Re: Medical Discount Program Part 3 - Thoughts --> mem...

[Guest guest]

I've found that there are frequently suppliers of services who will discount, if you ask. Most of the pharmacies will price-match. Costco has really cheap overall prices, and you don't need a membership to use their pharmacy. LabCorp gave me a list of very nice discounted prices for my cash-paying patients. And there's a private radiology group in Aurora (suburb of Denver) that has prices about 1/3 those of the hospital radiology group for cash-payers. I use them all the time. They're very nice on the phone if I need advice about ordering properly, also. They bill insurance as well, so I just tell everyone to go there. I warn all my patients that they can take my prescription for radiology anywhere they want, but they'll pay a lot more if they go to the hospitals.

Deanna

Exactly.

"if you could create a network of lab, xray and procedure suppliers who would also give discounted care to members. That would cover most of the outpatient health needs for these patients."

I imagine a 'honey comb' of IMPs doing exactly this; sharing the 'procedure suppliers' who are willing to discount services if they end up with fewer payment hassl es.

is doing this up in her neck of the woods for her patients of very limited means, without benefit of other IMPs nearby.

Back here in thorny Massachusetts, there are few cash patients. Because of the insurance mandate, everyone is required to have insurance or pay a penalty. Most of the plans offered on the 'insurance exchange' are these restricted, bundled things with punitive out of network rules.

This is a great thread. The idea has merit.This would would have more value to cash patients if you could create a network of lab, xray and procedure suppliers who would also give discounted care to members. That would cover most of the outpatient health needs for these patients. With enough cash patient volume, even small offices can undercut the high prices of hospital labs and still pay off a Piccolo CLIA waived tester. However, HSA patients are price sensitvive but far more complicated than cash patients. The insurance out of network rules complicates things for the patient and insurance contracts complicates this for physicians who aren't able to dump all insurance contracts now. Add the 'reform' of putting many current cas h patients under Medicaid and there's considerable business risk to an otherwise great concept.

VERY LIMITED illusion of "primary care" for not insurable, but on the model of knowing what you'll have to pay up front.

Sadly for hospital and REAL care in ER, this gets you NOTHING.......

Example of why drug store PA/NPs doesn't work.......

----- Original Mess age -----

From: Locke

To: practiceimprovement1 ; Practice Management Issues

Sent: Saturday, May 08, 2010 12:27 AM

Subject: Medical Discount Program Part 3 - Thoughts --> membership discount program for limited medical services at a discounted price

Sorry to keep hammering away at this whole Costco Medical Care model -- but I find it interesting.

It seems like there are more and more of these type of practices out there.

But it's not clear if this is the future or a good way to make a reasonable living.

Why I do find intriguing is this...

1. Insurances keep raising their rates faster than the cost of living.

2. Patient can only afford high deductible insurances.

3. The high deductible basically makes it like they don't have insurance since they have to pay the first $2,500 to $5,000 out of pocket.

4. Even insurance discounted fees add up.

But what if you did a membership where you get a discounted fee for service, but the doc doesn't have to deal with insurance at all.

I could totally see back to the future scenario where patients buy high deductible insurances (maybe even as high as $10,000 per year).

Then pay docs at the time of service for a discounted rate or a membership fee with discounted rates.

Primary Care docs basically drop all insurances since all the high deductible insurance is basically like runnin g a cash business anyway -- the families rarely meet their deductibles, so you are basically billing insurance only to wait and wait for the EOB to say they should have just paid you at the time of service anyway.

So why not just cut out the middle-man/insurance and take the money at the time of service - the patient can apply this toward their deductible -- which they will never meet anyway because it is so high.

Then we get back to the original idea of insurance -- to cover your a** when catastrophe happens (house burns down, car totalled, etc).

And you pay for the small stuff along the way.

Sigh -- one has to have a dream in life -- yes?

:-)

Locke, MD