Physicians Practice - July/August 2008 - (Page 60)

IDEALAB CATCHING ON Our model is expanding quickly. Over the last year, I have helped more than 20 healthcare providers around the country in their efforts to go cash-only. Our model is expanding quickly. Over the last year, I have helped more than 20 healthcare providers around the country in their efforts to go cash-only. My goal is to continue to free healthcare providers from the shackles placed on them by managed care, which I believe will improve care for patients. As I tell my patients, their healthcare is between them and me. It is very liberating to have the unwelcome third party out of the physicianpatient relationship. actually spend a lot less out-of-pocket in a year than if they bought a traditional PPO plan with a copay. Mine is not a “boutique” or “concierge” model. Those titles belong to practices that charge exorbitant fees to provide special service for the wealthiest patients. Nor is my Access Card program insurance. It is important to point out to patients that it is just a prepaid discount and does not give them any medical beneﬁts other than decreased fees at our ofﬁce. I have also offered an Access Card program to local employers. Selfinsured employers’ premiums are affected by utilization. If they use Access Cards for their primary care, then that decreases utilization (since it is not billed to insurance). What the employer saves in premiums more than covers the $25 peremployee per-month fee. Employees that normally have a $25 to $35 ofﬁce copay actually save money by only paying $20 at our ofﬁce. One of the companies that we have offered this to has about 500 employees, and stands to save enormous amounts of money. This type of direct-provider contracting bypasses the insurance company and cuts out the middleman. The employees still have their insurance if they are hospitalized or have surgery, or incur other large costs not covered by the Access Card. But their primary-care cost is greatly reduced by having their employer pay the practice directly. I am now considering opening some extended-hours clinics that will be ﬂat-fee based so that patients have the ultimate in price transparency. I am considering calling this the $50 Clinic. That’s right, everything is $50. This would be the modern healthcare iteration of the retail concept of ﬁxed-price stores. (You’ve heard of “dollar stores”?) This means that patients would know what to expect, and the costs for this type of after-hours access could be a bargain for those with and without insurance. Perhaps in another year, I’ll let you know how that’s going. • Brian R. Forrest, MD, an adjunct assistant professor at UNC Chapel Hill, is the founder and president of Access Healthcare and a practicing family physician in Apex, N.C. He can be reached via editor@physicianspractice.com. 60 | PHYSICIANS PRACTICE | JULY/AUGUST 2008 WWW.PHYSICIANSPRACTICE.COM http://www.insticomm.com http://www.insticomm.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - July/August 2008

Physicians Practice - July/August 2008 Contents The Bigger Picture: Battle Royale in the EMR Market Letters Physicians Practice Pearls: Hire Right Noteworthy Cover Story: Healthcare Reform: Voting for Change Patient Relations: Dealing with Problem Patients The tech Doctor: Is Self-Service Medicine Inevitable? Technology: Do EMRs Make You a Better Doctor? The Guide Idealab: Cash-Only Care Still Works The Administrators Desk: Who’s in Charge? Ask The Experts What Went Wrong: ‘Why Our Great Idea Didn’t Work’ Coding Start It Up: How to Launch a Practice: Operations Partnership: Don't Let Partner Conflict Destroy Your Practice Appraisals: What’s Your Practice Worth? Getting Advice: How to Hire a Consultant Classifieds Advertiser Index

Physicians Practice - July/August 2008

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