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Primary care needs a new operating system

Primary care was meant to be the front door to the healthcare system: the one-stop-shop we rely on for all of our general healthcare needs, and to help us navigate the rest of the convoluted care delivery ecosystem.

But as a front door, it’s pretty broken.

The impact of COVID-19 has shown us this more than ever before—primary care’s already overburdened system has crumbled under the pressure, with patients left to self-diagnose without lab tests or in-person visits, wait in eternal telephone queues for callbacks that may or may not happen. In short, the very place in the healthcare system that was supposed to help catch illness soonest, in fact, created barriers.

The truth is, though, it may have never been set up for success in the first place, given its extremely broad mandate.

Just consider the number of billing codes primary care has to manage: more than five times the number of billing codes (the mix of services that can be billed for and reimbursed through insurance) than the next specialty. Despite the fact that primary care physicians (PCPs) are the ones handling the vast majority of visit volume (52% of ~1B annual outpatient visits), primary care has been both underappreciated and under-compensated—only 5%-8% of overall healthcare spend (PDF), and the lowest annual income amongst all specialties (PDF).

Read the full article at Fierce Healthcare

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COVID-19 shows Direct Primary Care model’s strengths

As a family physician for R-Health Yardley, I am fortunate to be able to stay connected to my patients as we navigate and adjust to the current changes our community is facing. As a Direct Primary Care Provider, I am proud to be there for my patients, helping ease their anxieties as they cope with the concerns of COVID-19 and what it means for them and their families.

Direct Primary Care is an alternative to traditional primary care. It is a model that truly focuses on the patient-physician relationship and has been proven to promote positive health outcomes. Individuals who receive this type of healthcare, whether it is offered through their employer or they chose to enroll on their own for a flat monthly fee, have access to unique care opportunities. Direct Primary Care offers the same general medical care and chronic disease management but with so much more than what traditional primary care can offer. Our offices offer onsite labs and immunizations and coordinate care with specialists. However, the real benefits of Direct Primary Care are what make us unique. Our patients have little to no wait time for an appointment and we usually see them same day if needed. As a physician, I am not pressured to see a certain number of patients a day and don’t have an overwhelming stack of paperwork or billing to complete. This leaves me with more time to connect with my patients, getting to know them and listening to all their concerns.

Read the full article at The Intelligencer

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How COVID-19 Is Changing The Debate Over Health Reform

A revolution is occurring in the way medical care is being delivered in the United States. It is happening almost overnight.

People have stopped going to hospital emergency rooms. They have stopped going to doctors’ offices. Most of the nation is self-isolating. Doctors and patients are no exception.

They are communicating by means of phone, email, Skype, Zoom and other devices. Last December, Zoom was the host of 10 million video conferences a day. Last week, the company was hosting 200 million a day. Many of those were patient/doctor communications.

If you are like a great many people, you are probably wondering why it took so long.

Answer: government.

Read the full article on Forbes

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How Direct Primary Care shines a light during pandemic

In our previous piece, we discussed how the lack of price transparency in the American healthcare system has become an addictive painkiller — the “opiate of the masses.” Protection from the pain of prices that are hidden (opaque) dulls our thinking just enough so that we don’t get too worked up.

There’s a different model for the practice of medicine that is gaining increasing support among physicians and patients.

Direct Primary Care (DPC) is a timely subject because physicians using this model are among the best equipped, best prepared, and most effective on the front lines of the fight against the pandemic.

Pennsylvania is the first state to begin educating the general public, business groups, and medical schools about this model, and the first state to receive a grant from its medical society for that purpose. But DPC practices are springing up all over the country, with general practitioners leading the way, although specialists have started to follow.

Read the full article at the Courier Times

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Beware Limitations of Freedom Imposed to Battle Coronavirus

The drastic measures elected and unelected officials are taking to stem coronavirus (COVID-19) contagion reached new heights when President Trump invoked the Defense Production Act on March 18, 2020. The Korean War–era law grants the executive branch emergency powers to require American companies to increase production to combat shortages. Meanwhile, at the state level, governors have prohibited people from making purchases by closing bars, restaurants, spas, and salons.

Officials speculate the pandemic may overwhelm our limited medical resources. But as long as their data remains woefully incomplete, we must remember Newton’s Third Law of Physics: “For every action, there is an equal and opposite reaction.” The draconian restrictions officials are imposing could spark an economic catastrophe more disruptive to American life than the coronavirus itself. So, officials should restrain themselves from depriving people of their freedom to transact unless or until irrefutably necessary.

