Posted by: AtlasMD

January 2, 2014

Study Suggests More Insurance, More ER Visits

Sabrina Tavernise writes in The New York Times about a new study that flips a steadfast assumption on its head. At first glance, you’d think that giving people more access to Medicaid would lower the frequency of ER visits. However, a study conducted in Oregon has proven the exact opposite.

The study was published in the journal Science. It compared two groups of people — a 2008 lottery randomly selected thousands of low-income people in the Portland area and provided them Medicaid coverage; a second group entered the lottery but received no insurance. Here’s the shocker. “Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts,” writes The Times. The pattern was strong, holding true across most demographics, times of day, and types of visits. These even included conditions that we could have treated here in our Atlas MD office.

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Posted by: AtlasMD

January 2, 2014

Direct Care Thought Of The Day

“A single sunbeam is enough to drive away many shadows.”

— St. Francis of Assisi

Remember, the hegemonic nature of healthcare and its associated red tape means it can’t be wished away. However, it can be untangled one cash-only clinic, one dedicated doctor, one unhurried visit at a time. In the long run, healthcare in America can mean actual care.

Posted by: AtlasMD

December 28, 2013

Free Market’s Free Reign — Company Succeeds By Making Exercise And Vacation A Priority

Okay, so we’re putting in a caveat right out of the gate — Atlas MD WILL be checking emails during vacations and probably won’t be sending our limited staff to the gym during lunch. However, we do applaud one company that does EXACTLY that.

David Morken is the sparkling Co-founder and CEO of Bandwidth, a 15-year-old tech company. It was his idea to instate these policies: the company has (and enforces) a complete embargo on email to and from the company during vacation. Oh, well how about I just stay at the office all year? Nope. He also forces employees to take their vacations. And don’t forget the 90-minute lunches. They are paid, if you workout, along with your gym membership, shuttle to and from, your personal trainer, and a comprehensive assessment of your physical condition.

So why’s this cool? Well, for starters, Bandwidth was set to make $150M in 2013 – a 20% increase from 2012 – and, get this, they expect $200M in profitable revenues in 2014. So while yes, these policies might seem Draconian, they began with the proprietor and ended up positively influencing his staff, their work, and his bottom line. And no one in the White House told him how to do his job.

READ FORBES’ COVERAGE OF BANDWIDTH CEO DAVID MORKEN

Posted by: AtlasMD

December 26, 2013

This Hurts. New ACA Fees Coming 2014.

“Here comes the ObamaCare tax bill,” writes Fox News. Unfortunately, most insurers aren’t being forthcoming about the Obamacare taxes that are to be added on to premiums. Nope. Instead these “hidden fees” will be discretely passed on to customers.

One insurance company, Blue Cross Blue Shield of Alabama, wasn’t hush hush about it, though. They laid out the taxes on customer bills, using a separate line item for “Affordable Care Act Fees and Taxes.” Fox News lists out all the new taxes here. Ouch. You know, when we consider our push for more direct care nationwide, it’s hard not to notice that every new patient we enroll, who opts for lower monthly insurance payments using a wrap-around plan, is actually taking money away from the Federal government. Considering all this additional revenue they plan on bringing in from these healthcare taxes, isn’t this just another power ploy? And not to harp, but where’s the actual care in any of this dialogue?

Nowhere. Which is one of the biggest problems we have with it. It doesn’t address where healthcare is failing. Instead, it becomes a bureaucratic argument over dollars and line items, not patients and doctors having healthy, meaningful interactions.

READ ABOUT NEW OBAMACARE TAXES COMING 2014

The Moral Hazard Of American Healthcare

John F. Hunt, MD writes on Kevin MD, “If you learn nothing else today, I would ask you to learn that moral hazard is the cause of medical price hyperinflation.” His is a controversial post, meant to elicit click-through with the title, “The cheapest form of health care is to let sick people die.”

Obviously, Dr. Hunt doesn’t want anyone to die. However, his argument is that so long as it’s the government’s obligation to take care of people, prices will skyrocket. This is due in part to the inherent moral hazard. He explains, “Moral hazard is when the person who bears the economic burden of a decision is not the decision maker.” In healthcare, the moral hazard is a third party payer (insurance/government) bearing the economic consequences of a patient’s decision.

Dr. Hunt makes an excellent point. When there’s moral hazard, the patient cares less about drug and procedure cost, and what doctors charge. As a result, he says, prices rise when the “buyer” doesn’t care about these costs. He compares this to teens given no-reins access to their parents’ credit card. “[Then] if everyone in America let their teenage daughters go shopping for clothes… the prices would skyrocket.”

