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Policy Tip Sheet: States Should Expand Direct Primary Care to Help Expand Availability of Primary Care

One of the lesser-known factors driving skyrocketing health care costs throughout the country is the lack of primary care physicians. Indeed, many states are experiencing a severe shortage of primary care physicians. According to a 2018 report from United Health Group, 13 percent of American patients live in a county with a shortage of primary care physicians.

This shortage is exacerbated by the fact that many new physicians choose to practice specialty medicine instead of primary care. Although there are many reasons for this shift, the high costs and logistical challenges inherent in primary care medicine are major contributing factors. According to the American Journal of Medicine, the percentage of American primary care physicians decreased from 50 percent in 1961 to 33 percent in 2015. The United Health study also found that only 288,000 out of 869,000 physicians conduct primary care services.

Unfortunately, this problem is likely to become worse before it becomes better. The United Health Group study estimates that by 2030 there will only be 306,000 primary care providers in the nation. Additionally, by 2032, the number of Americans over the age of 65 will increase by 48 percent, according to the U.S. Census Bureau. This, along with several other factors, will magnify the need for primary care doctors.

Read The Full Article at Heartland Institute

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The Advantage of Paying for Medical Care Directly

According to a PBS health report about a retiree on a Medicare Advantage plan, Z. Ming Ma was issued a prescription from her physician that cost $285 for a 90-day supply. “A month later,” the article says, “Ma and his wife were about to leave on another trip, and Ma needed to stock up on her medication.”

But her 90 days weren’t up, so Anthem wouldn’t cover it. “Ma asked the pharmacist how much it would cost if she got the prescription there and paid out of pocket,” the article says.

The total cash price was about $40.

This is not uncommon. In fact, a study from USC demonstrated that nearly 25 percent of all prescriptions filled at the pharmacy cost the insurer less than what the patient paid in a copay. Yes, that means paying cash is more affordable than using your insurance card.

 

Read the Full Article at The Hill

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More Patients Turning to ‘Direct Primary Care’

Having quick access to a primary care doctor 24/7 is very appealing to Mick Lowderman, 56, who is married with two children, ages 10 and 8. He pays a monthly membership fee to AtlasMD, a direct primary care practice in Wichita, KS.

“It’s awesome that I can call or text Dr. Josh Umbehr when my children are sick and that I have a solution before they leave for school,” he says.

For example, when one child woke up coughing recently, Mick and his wife, Jennifer, contacted ‘Dr. Josh,’ who asked them to put her on the phone to hear her cough and then take a picture of her throat and text it to him.

“He prescribed an antibiotic, which we picked up at his office the same day.”

 

Read the Full Article at WebMD

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Dr. Lee Gross and Dr. Josh Umbehr discuss the Coronavirus Outbreak on Sean Hannity

Dr. Lee Gross and Dr. Josh Umbehr of Docs 4 Patient Care Foundation appeared on The Sean Hannity Show podcast on January 28th to discuss the Wuhan Coronavirus Outbreak and what the outbreak means for the American public.

“To put this into perspective, Influenza, we’ve already seen 15 million cases and 8,000 deaths. When we are talking about [the Coronavirus] vs. what we’re experiencing with the flu season, it’s not time to panic but it is time to pay attention and for the Chinese government to be open and honest.”

Dr. Lee Gross, Docs 4 Patient Care Foundation

The full interview can be found at 80:00 minute mark of the episode below.

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Congress has a Prescription for Health Care’s Sickly Status Quo

Despite the problems that plague American health care, innovative ideas exist to cure what ails it. But many transformative approaches are languishing in obscurity compared to insurance-based, big-government alternatives. One idea, reforming Health Savings Accounts (HSAs), is a powerful antidote to the sickly status quo. And Senator Ted Cruz’s Personalized Care Act (S. 3112) would implement this much-needed solution. S. 3112 — which has a companion bill in the House, Congressman Chip Roy’s HR 5596 — would lift unnecessary HSA restrictions, let Americans spend HSA dollars how they see fit, liberate employers, and unleash Direct Primary Care.

Created in 2003, HSAs are already powerful tools that empower patients. Individually owned, these plans allow patients to place pre-tax dollars into an account and use the funds for certain medical expenses. Frequently confused with the much less advantageous Flexible Spending Accounts (FSAs), HSAs are the ultimate tax-advantaged savings modality. That’s because they are not taxed on contribution, growth or use for an “Eligible Medical Expense.”

Currently, however, needless restrictions prevent HSAs from achieving their potential — and widespread adoption. Insurance companies, fearful of losing any power, were able to include language that prohibits Americans from owning an HSA unless it is linked to an insurance company’s High Deductible Health Plan (HDHP). This unnecessary requirement forces patients who buy HSAs to also buy overpriced traditional insurance policies, limiting the appeal of HSAs.

