Has this Nebraska doctor figured out a better healthcare payment strategy than the healthcare wonks on Capitol Hill?
While Capitol Hill bears witness to fiery debates over the future of the American healthcare system, a Nebraska doctor is addressing the growing crisis his own way. Unlike the vast majority of doctors, Dr. Todd Johnson, who specializes in Osteopathic medicine, has started the first insurance free practice in Nebraska that relies solely on a monthly membership fee with no copays, deductibles or costly urgent care visits.
According to Dr. Johnson, this system of consultation, called direct primary care, enables him to spend a greater amount of time with each patient, while offering a more personalized experience. Patients can visit the doctor any day of the week and receive a minimum consultation time of 30 minutes, as opposed to the usual 10-15 minutes. Johnson believes that due to the pressures of insurance, physicians are forced to see more patients, while devoting less time to each one. In fact, over 40 percent of a doctor’s indirect costs are insurance related.
Hence, by eliminating the paperwork and the hassles of insurance, Dr. Johnson tends to his patients faster and also offers them a more cost effective system of medical treatment.
Johnson structures his fees based on age, ranging from $50 for children and up to $100 for seniors. In addition, more than 90 percent of his clients possess some form of health insurance, but Johnson suggests that they seek out plans that enable them to pay for their own primary care, with the insurance covering only severe health situations.
However, the concept of direct primary care isn’t brand new. It has been in existence since 90’s.
Its popularity has grown of late, with a handful of doctors from around the United States adopting this model of practice. Another example following Dr. Johnson’s path is Dr. Bryan Hill of South Carolina. Dr. Hill learned about direct primary healthcare last year and decided to try it out. Hill says it works better for his patients because it allows him to spend more time with them, while also making scheduling easier. The membership fee helps reduce the cost of each consultation and also allows his patients to buy medication more cheaply.
Many patients who have subscribed to direct primary care have also opted for high deductible health insurance plans. This allows them to pay more out of their pocket for healthcare before the insurance covers the rest. This helps them keep a track of how much they are actually paying for medical treatment, and these plans work well in tandem with direct primary care.
Zooming out, if more doctors adopted direct primary care models, it would reduce the burden of providing healthcare to the people from the government. With numerous small practices around, patients would, theoretically, be able to pick the doctor whose membership plan most suits them. With healthy free market competition, patients would gain to access healthcare and drugs at reasonable prices. It would also reduce the chances of monopolization of the healthcare market by private or public entities.
So why hasn’t this model surged in popularity?
There is still a strong reluctance from a majority of patients to adopt what appears to be a radical method of healthcare. Most people don’t want to switch to direct primary care, especially if they mistake it for a substitute for insurance entirely. Another reason is that many doctors might end-up losing money because of seeing fewer patients for longer periods of time. Their income becomes solely dependent on membership fees.
Direct primary care appears to be an exciting model of healthcare that may entirely change the healthcare landscape as we see it. Provided that there are enough adopters, it may actually simplify the healthcare process to the benefit of patients and doctors alike. How and when will it impact the healthcare industry? Only time will tell.
Arin Gerald is a student at Boston University.