Re: Web discussions

[Guest guest]

Hi Dr Forrest, I'm glad you emailed. I've obviously done you a disservice in my description of the revenue drivers in your practice model and for that I beg your forgiveness. Your quality and overhead numbers are terrific, and I want to repeat that your egalitarian approach to improving access through low direct pay models is one that deserves broad replication.GordonDr. ,I received this thread from a colleague and would like to respond. I am not in this yahoo group so if you want to post that would be fine.We do not order extra tests for revenue. I consider testing part of overhead and if anything try to only order tests that I really need and always allow a patient to know the actual cost(posted in the waiting room)and decide if they want a test. In the subscription model I do not charge patients at all for labs and simply eat the cost and include in my overhead. For the a la carte patients that do not pay a subscription, the cost of labs is minimal and does not add much to our bottom line. I have another article coming out soon that will update physicians on the progress of the direct pay model. We are expanding rapidly and had 55 practices sign up to be direct pay practices the first month we launched the website this July atforrestdirectpay.com. Docs have simply had it with the old ffs/third payoff model. Just some interesting stats: Right now we have 99.6% collections for the last 9 years with only a 22% overhead. The average chronic patient with mmp usually spends about $500 per year for their care including quarterly followups with appropriate labs and an annual comprehensive physical with bloodwork that we do for free for those on a subscription to encourage them to get preventative care.FYI we are one of 33 Cardiovascular Centers of Excellence based on Accreditation from COSEHC(out of Wake Forest University) who audits our outcomes every three months. We are also in the top 10% for 22 HEDIS measures, A1C=6.5, LDL=72, and BP control rate at 85% to JNC 7 standards. All of this despite starting with a 50% uninsured population with an incoming average SBP of 192(in the hypertension clinic), a1c 11.3 and LDL of 172. We save the uninsured about 85% out of pocket for the services we provide and even save most of the insured a few dollars even over if they had instead gone in network.Also, I would like to thank you for being one of the pioneers to go ultra low overhead. I have always had one MA that does everything nonclinical and could not imagine being truly solo. But you have shown as many others now that we are not the biggest costs in healthcare. The biggest cost is the "machine" of the insurance industry and hoops that they put us through.Again kudos on being one of the low overhead cowboys and best wishes. Forrest, MD