Read the full article at RealClear Policy

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New Hudson clinic’s novel idea: a price list

“If, as a health care provider, you’re not paying attention to the financial wellbeing of your patient, you’re not treating the whole patient,” he said.

That approach is front and center at ReforMedicine, a direct-pay family medicine practice with offices in western Wisconsin. The newest location in Hudson opened this month at 596 Outpost Circle, Suite G.

“We’re built on the notion of doing things in a more cost-sensitive way,” said Usher, ReforMedicine founder and CEO. Part of that means giving patients a price list so they know exactly how much they’ll have to pay.

Being seen for an ear infection, sore throat or pink eye? $100.

Well child check or adult physical? $150.

Common lab tests? Starting at $48 a piece.

Read the full article at Rivertowns.net

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Commentary: Health care reform that’s superior to Medicare for All

Health care reform is shaping up as the defining issue of the 2020 election. According to Real Clear Politics polling, most voters say that health care is their most important issue.

For doctors, that’s no surprise. We hear complaints from our patients about the health care system every day. Chief among these is the exorbitant cost.

Average insurance premiums for employer-sponsored health insurance, which covers most Americans, have risen by more than 50 percent over the last decade. Deductibles have doubled.

How can families with median annual household incomes of around $60,000 pay $10,000 worth of combined premium and deductible costs per year?
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Direct Primary Care Could Bring Savings and Quality to Missouri Medicaid

Medicaid must be reformed to ensure its long-term survival. Over the past decade, Medicaid rolls have expanded faster than many states can afford. From 2013 to 2018, the number of Medicaid enrollees increased by nearly 28 percent, to more than 67 million. In 2017, the cost of Medicaid reached $581.9 billion, representing 17 percent of total healthcare spending nationwide.

In many states, the increased cost of health care can be traced to overregulation, rising drug and medical device costs, and increased use of long-term and behavioral health services. Even worse, bloated Medicaid programs, even in states that have not expanded, face viability problems. In Missouri, Medicaid costs have risen consistently over the past decade. According to the News Tribune, Medicaid costs have grown from 17 percent of Missouri’s general revenue in 2011 to 24 percent in 2018. In 2018, the Show Me State spent a whopping $10.3 billion on Medicaid.

Unfortunately, Medicaid cost overruns will continue to grow. According to a recent report from the Centers for Medicare and Medicaid Services, Medicaid expenditures are expected to rise at an average annual rate of 5.7 percent from 2017 to 2027, a rate that far exceeds annual U.S. gross domestic product growth. The Rapid Response Review, a study of Missouri’s Medicaid system that was completed in February predicts Medicaid spending could increase to as much as 30 percent of general revenue by 2023.

Read the full article at The Heartland Institute.

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How Four Pages Could Transform Health Care

Obamacare was trumpeted as a revolutionary bill when it passed into law in 2010. If a law’s impact depends on its number of pages, then the 955-page Affordable Care Act would have become one of the most impactful laws in U.S. history. But that has not been the case. That’s why Senator Ted Cruz’s innovative Personalized Care Act, weighing in at a paltry four pages but possessing powerful remedies, is desperately needed. The Personalized Care Act could transform health care by liberating Americans from employer-based health insurance, helping employers, providing new coverage options, and improving care quality.

This clever bill promises to revolutionize the U.S. employer-based health care system for the first time since its inception in 1942. Today, more than half of people under age 65 obtain insurance through their employer. That’s because employers purchase health plans with pre-tax dollars, while individuals buy their policies with post-tax dollars—substantially increasing the cost.

The Personalized Care Act, S. 3112, takes away this employer advantage by letting patients themselves buy medical coverage with pre-tax Health Savings Accounts (HSAs).

Read the full article at TownHall.

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Doctors picking direct care

Dr. Emilie Scott was only a few months into her first job when she started hearing the complaint: She was spending too much time with each patient.

Like many primary care doctors working in large medical systems, Scott was encouraged to see a new patient every 20 minutes. But that was barely enough time to talk and do a physical.

She eventually quit her job to try a new approach aimed at eliminating many of the headaches of traditional health care: tight schedules, short appointments and piles of insurance paperwork.

Instead of billing insurers, Scott now charges patients a $79 monthly fee that covers office visits, phone calls, emails, texts and certain medical tests and procedures. Scott typically sees six patients a day, down from around 30, and spends more time at each appointment. She hired two assistants to help handle paperwork compared with working with a department of billing specialists.

This approach — direct primary care — aims to leverage the extra time and money from avoiding insurance into improving care for patients.

“As far as our financial success, it does not depend upon having a team of people to figure out how to get money from the insurance company,” said Scott, who co-owns a private practice in Irvine, Calif., that serves about 900 patients. Scott said the practice has grown by word-of-mouth, without advertising.

In many ways, direct primary care is a return to a simpler time when doctors charged cash for their services. Patients say they appreciate the accessibility and simplicity of the system.

Read the full article at Times Union.

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