By Dr. Jeffrey Gold, Gold Direct Care, Boston, MA.
“Traditional primary care doctors realistically spend half their work day on insurance-related administration, which is a clear imbalance in the healthcare system,” says Dr. Gold. “A DPC model allows me to provide the personal, thorough level of care that my patients want and need, but also makes financial sense from both the business perspective for my practice and healthcare spending perspective for the individuals and families we serve.”
AUGUST 2015 – Today’s issue of the Boston Globe had a great article in the Business Section on the Rise of Retail Clinics and how they are rising to meet the needs of patients. The article is below for those who wish to read it and please read the comments, as they are always fantastic when it comes to articles on our healthcare system.
The main question I ask in this blog entry is: Why are these clinics popping up everywhere and having success? It is actually a very simple answer- they are filling the void that our fractured, third-party based healthcare system has left in its path of destruction of the physician-patient relationship. They are the callus on the fracture, but they are not the cast that will keep it fixed for good!
Patients used to have access to their OWN doctor or nurse when and if they needed them, even if it were for a simple question. Now, because of a warped third party payment system and corporate run healthcare, patients feel as if they are nothing more than a number on a list. They would rather go see a doctor or NP that knows nothing about them at a pharmacy than their “in-network listed ‘PCP’ “. Why? Because they do not want to listen to a 5 minute list of menu options on a phone; they do not want to be on hold for ten; they do not want to wait to have their problem addressed for hours to days, especially when ill; they do not want to pay a copay or deductible for a rash that could be diagnosed with a picture; and most importantly they do not want to be rushed in and out in 10 minutes after waiting for 45! So do I begrudge companies like CVS for opening these clinics and do I begrudge patients for going to them? Absolutely not!
RELATED STORY
DPC JOURNAL: 2015 Graphics GROWTH in DPC, UCs, Concierge Medicine & Retail Clinics On The Rise, Fall 2015.
So whom do I have issue with? I have issue with a system that has been perpetuated for long enough to allow this fracture and pseudo-callus to form. The reason I call it a “pseudo-callus”- and this is in no way to be disparaging to the doctors and NPs who work at these clinics- is because they are not the patients OWN doctor. Are the “providers” at these clinics going to be there when that simple cough turns into a lung mass or emphysema? Are they going to be there when that simple UTI is actually a bladder cancer? No matter how excellent the quick care is, I ultimately believe that people still crave their OWN doctor. DPC not only fills this void, it is the cast that will allow this broken system to heal once and for all. And not only do you not have to “check with your insurer about coverage”, my monthly fee is cheaper than the visits to these clinics. See here: CVS Minute Clinic Prices
It is time doctors and patients look for the cast rather than the band-aid.
Boston Globe Article: Minute Clinics Rising
Editor-In-Chief of The DPC Journal, Michael Tetreault
“We’ve been watching this [Retail Healthcare] for months and monitoring S.W.O.T. levels from DPC doctors, investors, business consultants and the like in DPC,” said Michael Tetreault, Editor of The DPC Journal. “DPC faces a unique challenge here. Employer partnerships and businesses have already started partnering with multi-site retail clinics which have referral systems to primary care and specialists already in place, like Rush University Medical Center in Chicago* (Source: NY Times, July 2015) which involves patient referrals and shared electronic health records.”
“From a promotional perspective, these large [retail] giants will be doing a lot of the heavy lifting and ad purchasing to persuade a growing segment of America’s population that there are transparent, affordable healthcare delivery options available out there. There is room for everyone, but investors and business experts alike report to us that employer partnerships are critical for DPC in the future (within the next 2-years and beyond). We’ve heard in the past few months that some DPC Doctors have begun to lower their prices to compete with these local centers [fees comparable to the $35-$79 DPC price point]. Primary Care offerings aside … the population at-large doesn’t know that much about DPC just yet, according to Google Trends “consumer search”. What we’re hearing across the country from the Convenient Care Clinic marketplace is that one of the most significant benefits Retail Healthcare Clinics AND UC’s will offer AND that will ultimately benefit DPC … is the critical consumer education component to so many people that don’t know anything about affordable healthcare delivery options, price transparency, convenient access to a healthcare provider, low-cost alternatives and the like.”
SOURCE: http://news.golddirectcare.com/2015/08/retail-clinics-filling-the-void/
RELATED “Employer Partnership” NEWS from The NY TIMES (JULY 2015):
“Retailers have left it alone for decades, but now they see opportunity because traditional providers have not always been responsive to the changing needs of consumers, which creates opportunities for others to step in,” said Mark Grube, managing director of Kaufman Hall, an Illinois consulting firm to the Boston Globe (August 9, 2015).