He explains the catch-22 in play here. So long as the government/insurance are responsible for payment, the actual prices of services will be hyper-inflated. The only way to break this cycle is to make the patient the person who bears full financial responsibility. The problem is that we as a populace need to make that leap of faith. Direct care patients are doing this. Direct care docs are doing this. The question is when will everyone be doing this? Only then will we see prices return to realistic levels. Seriously, the out-of-pocket cost of an ambulance trip alone would break most Americans’ banks.

READ DR. HUNT’S BLOG POST ON KEVIN MD

Posted by: AtlasMD

December 23, 2013

Is The ACA Deadline Update A Publicity Stunt?

NPR reports that the administration has granted a one-day extension on Obamacare sign-ups. According to NPR, “The deadline that had been midnight on Dec. 23 has been pushed to Christmas Eve at midnight.” So why the update? Apparently the government realized that there were issues with time zones, and that more time should be allotted to compensate.

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It’s a good thing the federal government isn’t an actual person. We’d be concerned that their head is attached to their shoulders.

READ MORE ABOUT OBAMACARE DEADLINE UPDATE HERE

Posted by: AtlasMD

December 23, 2013

Smartphone Cholesterol Checks Could Be A Smart Tool For Direct Care Docs

Cardiovascular Business reported on a new accessory that uses a smartphone camera to measure cholesterol levels. The smartphone system is in development and uses analytical software (this would be downloaded as an app) and a smartCARD accessory that fits over a mobile phone camera. From here, a user would place a drop of blood on a commercially available test strip (similar to glucose monitoring), which fits into a smartCARD reader. The camera phone accessory measures the color change on the strip which the app then processes to display a cholesterol value on the phone’s screen.

According to Cardiovascular Business, the Cornell team found that it takes 60 seconds for the blood sample to change colors, with a 1.8 percent accuracy rate. They tested it on various smartphone platforms and found that their system had a maximum error rate of 5.8 percent, around the same rate as at-home testing kits.

So far there is one drawback: the system in question can’t discern good and bad cholesterols; only a total reading is given. However, tools like these should be introduced into the direct care practice when they hit the market. How cool is it to empower your own patients to be able to do their own cholesterol tests? If you’ve ever tried to lose weight or manage your blood sugars as a diabetic, first off, you know it’s challenging. It takes will and discipline. But tools like these are great because they enable people to track their own progress. People need that connection or lifestyle changes can wind up feeling austere. Although, we don’t have a problem if our patients want to come in every few weeks to get an A1C or cholesterol reading. We’re more than happy to oblige.

Posted by: AtlasMD

December 20, 2013

Wichita Eagle Spreads Direct Care Cheer

Thanks to reporter Kelsey Ryan who shared a touching Atlas MD story in her recent report on our model of care. She focused on one of our patients, Michael Scheidt, who’s been enrolled in our practice since around the time we opened up. His wife was extremely sick and practically bedridden when he signed them both up for Atlas MD care. Dr. Josh was able to drive to their home and check up on her, which helped them tremendously. Even after the passing of his wife, Scheidt told the Wichita paper that he keeps coming in to see us because it’s “just so darn cost effective.” This was a real tearjerker. Thanks for your kind words, Michael.

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Posted by: AtlasMD

December 18, 2013

Healthcare’s Horizon Looks Costly, Bureaucratic

It looks like the sky is falling, according to the 2014 Watch List released by the Physicians Foundation. Sure, we paraphrased a bit here but there’s not much that docs are optimistic about except the repealing of the Medicare sustainable growth-rate formula.

“While the promise of a better future for healthcare remains, the current path is leading us toward a more monopolistic, bureaucratic and costly healthcare system,” Lou Goodman, Physicians Foundation president and Texas Medical Association executive vice president and CEO, said in a news release. “It is critical for policymakers to more regularly seek the counsel of physicians as they begin to implement health reform, since they are the true voice in determining the future of patient care.”

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Posted by: AtlasMD

December 16, 2013

The Doctor Will See You All Now

We thought Time was kidding when they wrote about something called “shared medical appointments, or group visits.” But no, evidently this group therapy approach to medical care is gaining popularity. Could it be a more satisfying way to see your doctor? It’s too early to tell, but either way, we’re excited here at Atlas MD. Security issues aside, we’re behind any movement that puts the patients in the driver seat. As is the case here when we Tweet with clients, the patients have to provide authorization and be comfortable talking about themselves in front of other people.

You might be thinking, this is ludicrous. But when it comes to diabetics, it makes perfect sense. Taking care of that condition is a full-time job, and as much as family, friends, and even docs, can empathize, there’s no replacement for people who’ve gone through the same ordeal you have.

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