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DPC Simplifies the Purchase of Health Care for Patients

By Michael McGrady

 

As lawmakers bemoan the complexity of expanding access to affordable health care, doctors and patients have found a surprisingly simple solution.

 

Direct primary care (DPC) physicians enroll patients in a membership plan and provide them health care services without the need for insurance or any other third-party payment. Similar to memberships at Sam’s Club, Costco, or even a local gym, DPC memberships enable the delivery of quality health care services at discounted prices.

 

With prices ranging from $25 to $200 per month, each membership grants a patient virtually unlimited access to a physician for primary care and certain labs and tests, which amount to roughly 80 percent of most patients’ medical needs.

 

Beautifully Simple?

Dr. Chad Savage operates YourChoice Direct Care, a DPC family practice in Brighton, Michigan. Savage says the beauty of the DPC payment model is its simplicity, predictability, and affordability.

 

“The most unique aspect of the experience of payment in our practice is its simplicity,” Savage said. “Instead of going through a labyrinth of complex payment schemes, as is the norm with an insurance-based practice, we are a membership model offering a low-cost monthly membership that is affordable, predictable, and budgetable.”

 

DPC makes paying for health care as easy as paying for the gym, Savage says.

 

“There is no complexity or confusion,” Savage said. “It can even be scheduled to charge out to a credit card like a gym membership.”

 

‘Efficient and Ethical

Part of DPC’s simplicity is its price transparency. YourChoice Direct Care lists its prices online.

 

Savage charges $39.99 per month per person for patients under the age of 39. His rates increase with each age group, but he offers special discounts that include reduced costs for spouses and family members. Savage’s memberships include basic preventive health procedures, like flu or strep tests, at no additional cost.

 

DPC’s price transparency is not just convenient—it’s right, Savage says.

 

“I think DPC is incredible,” Savage said. “I think it is the most effective, efficient, and ethical payment model for primary care.”

Beyond Primary Care

Savage says the principles enabling the DPC model’s success apply to medical specialties, not just primary care.

 

“Generally, the pricing is still very simple for a specialist—direct low-cost fee for service,” Savage said during a presentation at a conference in Orlando, Florida, hosted by the Docs 4 Patient Care Foundation in November 2018. “Unless someone was in a chronic disease state that required consistent follow-up, like rheumatoid arthritis, most specialists would likely benefit from a direct fee for service instead of [a] membership arrangement.”

 

DPC physicians and specialists with direct-pay models are teaming up.

 

“I have a cardiologist who works with me now, and she uses low-cost direct fee for service and charges cash rates on inexpensive cardiac testing and diagnostics,” Savage said.

 

Refining Innovation

The innovation that led to DPC could lead to greater innovations for doctors and patients down the road.

 

“DPC is the best model out now,” Savage said. “However, that doesn’t mean something better could not come up later. And if it does, we should all be allowed to transition to that easily.”

 

By contrast, Savage says, the insurance-based system dominant in the United States stifles innovation.

 

“The current insurance-based, third-party payment scheme actually restricts the transition between effective payment models,” Savage said. “This limits innovation.”

 

Savage will likely speak at the next annual DPC conference hosted by the Docs 4 Patient Care Foundation, scheduled for November 14-16 at the Rosen Centre Hotel in Orlando, Florida.

 

Register for the conference today.

 

Michael McGrady (mmcgrady@mcgradypolicyresearch.org) is a free-market health care journalist. McGrady’s work has been published in The Wall Street Journal, Washington Examiner, Newsday, The Hill, Patient Daily, The Heartland Institute’s Health Care News, and others internationally.

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Doctors Set New Trends Direct-Pay Revolution

By Michael McGrady

 

A revolution is afoot in the world of providing affordable, high-quality health care. At the center of this world are doctors and patients who embrace a free-market health care delivery system, rejecting the encroachment of insurance companies on the sacred doctor-patient relationship.

 

That’s the message to be delivered to a projected 400-plus attendees at the next annual Docs 4 Patient Care Foundation conference on direct primary care (DPC), scheduled for November 14-16, 2019, at the Rosen Centre Hotel in Orlando, Florida. (Register today.)

 

Dr. Elaina George, an ear, nose, and throat specialist with a private practice in Atlanta, Georgia, delivered a similar message in a breakout session at last year’s conference in Orlando, which drew 370 attendees. The dominant and expensive third-party-payer system has reduced face time for patient care during office visits, George says.

 

“The rising costs of running a small business has led physicians to spend less time with patients,” George said.