CVS’s new anti-tobacco stance has helped it forge affiliations with employers interested in reducing healthcare cost expenditures and regional hospitals.*
Before CVS went tobacco-free, negotiations with local health systems were awkward, Mr. Merlo said during a recent analyst conference call.
“Consumers are saying: I want all of that at a place near my house that’s open on Saturdays, when it’s convenient for me. I want that place to post prices. It’s in CVS’s interest to pull in more and more pieces of that puzzle,” said Ceci Connolly, managing director of PwC’s Health Research Institute. CVS might have more sway reducing health care costs in its role as a middleman between drug companies and patients with drug benefits.
DPC Editor in Chief alongside DPC Doctors Clint Flanagan, MD (Nextera in CO.) and Dr. Robert Lamberts, MD (Augusta, GA), emphasize the importance of DPC coupled with employer partnerships (Aug 1, 2015) at the Westin Peachtree Plaza Hotel Ballroom during the Atlanta Concierge Medicine Assembly, hosted by Concierge Medicine Today (CMT), EXL Pharma/EXL Events, Practice Builders and The DPC Journal.
The company is expected to start shifting the balance between end users on one hand, and drug manufacturers and wholesalers on the other. A new partnership with Rush University Medical Center in Chicago will involve patient referrals and shared electronic health records. Anthony Perry, vice president for ambulatory care and population health at Rush, said that traditional health care providers and companies like CVS could be natural allies.The flip side, he said, is that CVS can refer people with more serious ailments, but no primary care doctor, to Rush. “So CVS can now say: You need to see a primary care doctor, and we can connect you.”
SOURCE: *http://www.nytimes.com/2015/07/12/business/how-cvs-quit-smoking-and-grew-into-a-health-care-giant.html?_r=0
ADDITIONAL DPC INSIGHT into EMPLOYER Partnerships and DPC, the impact of Retail Healthcare/Employer Partnerships and more.
John Blanchard, M.D., doesn’t bill health insurers for services. Instead, through his Premier Private Physicians PLC office in Troy, he sells subscriptions for primary care to patients at about $200 a month.
“The volume to value paradigm shift in health care is driven by employers, powered by technology and led by Qliance. The message is loud and clear if you are shopping for value in health care those of us in Direct Primary Care open for business,” said John Blanchard MD CEO Premier Private Physicians Management LLC.
“MedLion has always been focused on the employer market,” said Dr. Samir Qamar, CEO of MedLion.
“As the direct care movement continues to evolve, it is important that providers evolve with it and continue addressing the needs of payers, whether they are consumers, employers, or more traditional plans who are starting to see the benefits of the model. I think Qliance is an excellent example of a provider who is learning and adapting to the market and this evolution of their strategy seems like a solid path forward,” said Zak Holdsworth, CEO, Hint Health.
RELATED RESOURCE: mp3 Audio —
“MD2B: $95 — Identifying & Working With Employers In Your Local Market”
Bill Cossart, President & CEO of MedFirst Partners.
“We have a Third Party Administrator who immediately saw the benefits a corporate physician can bring to a self funded employer,” said Bill Cossart, CEO/Founder of MedFirst Partners, a consulting firm that assists Direct Primary Care (DPC) physicians with their entry into DPC. “Even smaller companies can easily adopt DPC. The employer sees the rebates and the employees love the level of service with a 24/7 DPC Phyicisian and the Doctor gets to practice medicine the way they always dreampt about. Everyone wins. There are no losers in this arrangement.”
James J. Eischen, Jr., Esq., Partner at HIGGS, FLETCHER & MACK LLP
“Retail primary clinics will compete for employer-funded opportunities,” says James J. Eischen, Jr., Esq., Partner at HIGGS, FLETCHER & MACK LLP in an interview with DPC Journal Editor, Michael Tetreault. “DPC physicians with persistent patient panels and persistent connectivity with patients are more likely to deliver consistently connected care management versus a retail clinic experience. [Remember], the problem with HMOs was not cost, it was lack of patient direct investment and misaligned reimbursement causing an impersonal and disconnected PC/patient relationship. Retail clinical medicine seems poised to pose the exact same problems: lack of PC/patient relationship, lack of direct patient investment, potentially too impersonal.”
Catherine Sykes, DPC Journal Publisher and Managing Director
“Employers don’t live in a bubble,” says Catherine Sykes, Publisher of The DPC Journal to a group of physicians in Atlanta, GA on August 1, 2015. “They’re quite aware of what affordable free market healthcare delivery models are emerging nowadays and how these may or may not impact a bottom line [Worksite medicine; On-site Corporate healthcare clinics; Corporate wellness programs; DPC; etc.]. However, a similar demographic (typically age 25-45; where patients pay $79 to $99 for minor illnesses and injuries, and where most insurance plans are accepted*) is utilizing DPC and other low-cost free market healthcare options. As others have noted, if physicians do not clearly make the “continuous,” yet slight promotional pivot from enrolling individuals and families into their practice, there are now other healthcare delivery options […once the Target deal closes, CVS will operate about 9,600 retail stores alone, or about one out of seven retail pharmacies, according to Pembroke Consulting.*] that will relieve an employers cost-saving tension.”
