Ask Dr. John Part 2 – The Struggles Physicians Face While Working in a Traditional Care Model
Figuring out the right model of care for you is something physicians can struggle with. There are pros and cons to both, but studies show the Direct Primary Care (DPC) model is rising in popularity. In part two of our three-part blog series, Healthcare2U’s Dr. John Rodriguez shares why he thinks physicians are distancing themselves from the traditional fee-for-service care model and some of the “bad debt” they can carry. If you haven’t read it yet, don’t forget to check out our first blog in this series, which discusses the benefits of working with a DPC model.
Q: Why are physicians interested in moving away from fee-for-service care to direct primary care?
A: Currently, the majority of clinics operate under the fee-for-service arrangement with insurance companies. In other words, we see a patient, submit that visit to the insurance company, they reevaluate the charges at a significantly reduced rate, and if we are fortunate, they send a payment to us maybe 30 days later. Unfortunately, those payments have not kept up with the pace of medical inflation. Over the years, many physicians have had to leave health care altogether or become employed by hospitals or insurance companies.
Some practices have adopted a DPC model, which involves receiving payment from either the employer or individuals for healthcare services. Payments can be structured as monthly memberships, or individuals can pay per visit. Considering many high deductible plans, it makes a lot of sense to engage a physician practice under a DPC model because that’s going to, in the long run, save money and keep you healthier because you have meaningful and quality time with the provider.
There are different types of arrangements that can be made through hybrid models. This can be a combination of partial insurance payments and/or a membership payment in addition. All this helps to lower the cost of health care and improve the time spent with patients, which improves patient satisfaction as well as physician satisfaction.
Q: Can you talk us through the “bad debt” that many physicians carry?
A: Bad debt is one of the many struggles physicians have suffered with for years, and if it’s not dealt with properly, can break a clinic. That debt is made up of two components: insurance companies not paying their bills or patients not paying their share of the bill. Ultimately, it’s the physician or the clinic who goes unpaid. To try and overcome it, physicians must hire more employees to try and capture that bad debt – you would hope and think that we shouldn’t have to do this. Unfortunately, debt collectors do exist in society, and it’s even more problematic in health care because we have a battle of wages against insurance companies, which are never nice to independent practices. Again, bad debt will make or break a clinic, and to be able to be paid for your services is extremely important.
Make sure to stay tuned when we feature our third and final blog with Dr. Rodriguez, where we discuss how he started his journey of working in a DPC practice. For more information on Healthcare2U’s Direct Primary Care membership, check out some of our other blogs.
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