Sunday, December 11, 2016

Direct Primary Care Conference - Nuts

Physicians are starting new methods of reimbursement, to decrease operating overhead and eliminate much of the bureaucracy involved with billing health insurance plans.

Two  terms which may not be familiar to patients are 'direct pay'  and 'concierge medicine'.  Both eliminate the insurance plan as an intermediary for payment of patient services.

Health insurance as we know it today is not insurance.  It has evolved into a comprehensive health plan(s) governed my medicare and commercial health plans.  Their goal is to  increase and/or maintain profitability in lieu of patient care.  They are designed to provide reimbursement for soup to nuts. This is very inefficient and increases  cost measurably.

Purchasers of health plans no longer have a choice of tier or to opt-out of unneeded coverage. The 50 year old post menopausal woman pays for pregnancy care, and delivery even though she will never use this coverage.

The DPC and Concierge plans are designed for primary care (family practice and some internal medicine and pediatric practices)

The Direct Primary Care conference, is sponsored by 'Doctors for Patient Care' and independent non-profit organization whose mission is to alter the current health care system.

Our Principles


Direct Primary Care (DPC) is an innovative alternative payment model for primary care being embraced by patients, physicians, employers,payers and policymakers across the United States.The defining element of DPC is an enduring and trusting relationship between a patient and his or her primary care provider.

Empowering this relationship is the key to achieving superior health outcomes, lower costs and an enhanced patient experience. DPC fosters this relationship by focusing on five key tenets:

1. Service: The hallmark of DPC is adequate time spent between patient and physician, creating an enduring doctor-patient relationship. Supported by unfettered access to care, DPC enables unhurried interactions and frequent discussions to assess lifestyle choices and treatment decisions aimed at longterm health and wellbeing. DPC practices have extended hours, ready access to urgent care, and patient panel sizes small enough to support this commitment to service.

2. Patient Choice: Patients in DPC choose their own personal physician and are reactive partners in their healthcare. Empowered by accurate information at the point of care, patients are fully involved in making their own medical and financial choices. DPC patients have the right to transparent pricing, access, and availability of all services provided.

3. Elimination of Fee-For-Service: DPC eliminates undesired fee-for-service(FFS) incentives in primary care. These incentives distort healthcare decision-making by rewarding volume over value. This undermines the trust that supports the patient-provider relationship and rewards expensive and inappropriate testing, referral, and treatment. DPC replaces FFS with a simple flat monthly fee that covers comprehensive primary care services. Fees must be adequate to allow for appropriately sized patient panels to support this level of care so that DPC providers can resist the numerous other financial incentives that distort care decisions and endanger the doctor-patient relationship.

4. Advocacy: DPC providers are committed advocates for patients within the healthcare system. They have time to make informed, appropriate referrals and support patient needs when they are outside of primary care. DPC providers accept the responsibility to be available to patients serving as patient guides. No matter where patients are in the system, physicians provide them with information about the quality, cost, and patient experience of care.

5. Stewardship: DPC providers believe that healthcare must provide more value to the patient and the system. Healthcare can, and must, be higher-performing, more patient-responsive, less invasive, and less expensive than it is today. The ultimate goal is health and wellbeing, not simply the treatment of disease.

DPC providers are committed to ensuring that American healthcare delivers on these goals.

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