered before their insurance takes over. It makes sense that, with the growth in high deductible plans as a result of the ACA, more self-pay consumers will emerge.

Growth of Concierge Services

Long before the Affordable Care Act, many doctor’s practices and medical clinics made the decision to not accept insurance, as the overhead involved with validating coverage, submitting claims, managing disputes, and collecting payment simply wasn’t worth it. Many practices faced closure unless they went this direction. For other practices, they have realized they can offer greater care to patients by ridding themselves of the headache of health insurance altogether. These practices are called “Concierge Medicine” or Direct Care, and are growing in popularity as patients demand better care, and are willing to pay a membership fee to receive it.   Medical practices are going this route simply because it’s more profitable to them. They no longer need to have a dedicated staff required to manage billings, collections, and other paperwork that goes along with a third party payment system. And, even at reduced prices, they can provide better care to their patients. Many practices are adopting a “hybrid” model, where consumers have a choice of paying for their preventive care directly, or paying higher fees by leveraging their insurance. With the Affordable Care Act, where consumers are required to carry insurance else pay a fine, the growth in Concierge Practices is likely to continue.

Taking all this into consideration, it is reasonable to expect that medical clinics should see an uptick in their cash payment receipts. This is simply due to the fact that cash continues to be the dominant payment method among consumers.

With more patients paying for services with cash, medical clinics and doctor’s offices are now facing the same dilemma other retailers face – how to manage it.

Considering the aforementioned trends, we’ll now address why a smart safe makes sense for a medical clinic. We’ll break this discussion down into three factors – efficiency, accuracy, and transparency.


Medical practices that pride themselves on efficiency and organization can process more patients in a given timeframe than those that aren’t. The key is to maintain such high quality standards without sacrificing patient care, and efficiency helps enable this. A smart safe complements this strategy very well. Smart safes can be set up in such a way that front office staff can use it as part of their day to day activities and deposit cash as it is received.   By having the cash stored in a secure system, this mitigates the need to move cash from the front desk to a back office, waiting for another employee to count, reconcile, and prepare deposits. A smart safe, if used effectively, can save a medical practice substantial labor costs, driving the efficiencies that are needed in a rapidly dynamic environment.


Much like patient medical records, accuracy is paramount to a medical practice, not only for customer satisfaction but for legal and compliance reasons.   A smart safe contributes well with this requirement, as all transactions are recorded to the user level, and notes deposited into the validators are able to detect, and reject, counterfeit bills. Preparing bank deposits is substantially easier, faster, and more accurate, as the smart safe maintains a continual record of deposited notes. A smart safe can save a medical practice a substantial amount of labor hours currently allocated to the manual handling of cash.


Patients have a right to complete transparency with regard to their own records. Along the same lines, a medical practice should put in place the tools and assets needed to ensure complete transparency in everything they do. A smart safe helps in this effort. A smart safe is not only a secure repository for cash funds; it is also a reporting mechanism. A smart safe can generate a myriad of reports a business needs to help manage its cash business. Furthermore, such reports can be accessed remotely over a network, which is extremely convenient for a medical practice with multiple locations.


The healthcare industry is rapidly changing. Whether it’s due to legislation, a proliferation of new types of insurance, or a gradual evolution in consumer preference, paying for healthcare is evolving more towards a consumer self-pay model. Proponents of this movement claim that this will drive overall healthcare costs down over time. The jury is still out on that. Nonetheless, the self-pay model will continue to claim its fair share of the healthcare market, and medical practices need to be prepared to handle this.

Whether they admit it or not, medical practices are in the cash business, as cash continues to be the leading payment vehicle for consumers. As the self-pay model continues to evolve, medical practices need to make the necessary investments in order to best handle the predicted influx of cash.   A smart safe is a proven way to take that needed first step.

Different industries have caught onto this. It’s time for the medical industry to take that next leap.