 

According to George, doctors should join the direct-pay revolution to reclaim ground insurers have taken from the doctor-patient relationship.

 

The direct-pay revolution, as profound as the shift from house calls to doctor’s offices a generation ago, calls on physicians to stand up to regulators and advocate for quality, affordable patient care.

 

“It is our job to reframe the physician [and] seize the opportunity to re-frame our role along with the patient as the foundation of our health care system,” George said.

 

Teaming Up

In her presentation during a breakout session, “Empowering Specialists in DPC,” George prescribed a multipronged attack for direct-pay compatriots. Independent doctors must feel the empowerment to become entrepreneurial, George said. This may mean straying from the Medicare and Medicaid payroll.

 

Price transparency and using innovative technology will improve the doctor-patient relationship and the overall continuum of care, George said. In addition, physicians should “carve out” clinical partnerships with local established care systems.

 

Primary care physicians with DPC practices should partner directly with independent specialists, George said. DPC patients pay monthly membership fees to their primary care physicians for treatment most of their health care needs. To meet patients’ other needs, many DPC practices negotiate cash deals with specialists.

 

Hippocrates, Revisited?

George says the reign of government-centered health care is over—or should be.

 

“You can’t have one size fits all,” George said. “Ultimately, the continued growth of a parallel, free-market health care system, which will provide competition, will help independent doctors, patients, and the health care system.”

 

A direct-pay, free-market system will free physicians to practice medicine as they are meant to, George says.

 

“We want to practice medicine using the Hippocratic Oath,” George declared. “My job as a doctor is to be an advocate for my patient.”

 

Joint the direct-pay revolution. Register today for D4PCF’s DPC conference on November 14-16, 2019, at the Rosen Centre Hotel in Orlando, Florida.

 

Michael McGrady (mmcgrady@mcgradypolicyresearch.org) is a free-market health care journalist. McGrady’s work has been published in The Wall Street Journal, Washington Examiner, Newsday, The Hill, Patient Daily, The Heartland Institute’s Health Care News, and others internationally.

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Grace-Marie Turner Delivers Keynote ‘Health Care Landscape’ Talk at Direct-Pay Conference

By Michael McGrady

Droves of doctors and free-market health care experts are once again preparing to descend on the annual direct primary care (DPC) conference hosted by the Docs 4 Patient Care Foundation in Orlando, Florida, on November 14-16, 2019.

 

Last year’s conference drew a record 370 attendees to the gathering at the Rosen Centre Hotel in Orlando. The conference promotes DPC as an innovative direct-pay health care model as a doctor- and patient-friendly alternative to the United States’ insurance-based health care system.

 

Grace-Marie Turner, founder and president of the Galen Institute, a free-market think tank based in Washington, D.C., gave one of the 2018 conference’s two keynote addresses.

 

Turner delivered her address, “Understanding the Legislative Landscape for Health Care in Washington, D.C.,” to a packed house that included doctors and other health care professionals, some of whom received continuing medical education credit for Turner’s talk.

 

Turner argued the direct primary care model can improve the current state of the U.S. health care system, a key theme of the D4PCF conference, titled “Direct Primary Care 2018: Nuts and Bolts to 2.0.”

 

‘Coordinated Approach’

Turner said direct-payment models, as opposed to a single-payer approach, are the surest way to reduce the costs of care. The best health care solution is a “coordinated approach between a doctor and the patient,” Turner said in a section of her speech concerning DPC.

 

DPC practices charge patients a flat monthly fee in exchange for routine primary care services, often including labs, tests, and unlimited office visits.

 

Out of Insurance

The DPC movement has grown substantially while health insurance premiums have skyrocketed and insurance networks have shrunk since passage of the Affordable Care Act in 2010.

 

“The networks are getting narrower and narrower,” Turner said.

 

Turner praised efforts by free-market health care advocates, including the Galen Institute, and of Trump administration officials to make health care and insurance plans more accessible and affordable. She applauded the Trump administration’s expansion of bridge coverage plans and association health insurance plans, as well as its the continued push to reform regulations governing the interstate sale of insurance.

 

‘Medicare for All’ Myth

Turner denounced a proposal known as Medicare for All, a model that has been supported by hundreds of Democrats in Congress and among state legislators. Estimated to be a $32 trillion commitment over 10 years, one Medicare for All bill currently championed by congressional Democrats could lead to federally funded universal health insurance that would damage the quality of overall care delivery. The DPC movement should serve as the leading innovation to combat advocacy of universal health insurance, Turner argued.

