Direct Practice Model Turns Health Care right side up again

With a direct relationship, medical providers are motivated to give you the highest quality service possible and at the lowest price

When you go to any service provider outside of healthcare, you are clearly the customer. You call the shots and the provider is unquestionably and ultimately accountable to you. If he doesn’t do a good job for you or if he costs you too much, you just won’t be back. You decide to go back and refer your friends only if you find value and convenience in the services that were provided. This sounds familiar because this is the way it happens for every other service we receive in our economy except for healthcare.

Having a direct relationship with your doctor works in very much the same way it does with any of your other type of service. Your doctor is working for you again. Access to your doctor is easy and customer service is important again. Your direct practice doctor is interested in addressing your concerns, all of your concerns and not just the ones reimbursed by your insurance. By eliminating necessary diagnostics, ER visits, and prescription drugs, your direct practice doctor can reduce our out of pocket costs too. Your doctor is motivated now to take care of you and to keep you well by preventing problems and keeping you out of the hospital, the way it should be.

In ancient China, doctors would be paid only until their patients got sick.

Three direct pay options

We offer you three different direct pay options. Because every situation is different and insurance can be so dang complicated, you choose the option that works best for you.

Broken Third Party Healthcare

Our healthcare system has forgot about us

The personal touch is gone, visits are hurried and It’s almost as if they just don’t even care to keep you as a client. Many of us don’t even see our doctor anymore but instead see physician assistants or nurses. We have come to accept the impersonal hurried and fragmented healthcare experience as normal. It is because you are no longer the customer in this transaction. Your doctor and his staff are catering to their real client, the one that’s paying them, that third-party insurance company.

Modern clinical encounters and medical decision-making are influenced by insurance companies on more levels than you might imagine. From the amount of time your doctor spends face to face with you, to the tests ordered, to the choice of medications, to the multiple visit required, to the choice of specialists; it’s all done to maximize reimbursement and minimize work. Your doctor has essentially become an extension of the insurance companies through their careful manipulation of the payment framework.

It seems as if the whole point of our insurance driven third party healthcare is to keep us sick and scared seeing more doctors, doing further diagnostics, taking more prescription drugs, and spending greater amounts of money every year.

Direct Practice Model Saves Money

Regain control of your healthcare spending

Insurance companies are like Las Vegas casinos. Casinos are happy to keep you playing and paying so they toss you a small payout every now to keep you interested. These casinos will never pay out more than they take in. They work hard to maximize the money coming in and limit expenditure on your health. The margin is necessary to cover their overhead, overpaid executives’ salaries, and anticipated corporate profits.

Imagine if 100% of your healthcare dollars actually going toward your healthcare. When you have a direct relationship with your healthcare service providers, that is exactly what happens.

When you have a direct relationship with the healthcare service providers, you choose to pay only for the services you actually receive. Patients tell us we can save them thousands of dollars over the course of the year in this way. It’s hard to imagine today some people still continue to pre-pay monthly premiums for services they will not likely ever need.

The Insurance Proposition

Rising costs and broken promises

Insurance was originally intended to protect us in the unlikely event of a very expensive catastrophic incident. Consider your homeowner’s insurance policy for example, that would engage in the unfortunate event such as a total loss due to a fire. But such events are statistically unlikely to happen in your lifetime and that is what keeps home insurance premiums affordable. On the other hand, you would never use your homeowner’s insurance for minor maintenance items such as unclogging a drain, minor pest control, or gardening. If you wanted that service, you would choose a gardener who you believed will do a good job and pay a fair price for the service out of pocket.

Rising Premiums for Added Services

Imagine if your homeowner’s insurance decided to raise the monthly premium and include gardening as a benefit. They would of course use a portion (maybe 50%) of your added premium to pay for your gardening as promised. You might first get a pre-authorization for your gardening and then, when approved, have to use their “in-network” gardener. They have already established a network of gardeners willing to work for a reduced fee and the promise of high volume referrals. The insurance company would have rules so they would never lose money on this new benefit. They would dictate which types of shrubbery and trees are covered under your policy, how often the gardener can come to your home, and of course you would have a copay for every gardening visit.
Why would anyone decide to pre-pay for home maintenance like gardening and give up their right to have a direct relationship with their gardener?
Insurance companies invest large marketing dollars convincing you they have the best providers in their networks, and scare you into believing your cost would be so much more if you had a direct relationship with the service provider.

The Health Insurance Lie

More expensive than ever and still climbing, health insurance has gotten way out of hand. The health insurance companies expect us to pre-pay every month higher and higher premiums by promising to cover more and more items. What they don’t tell us is that we are not very likely to use or need many of these added items that we are paying for. They make the rules like prior authorizations and out of pocket co-pays to discourage utilization of those benefits. They know exactly how much they are will pay out and set premiums accordingly to protect their margins and continued corporate profits.

The Insurance Proposition

Insurance was originally intended to protect us in the unlikely event of a very expensive catastrophic incident. Consider your homeowner’s insurance policy for example, that would engage in the unfortunate event such as a total loss due to a fire. But such events are statistically unlikely to happen in your lifetime and that is what keeps home insurance premiums affordable. On the other hand, you would never use your homeowner’s insurance for minor maintenance items such as unclogging a drain, minor pest control, or gardening. If you wanted that service, you would choose a gardener who you believed will do a good job and pay a fair price for the service out of pocket.