To save money, these docs don’t accept insurance
While retainer-based medical practices offering care known as concierge medicine have taken some heat over the years for charging big bucks to patients for improved access and added amenities, some view a different form of retainer care as a cost-saving approach.
Direct primary-care practitioners seek to offer affordable retainer-based care that focuses on wellness and prevention. The difference between direct primary care and traditional concierge care is that direct primarycare providers generally do not accept any form of insurance. The idea is to free the practice from the burden of dealing with insurers to offer handson, accessible care at prices that are affordable to the uninsured or those covered by high-deductible plans.
A direct primary-care practice offers the similar expanded access to weekend hours and an increased focus on wellness prevention that concierge-care practices typically offer. For example, clinics run by direct-care for-profit Qliance Medical Management, Seattle, might have a patient visit to deal with a persistent cough or to pass a kidney stone, says Dr. Garrison Bliss, chief medical officer of Qliance, which has been in operation since 2007.
The company’s clinics also offer unlimited access to vaccinations, women’s health services, pediatric care and ongoing management of chronic disease.
Healthcare’s current approach of having insurance cover primary care and catastrophic-type medical care makes no sense, Bliss says. If your homeowners insurance policy paid for the water bill, gas bill and other such costs, “it would be just as dysfunctional as healthcare,” Bliss says.
It makes more sense to take highfrequency primary care out of the equation of insurance, and allow primary-care practitioners to focus on wellness and keep patients out of the hospital and its emergency room, he says.
“We think this is going to be a remarkably effective way to manage healthcare costs,” he says. A recent analysis of Qliance’s care by the company found its patients to have much lower ER visits, hospitalizations and surgeries, among other things. In 2010, ER visits per 1,000 patients were 65% lower at Qliance when compared with a regional benchmark, hospitalizations were 43% lower and surgeries were 82% lower, according to the company.
Qliance clinics charge a one-time $99 registration fee per family plus from $49 to $129 a month, depending on a patient’s age and level of care sought. A 40-to 49-year-old patient who wants bedside hospital coordination of care would pay $99 a month, while a patient in the same age category who doesn’t want such care coordination would pay $79 a month, Bliss says. The older the patients, the more they pay. Clinics are open seven days a week and welcome patients who otherwise might go to an ER, Bliss says.
At least some members of Congress have heard about Qliance’s approach, with Bliss submitting written testimony for a May 12 hearing by the House Ways and Means Committee’s health subcommittee that focused on innovative healthcare delivery and physician payment reform efforts.
“Our physicians have the time to provide the 90% of care most people need to see a doctor for, including routine primary and preventive care, urgent care and chronic disease management,” Bliss wrote in his testimony for the hearing. “We intend to reinsert the concepts of value and humanity back into the healthcare system.”
Bliss notes that unions and employers are showing a lot of interest in his company’s model, which he says works well when combined with a catastrophic health insurance policy.
Qliance’s Dr. Erika Bliss conducts a wellness checkup. The company’s clinics offer a wide array of preventive services.