RELATED STORY
SCHIMPFF, MD: Will direct primary care be offered by employers?
James J. Eischen, Jr., Esq., Partner at HIGGS, FLETCHER & MACK LLP
“An enlightened approach would continue to seek direct patient/employee monthly contribution as an investment in better health, have plans/employers also contribute toward DPC fees because that makes good business sense (saves money, solid ROI),” adds Eischen. “Let’s stop defining DPC as never accepting plan dollars in either proposed state legislation or generally. Let’s stay open to what plans and employers may be willing to contribute, keep an open door to plans and employer funding, and see the integrity of DPC as based on direct patient investment to a PC provider for persistently connected high-touch primary care.”
“Employers, both large and small, are struggling with the staggering costs of healthcare in this country,” said Mason Reiner, CEO at R-Health. “They are desperately seeking innovative solutions that involve something other than shifting ever more costs to employees and their families. Independent primary care physicians can be an employer’s most valuable ally as they seek ways to improve the care their plan members receive while controlling costs. When given the rare opportunity to sit in the same room with independent primary care physicians to discuss healthcare, employers find the DPC physician perspective both eye-opening and refreshing.”
RESOURCES … WHAT ORGANIZATIONS IN DPC HAVE ALREADY MADE THE PLUNGE INTO DPC and are WORKING WITH EMPLOYERS IN THEIR LOCAL MARKET? Additionally, what insight/resources are available for DPC Doctors? (In random order below)
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Integra employees get their own primary care clinic (Source: Paladina Health)
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PHILLY: CultureWorks offers R-Health’s direct primary care plans to its coworking members (By Dan Eldridge Tuesday, July 08, 2014)
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Employers Are Offering Qliance (January, 2015)
- MP3 Download | $95 – MD2B and Working With Employers:
- Addressing How DPC and Concierge Care Practices Work for/with Employers;
- Study: a Snapshot of Who Is Currently Doing It;
- Creating a Profile of an Ideal Employer;
- What Are Employers Looking for? A Profile of Receptive Employers;
- Determine Your Unique Selling Points;
- Uncover Objections You Need to Be Prepared for;
- How to Find Employers in Your Area and more.
- (Updated: August 2015)
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Tufts Medical Center, DPC and The PDC Concierge Medicine Program
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Direct primary care emerges in post-reform world. (By Ryan Liabenow DECEMBER 16, 2014)
- Plymouth business opens free clinic for employees (April 30, 2015)
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One Medical in AZ: San Francisco physician group enters Arizona with Dignity Health partnership. (FEBRUARY 2015)
- DPC Doctor, Jeff Gold, MD – Town Hall Meeting for Boston-Area Employers & Individuals: Direct Primary Care
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MONSON: An Obamacare Loophole [cost sharing]. — A small group of Christians got together to help each other pay for some medical bills, and the movement was born. (SUMMER 2015)
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EverMed — ‘“There are three key groups we want to serve,” Jonason explained, “the independent medical practice, small to mid-size employers and individuals.”’
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MedLion Management, Inc. and Pan-American Life Insurance Group Collaborate to Lower Healthcare Costs for Employers
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WARSHAW, MD: “Why it is the Perfect Fit for Self-Funded Employers.”
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DPC Journal Spotlight on Dr. JEFF GOLD: “DPC is a win-win for everyone,” Dr. Jeff Gold says.
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DPC Leadership Response To Washington State OIC Report: ‘Outlook for DPC is bright throughout U.S.’
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BOSTON, MA: MedFirst Partners Introduces Affordable Membership-Based Direct Primary Care Healthcare Option
- Collaborative Health Partners of Virginia began approaching local self-insured companies last year with its direct primary care plan.
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Expedia, online travel giant — and Qliance, together promotes employee well-being
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INTERVIEW: MedLion’s Dr. Samir Qamar — How Physicians Can Offer Direct Primary Care to Employers
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QLIANCE: New Primary Care Model Delivers 20 Percent Lower Overall Healthcare Costs, Increases Patient Satisfaction and Delivers Better Care .
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Employers Developing Reliance on Direct Primary Care Providers Like Qliance, MedLion (January 2013)
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FORBES: ‘WeCare Clinics, Iora Health, Qliance Medical Management, MDVIP, and OneMedical have all reported reductions in total healthcare costs for their patients of 15% or more versus population norms*.’