 

‘Bridging the Divide’

Gregory Skochko, a doctor preparing to launch a DPC practice in Philadelphia and an audience member during Turner’s address, says Turner is closing a gap between medical practice and public policy.

 

“I love to hear from people like her who are bridging the divide between the clinical health care industry and players like us and the actual people making the policies that affect us,” Skochko said.

 

Register now for the 2019 DPC conference hosted by the Docs 4 Patient Care Foundation at the Rosen Centre Hotel in Orlando on November 14-16.

 

Michael McGrady (mmcgrady@mcgradypolicyresearch.org) is a free-market health care journalist. McGrady’s work has been published in The Wall Street Journal, Washington Examiner, Newsday, The Hill, Patient Daily, The Heartland Institute’s Health Care News, and others internationally.

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What Republicans and Democrats can do to fix our health care

Anyone watching the most recent round of Democratic presidential primary debates should recognize that in both the first and second sets of debates, all the candidates worked from the assumption that Americans face a binary choice: government-run health care or private health insurance.  Republican responses to the debates made the same assumption.

Big Brother or Big Insurance — love one, hate the other.  That’s the anemic range of health care messaging to expect from Democrats and establishment Republicans alike.  The problem?  Both sides are wrong — myopically, expensively wrong.

Democrats insist that you must love government-run health care and hate private insurance companies.  Republicans insist that you must love health care from insurance companies and hate government-run options.

But government-run and private insurer–run health care are both bad options, especially when Democrats and establishment Republicans present them as the only ones.  That’s why I choose option three: patient-run health care.  So do my patients, and so do countless other patients across the country — not that you’ll hear about them in the debates.  Such patients — many of them low-income — buy health care directly from their doctors for pennies on the dollar compared to what Democrats and establishment Republicans would have patients (or taxpayers) pay for insurance.

Instead of patient-run health care, expect to hear more about its opposite: government (single-payer) health insurance.  On its face, it sure sounds good: free health care!  Who wouldn’t like that?

Read the full article by Chad Savage, M.D. at American Thinker.

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Ep. 85 Trump’s 6/24 Executive Order: A Turning Point for Direct Primary Care?

President Trump’s June 24, 2019 Executive Order on health care transparency contains a key provision regarding direct primary care.  We have the pleasure of having back on the show Dr. Lee Gross.  Dr. Gross and colleagues in the DPC movements were instrumental in getting the White House to clarify a prior ambiguity regarding how direct primary care membership fees ought to be considered from a tax standpoint.  Dr. Gross will be telling us about this effort and about the implications of that change for the growth of the direct care movement.

Dr. Gross is a family physician in North Port, FL.  He is a pioneer and a leader in the DPC movement.  He is a health care consultant to physician practices, medical organizations, insurance groups, hospitals and private businesses. He founded and serves as President of the Docs 4 Patient Care Foundation and he is chairman of a new lobbying organization called DPC Action.

Listen to The Accad & Koka podcast.

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Why the Trump Executive Order Making Healthcare More Transparent Is A Big Deal

On June 24, President Trump signed an executive order, intended to return health care decision-making back to patients. It requires hospitals to publicly disclose how much patients will actually pay for services that they receive. It also gives patients the ability to use funds in tax preferred accounts such as HSAs (health savings accounts) to shop for health care. Both puts power in the hands of patients by providing information and opportunities previously unavailable to them.

Health care is the only industry where consumers have no idea how much they will pay for services until after they have received them. Powerful special interests, like insurance companies, hospitals and pharmaceutical companies, prefer to keep things as complicated as possible, shielding patients from the true price for medical services. At the executive order signing ceremony, a young woman shared the story about the stage 3 cancer that she successfully battled, but that caused her family tremendous financial hardship. Much of this problem was caused by the inability to shop for medical services. She had difficulty understanding why two bone scans done three weeks apart at two different facilities in the same city should differ in price by 30 percent.

Read the full article on Townhall.

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Refuting the Tortured Arguments Against Health Care Price Transparency

President Donald Trump signed a historic executive order on June 24 that will require hospitals and insurers to disclose medical care prices. Once enacted, patients will for the first time in decades have an unfettered view of the ugly underbelly of the health care beast.

Those who oppose health care price transparency rely on several arguments. One is that the process of revealing prices will prove very costly and that providers will pass this supposed expense on to patients.

