Concierge Medicine for the Masses
it concierge medicine for the masses. The idea is that routine, mundane primary
care should not require expensive insurance and can be cheaper without it.
Williams, “Primary Care at $54 a Month,” New York Times, May 21, 2012
23. 2012 - Rain-soaked Seattle is America’s leading innovation
center. Microsoft, Amazon, and Starbucks
started there. It must be the climate. When you're inside escaping from the rain, you have plenty of time to think, tinker, and weed out the clinkers.
This innovative climate extends to health care as well. Simple Care, a network of
primary care practices across the U.S. began there. So did Qliance, Inc, founded by Dr. Garrison Bliss, a Seattle
internist, who also co-founded the Direct Primary Care Coalition, which lists
more than 60 Direct Primary Care Medical Homes in U>S. in 24 states.
What follows are excerpts of an article in the May 21
New York Times describing how Qliance operates.
road 50 hours a week, the drivers who work for Becker Trucking, headquartered
in Seattle, have little trouble finding cheap eats at the all-night diners
lining the interstates of the Pacific Northwest.
drivers were struggling with chronic poor health, and the company’s health
costs were rising fast. What his employees really needed, the company president
realized, was better access to doctors.
turned to a novel solution. Becker pays $54 per employee per month to a primary care provider called Qliance.
Employees get unlimited doctor visits, 24-hour e-mail access to the medical
staff, and same-day or next-day appointments. There is no insurance involved in
their primary care: no expensive premiums, no complicated claims, no mysterious
are notorious for not being the best in using health care,” said Frank Riordan,
president of Becker Trucking. “But now they can go into the clinic as many
times as they want, and participation is high.” Two drivers no longer need blood pressure medication, Mr. Riordan added.
of health care model is called direct primary care, and it is getting a closer
look not just from businessmen like Mr. Riordan, but also from researchers and
government officials who see it as an effective way to lower costs.
“It is a
very promising and good model,” said Dr. Arnold Milstein, a professor of
medicine at Stanford University and head of the Stanford Clinical Excellence
Research Center. “It is speedy and economical, and these practices are making
themselves available to working people.”
primary care derives from an unlikely source: the so-called concierge practices
that began appearing a decade ago, catering primarily to the affluent.
Concierge practices generally do not accept insurance, either; instead, members
are charged thousands of dollars annually for unlimited access to their
often is lucrative for doctors but “less accessible to patients who cannot or
choose not to pay a membership fee,” according to a federal report issued in
concierge model carries a lot of baggage in being health care for the wealthy,”
said Dr. Erika Bliss, a family physician and Qliance’s chief executive. “We
want to grow this and bring the price point down to average Americans.”
fee does not cover anything beyond primary care. Typically employers combine
direct primary care with high-deductible insurance plans, needed to cover
hospitalizations and visits to specialists.
“Health insurance is supposed to protect you
against risk, like car
insurance does,” said Dr. Bliss. “We don’t insure our cars for tire
changes and tune-ups.”
though Becker pays Qliance for primary care and pays half of each worker’s
$5,000 annual deductible for insurance, the company’s costs dropped 11 percent
in 2010. Costs had been rising about 14 percent annually, Mr. Riordan said.
who work for Qliance are salaried, Dr. Bliss said, reducing the financial
incentive to order unnecessary tests. Direct primary care practices keep costs
low by sidestepping the bureaucracy associated with insurance and reducing
unnecessary and expensive trips to the hospital or emergency room, she said.
primary practices are also less likely to refer to a specialist for something
they can handle themselves, Dr. Milstein said.
practices already operate in 24 states, treating more than 100,000 patients,
according to the Direct Primary Care Coalition. Physicians at Qliance, one of
the larger practices, will care for more than 10,000 patients this year, double
last year’s number. Another provider, MedLion, headquartered in Monterey,
Calif., plans to open clinics in Miami, New Mexico and Oregon, according to the
company’s chief executive, Dr. Samir Qamar.
Clients tend to be
individuals without insurance, small businesses and unions."
Tweet: Direct primary care practices, like Qliance in Seattle, charge $50 to $60 a month for 24/7 access to routine primary care.
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