Read the full article at TownHall

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We Have Never Been Closer to Free-Market Revolution in Health Care

It certainly doesn’t feel this way at times, but we have never been closer to a true free-market health care revolution than we are right now.

Thanks to an executive order (EO) signed by President Donald Trump, proposed legislation by Sen. Ted Cruz (R-Texas) and Rep. Chip Roy (R-Texas), and existing medical savings account law, we could be witnessing a free-market makeover of health care that delivers better care at lower prices.

Now, some may incorrectly think that we already have a free-market system in health care. This is clearly not the case, however, as centrally controlled pricing and extensive crony systems are rampant, shackling Americans with the most expensive and complex health care system in the world. Despite this dysfunction and the efforts of entrenched special interests, the United States is on the precipice of substantial reform.

Read the full article at The Epoch Times

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Socialism, Health Care, and Excuses to Steal Personal Liberty

Sen. Bernie Sanders, a democratic socialist, is one of two candidates remaining in the race for the Democratic presidential nomination. Former New York Mayor Michael Bloomberg, a billionaire who recently dropped out of the Democratic race, is now spending a fortune trying to ensure President Donald Trump loses in November.

There’s a lot of talk about Bloomberg’s previous attempt at a soda ban and Bernie’s Medicare for All. But no one is talking about the insidious assumptions that animate these policies—or how they turn health care into a vehicle for stealing your personal liberty and implementing socialism.

Let’s back up a moment. In 2012, Bloomberg, then mayor of New York City, cited public health as he proposed limiting the size of soda that New Yorkers could purchase. In a country founded on freedom, this type of unprecedented government overreach directly conflicted with the liberties we enjoy in this country. So, how exactly did Bloomberg justify such an intrusion?

Read the Full Article at Townhall

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Disney Plus — for Health Care?

Over 10 million people have signed up for Disney Plus since it launched last year. It’s easy to understand why. The service gives subscribers access to hundreds of movies and television shows for just $7 a month — no cable plan required.

Imagine if we applied that model to health care. For a flat monthly fee, subscribers could get everything from flu shots to lab tests “on demand” — no expensive, cumbersome insurance plan required.

This model already exists. It’s called direct primary care — and Americans young and old, rich and poor alike are increasingly turning to it as a means of securing affordable, high-quality health care.

Under direct primary care, a patient pays a doctor a subscription-style fee in exchange for access to an array of services. Just a decade ago, there were only a handful of direct primary care practices scattered across the country. Today, over 1,000 serve around half a million people in 49 states.

Read the full article at The Desert Review

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Bye-bye health insurance: How direct primary care can save you money

Dr. Rebekah Bernard isn’t just a primary care doctor, she’s an entrepreneur.

Fed up with the healthcare system, she opened her own direct primary care practice in 2016 called Gulf Coast Direct Primary Care.

“Right now, they say doctors spend more time on paperwork than they do with patients. Direct primary care totally changes that,” Bernard says.

What is it?

Direct Primary Care is just as it sounds, direct. There’s no insurance company, no middleman, or government involved.

Patients pay the doctor a monthly fee, in this case around $75 bucks, for unlimited visits.

Read the full article at WINK News

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The Direct Primary Care Solution for America’s Health Care Woes

Austin — “the live music capital of the world” — is a lovably “weird” city and home to many musicians and artists. Willie Nelson, Stevie Ray Vaughan, Townes Van Zandt, and Janis Joplin all called it home at one time or another. Great venues like Antone’s, the Broken Spoke, and Stubb’s kept the music scene alive for years, and as it continues to evolve, they serve as storied reminders of what has always made Austin great — a vibrant arts scene.

When I was in law school at the University of Texas, I remember rushing to buy the 2-CD KHYI set each year for the best music of the day. But I also recall that the proceeds from the sale of the set went to providing health insurance for artists. This was a way people in the arts community looked after one another.

Unfortunately, while the creative community remains alive in Austin, the rising cost of housing, driven both by demand and by property taxes, and the skyrocketing cost of health care are crushing many of the artists who live gig to gig and paycheck to paycheck. Since 2013, insurance premiums have gone up more than 60 percent across the board, while private-market premiums have doubled and even tripled. While Washington “leaders” dither and waste time, some creative doctors are using a fast-growing direct-primary-care (DPC) model that may well save the day.

Read the full article at National Review

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