This argument is ridiculous. The expense, if any, of posting health care prices will be infinitesimal to providers and vastly surpassed by the benefits to be created by empowering patients with additional pricing information. Prices are readily available on nearly everything sold throughout our economy. From a 25-cent gum ball to a $40,000 SUV, prices are almost always out front, posted, and prominent in U.S. markets. Only in medical care are prices obscured until long after the service is provided, leaving the patient with almost no negotiating power to get a fair price on these “gotcha” bills.

Read the full article at Townhall.com

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Physicians Applaud Executive Order Exposing True Health Care Costs & Opening Doors for Direct Primary Care Patients

FOR IMMEDIATE RELEASE
June 24, 2019

CONTACT
Dan Rene of LEVICK
202-973-1325 or drene@levick.com

PHYSICIANS APPLAUD EXECUTIVE ORDER EXPOSING TRUE HEALTH CARE COSTS & OPENING DOORS FOR DIRECT PRIMARY CARE PATIENTS

Transparency to Close Gap Between ‘Costs’ and ‘Price’ of Health Care and Allow for Patient Choice

[Washington, DC] [June 24, 2019] – At an event today at The White House, physicians from the Docs4PatientCare Foundation (D4PCF), the only health care organization composed of practicing physicians with hands-on, practical knowledge of the American health care system joined President Trump as he signed an Executive Order demanding transparency in what has become an opaque cost/pricing system.

At the event, physicians applauded the recognition of Direct Primary Care options allowing patients to use Health Savings Accounts for their care. These innovative relationships established between a physician and patient without the distraction of an insurance company or other third-party interference are increasing in the health care marketplace.

“In this age of information, we can compare prices on everything, except our health care, which places patients at a disadvantage,” stated Dr. Lee Gross, President of the Docs4PatientCare Foundation. “The prices patients pay for health care must be driven by the costs of that care, not a patient’s ability to pay nor a result of secret negotiations where the only motive is profit – at the expense of the patient.”

The Executive Order will compel disclosures of details on what it costs for insurers, doctors, hospitals etc., to provide health services. There is often a major delta between the costs of these services and the prices paid by patients, insurance companies, and the government.

“Until we know what the true costs are, having a fair pricing system is impossible,” Dr. Gross continued. “By developing rules that force everyone to show their cards simultaneously, we will finally achieve truth in the health care marketplace.”

The current system keeps patients and their doctors in the dark about pricing considerations – especially for the vast majority of predictive health care decisions.

The Docs4PatientCare Foundation team attended as guests of the White House and were recognized for their expertise and leadership in these transformational endeavors.

“While this Executive Order and subsequent rule changes may expose some warts in the previous contracting process, the patient will come out ahead. An informed consumer will be healthier and make better decisions. And doctors who pledge to first do no harm can take that a step farther and to do no financial harm to their patients too,” Dr. Gross continued.

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Please visit: http://d4pcfoundation.org/

For more information or to schedule an interview with the Docs4PatientCare Foundation leadership, please contact Dan Rene of LEVICK at 202-973-1325 or drene@levick.com

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Fixing High Healthcare Costs Should Help Patients And Not Insurance Companies

The latest attempt to tame the healthcare beast is a surprisingly bipartisan effort coming out of the Senate. The Lower Healthcare Costs Act of 2019, introduced by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) would attempt to solve a problem that has attracted considerable attention recently- surprise medical billing.

Surprise medical billing occurs when a patient who has insurance, receives a bill from a doctor after expecting the services they received to be covered and paid for by insurance. This troubling situation mostly occurs in an emergency situation and fortunately does not occur very often. However, when it does, it is aggravating to patients and costly.

The proposed Senate bill attempts to fix this problem by dictating that doctors not on insurance panels are paid a rate that is tied to the Medicare fee schedule in their community. This is a bad idea which will have far-reaching ramifications, ultimately harming patients in the long run.

Read the full op-ed on Townhall.com

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DPC Physician meets with Senators and Congressman on HR6199

Dr. James Pinckney II, ABFM of Diamond Physicians met with eight senators and two congressmen last week in an effort to reintroduce the Direct Primary Care Bill HR6199.

To further demonstrate the effectiveness of direct primary care, Michael Schneider, CEO of A-1 Locksmith DFW, accompanied the team. Together, they presented how a small blue-collar business was able to save 25% on their health benefits as a company while improving the care and health of their employees.

As this process progresses, it’s becoming increasingly likely that direct primary care membership will become a qualified medical expense under 213-D via executive order. This would allow for the bill to bypass congressional approval.

Upon passage, the bill would allow consumers to use HSA cards to pay for direct primary care membership.

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