Staying Independent...Together

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   RE: Direct Primary Care
 From: Jean Antonucci
 To: Member Forum
 Posted: 11-22-2017 11:20
 Message: well I think  this is just  cash   pay discount no? I used to offer a 30./mo, must pay it for 6mo,  then 15.00 when you came in no matter what you cam e in for,  program.   One business owner paid half of the thirty dollars a month for employees who I would see as needed It was frankly  a hassle to  remember to bill but I  did not have enough volume to set up a system
 Now I just  have any cash pay people pay then and there No billing And so the price is lower but the price is off my usual charge sheet --remember if you take medicare you can have only one fee schedule but you can discount it if you have a reason that accounts for the  discount- like no billing  So say you have 99213 charge at 105.00  Insurers pay  68- 105   So the cash price is 75.00 Done


Do take credit cards  I use square I like the chip cards because you get a row of green lights and it amuses me:)

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Jean Antonucci
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Original Message:
Sent: 11-22-2017 09:58
From: Michael Barron
Subject: Direct Primary Care


That is a very interesting question.  Essentially you are taking on risk without data to know where to set the payments which would both moderate your risk and provide something affordable to your prospective patients.  If you set it too low, you lose money by provide services for free.  And if you set it too high, you lose business because the number of patients will be low.  This is what actuaries do for health plans.

I think most of the DPC community as tried to err on the side of making the prices high enough to insure they don't lose too much money and go crazy/bankrupt.  There are several ways to do this:
1) co-pays with each visit
2) separate changes for items like phone calls, filling out forms
3) pricing based on risk, eg the older you are the more you pay

Good luck and keep up posted with how it goes.

Michael Barron MD



Original Message------

Greetings!

With the current ACA enrollment period in process and the significant rate hikes that patients are experiencing, we have decided to offer our uninsured patients DPC. Would anyone be willing to share how they structure this in a way that is beneficial for patients without the practice loosing their shirt? I know there will be 'super-users' but also those that really don't abuse the service.

Thank you!

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Tracy Baum
Mountain Sage Family Clinic
Dubois, WY
307-455-2807
baumnp@gmail.com
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