We all know insurance companies like to insert themselves into just about every aspect of health care. Many insurance plans make you go to an approved doctor at an approved hospital for approved procedures and take approved drugs. Fee-for-service docs don’t have much say here. They’ve handed all this control to insurance companies and the insurance companies use it, they say, to control their own costs. But is that all they use it for?
March 14, 2014
March 13, 2014
Myth Buster, Cash-Only Medicine Edition
Some people have a knee-jerk reaction when asked about direct primary care: “Only the rich can afford direct primary care” and the end result will be “fewer doctors seeing fewer patients”. These statements are true but ironically only in context with the current dysfunctional system that impairs quality by reducing actual patient care time. It’s this patient mill mentality that drives doctors away from a career in primary care, and further exacerbates the problem. Its leads to efficiency delusions like Meaningful Use Stage 2, and ICD-10 billing codes and fast-talking EMR vendors which all to the red tape that makes healthcare so needlessly expensive.
The current insurance-driven primary care system is underfunded and overburdened and gives poorer quality care than a direct care system would. The top 9 conniptions about direct care are as follows:
March 13, 2014
Healthcare Startups Can Save Lives, Rake in Money, And Introduce Competition.
Ron Gutman is on a mission to bring back the village doctor. But he’s going about it in a different way than we are. He runs a three-year-old startup called HealthTap. They offer an online service that replicates a house call. With his app, you can instantly connect with physicians via the net and ask them personal medical questions.
March 12, 2014
Yes, The Customer’s Always Right. And That’s What’s Wrong With Fee-For-Service Medicine.
If you’re a patient dealing with insurance, Stephen C. Schimpff has something to tell you. You aren’t really your physician’s customer. That’s because the insurer will decide whether and how much to pay the physician after they’ve seen you. You’re largely a bystander in the relationship, he says. The doctor’s customer is actually the insurer.
March 12, 2014
March 11, 2014
We Know Fee-For-Service Healthcare Has Problems. But Would You Guess That It’s Hurting Patient Credit Scores, Too?
Mounting evidence shows that chaos in medical billing isn’t only affecting our nation’s health. It’s marring the financial reputation of many Americans. That’s because the bills themselves can take months to sort out, and medical debts can be reported rapidly to credit agencies, often without notification. Even small unpaid bills can severely damage credit ratings.
March 10, 2014
Oregon’s ACA Healthcare Website Failed, Too. But The Reason Why Could Spell Direct Primary Care Success.
The state of Oregon has paid software giant Oracle over $100 million to build a healthcare exchange site. Unfortunately, it doesn’t work. And now it appears that Oregon is stuck with Oracle because they can’t hire another firm to finish the job. This is case and point of an old-school IT provider lagging behind the current trends in building massive web operations i.e. the open source approach used on mega-scale websites like Google and Facebook.
March 10, 2014
Vote For Atlas MD As The Most Influential Cash-Only Clinic
Concierge Medicine Today is asking their readers ‘What are the most influential “brand names” and “people” in the concierge medicine and direct healthcare marketplace? We earned their nod amongst an impressive list of insurance-free clinics/physicians. Results will be revealed mid-March, so if you have time, vote for us! Atlas MD is primary care fit for a CEO — free procedures, unlimited office and tech visits, discounted labs and prescriptions — at a price fit for all of us. Thanks for your support!
March 8, 2014
Cut The Red Tape: Dr. Ciampi — Portland, Maine
In South Portland, Maine, Dr. Michael Ciampi took a step last spring that Bangor Daily News said some physicians would describe as radical (not us, though). He reclaimed his practice from the Mercy health system because he found that patient care was too impersonal. Then he stopped accepting insurance and Medicaid so that he could work more directly with his patients. Earlier in 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.
March 7, 2014
Direct Care Is Actually Affordable. Direct Care Is Actually Care. Something The ACA Wishes.
When Blue Shield of California was designing the new health plans it would offer individuals under the Affordable Care Act (ACA), the insurer made a simple request to doctors and hospital in its network — lower your prices or get left behind. The insurer asked providers to accept reimbursement rates as much as 30 percent lower than what Blue Shield previously paid through plans sold on the individual market. Keep in mind that billing through a third-party-payer is about to multiply tenfold in complexity (from ~15,000 to +155,000 billing codes with ICD-10), meaning that getting paid will require more work for fee-for-service docs. In fact, providers are attending training seminars, paid for out of pocket, to learn how to deal with this billing beast.
Some providers got on board with Blue Shield, but not all of them.