Staying Independent...Together

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   RE: going direct pay - I think
 From: Peter Liepmann
 To: Member Forum
 Posted: 02-15-2018 23:38
 Message: Yay for all of you and us!!
Also see below.
This is one solution- there's a group of benefits and corporate types who have figured out that PRIMARY CARE IS (an important part of) THE ANSWER to fixing the health care system.  These enlightened CEOs have figured out the formula:
high quality primary care, (best as salaried or DPC, which will cost about twice as much as they're spending for primary care now)
directed referrals to high quality/low cost centers of excellence
(some pharmacy solution, NOT the commercial PBMs)

Rosen hotels has cut their health care costs in HALF by doing this.  WE know it's possible, because we've been talking about it for years.
Here's guys with big money who want to work with us.
Dave Chase has a bunch of great articles on LinkedIn. This is his book:
Their blurb below
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Today's Free Kindle Day is one way for us to say thank you for your support and to spread the message to more people. We'd like to ask you to do one simple thing once you get your copy.

Peter Liepmann MD FAAFP MBA
My mission is to fix US health care
Bakersfield CA
Original Message:
Sent: 02-14-2018 10:26
From: Jean Antonucci
Subject: going direct pay - I think

NAh Kevin Egly is still out there   Last talked to  him maybe 1 yr ago  They struggle   And Gwen Hanson is till out there Gordon says

In 3 yrs I hope to have the mortgage gone  Then I think I will  dump many insurances and do medicare and mediciad only and wind  down   Things are getting worse and worse and those who could speak who could do something  do nothing Except for Lynn.   Those who promote worthless complexity  speak and do alot This is  not a country that wants primary care We would have to unionize or strike


     Jean Antonucci MD
     115 Mt Blue Circle
     Farmington ME 04938
ph 207 778 3313   fax 207 778 3544


Original Message------

So, I think Jean will be the last original IMP standing.

At the end of this year, I plan on severing my insurance contracts and going direct.
I am tired of working 65-75 hour weeks with fully half of my time spent on the demands of insurances - documentation, billing, coding, referrals, prior authorizations, and "quality ( read - checking boxes and pasting text blocks)"
Although in my IMP practice as it stands now,  I could continue to work and earn enough to live well ( about $120-140K per year), I asked myself: why am I working this hard to make insurance companies richer?
After Jan 1 of this year, the 2 biggest insurers in the state began to require 100% specialist website referrals for their respective managed medicare and -caid products, and  I saw my admin work spike another 2-3 hours per week: I also saw the writing on the wall. This incessant grinding down of the primary care work force cannot end well for us (the grindees).
For the past 3-4 years, I worked within the state's quality organizations and the health insurance commissioner's office to try to change the flawed quality measurement system towards more sensible, less burdensome quality measures based on HowsYourHealth, but at our last meeting 2 weeks ago, I realized the obvious truth:  that these bureaucrats really have no intention of changing the rules for small practices to make "quality" work less burdensome. Another pipe dream, up in smoke.
These two realizations coming together have finally cracked my rose colored primary care lenses. This crazy health care wealth extraction system is not going to change, not one iota, until it implodes.

The direct practice upstairs is doing quite well, due to the scarcity of quality primary care in RI.
I'm going to charge the old IMP standard of $1/day for no holds barred primary care ( way less than the going rate of the folks upstairs, who are 25- 50- 75-100 $ per month, depending on age).  I expect I will keep around 1/4- 1/3 of my 750 patients ( we will see! )  so I will get to breathe.  Perhaps I will travel around the country a  little and visit you guys ! For every 100 paying patients, I will see 15 medicaid or medicare patients that don't have the resources to pay me ( I have the list percolating now). Going to use HintHealth for collecting money; possibly may moonlight a little at the Navy base or the University Health center if needed.

Hurrah ! I 'm embarking on another IMP adventure !


Lynn Ho

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