Staying Independent...Together

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   RE: going direct pay - I think
 From: Michael Barron
 To: Member Forum
 Posted: 03-01-2018 10:42
I agree with PJ.  Things are much better now than they were 10 years ago, including those of us that take insurance.  When I started I had no access to value based reimbursement, risk sharing, shared savings, etc.  Now the bulk of my income comes from those types of contracts.  Medicare is leading the way on this, but Medicaid and commercial plans all over the country moving in the same direction.  

I also think the debate about the value of primary care has been settled: high quality primary care = cost savings.  This should make a big difference going forward since there doesn't seem to be much resistance to doctors sharing in that savings.

Of course, there are 2 big changes that go with getting shared savings: the increased importance of diagnosis coding and accountability for quality measures.  These add work for us, but we can't get access to the shared savings without them.  They provide some insurance for payers that we aren't gaming the system by refusing to take care of sick patients and skimping on preventive care.  I'm convinced that the time/money needed for these 2 efforts is much smaller than the potential income from cost savings.  We just have to make sure our contracts make that effort worthwhile.

------Original Message------

There are some of us making money just dandy as private practices. Not direct pay. Regular insurance. We just arent the ones posting on here. It is not all disheartening. There are many variables that influence whether you can be successful...  It makes me sad to think that readers of this forum come away thinking all gloom and doom because I was quite inspired by these forums a decade ago.

PJ Parmar

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